Liapi Artemis, Mavrantonis Constantine, Lazaridis Panagiotis, Kourkouni Eleni, Zevlas Andreas, Zografos George, Theodoropoulos George
1 Surgical Department, "G. Gennimatas" General Hospital of Athens (Artemis Liapi, Andreas Zevlas), Athens, Greece.
6 Department of Surgery, "Hygeia" Hospital (Constantine Mavrantonis, Panagiotis Lazaridis), Athens, Greece.
Ann Gastroenterol. 2019 Mar-Apr;32(2):185-192. doi: 10.20524/aog.2019.0350. Epub 2019 Jan 15.
Our study validated the low anterior resection syndrome (LARS) score questionnaire, the colorectal functional outcome (COREFO) questionnaire, and the Memorial Sloan-Kettering Cancer Center bowel function instrument (MSKCC-BFI) in Greek rectal cancer patients.
Internal consistency, repeatability, construct and discriminant validity were evaluated for LARS, COREFO, and MSKCC-BFI questionnaires. The convergent validity was assessed by correlations with the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-CR29 domains.
The internal consistency of the questionnaire's subscales was satisfactory (Cronbach's a>0.6). The repeatability test showed extremely high reproducibility (intraclass correlation coefficient >0.9). High positive correlation was detected between the 3 questionnaires' total scores and each of their questions (rho>0.5), indicating their valid construction. All questionnaires demonstrated a good convergent validity through correlations with comparable domains of the EORTC QLQ-C30 and CR29. Statistically significant associations were detected between LARS, COREFO, MSKCC-BFI scores and tumor distance and temporary stoma (P<0.001 and P=0.009, P<0.001 and P=0.005, P<0.001 and P=0.002 respectively). In addition, COREFO and MSKCC-BFI scores were significantly associated with radiation therapy. LARS score was significantly correlated to all COREFO and MSKCC-BFI subscales.
The Greek versions of the LARS score, COREFO and MSKCC-BFI questionnaires were proven to have good psychometric properties and can be used as specific and valid instruments for measuring LARS. Since the COREFO and MSKCC-BFI questionnaires, which are more extensive and possibly less applicable in routine clinical practice, showed no advantages in relation to the LARS score, the latter may be established as the simplest, fastest to complete and most targeted tool for assessing LARS.
我们的研究验证了希腊直肠癌患者的低位前切除综合征（LARS）评分问卷、结直肠功能结局（COREFO）问卷和纪念斯隆凯特琳癌症中心肠功能量表（MSKCC - BFI）。
对LARS、COREFO和MSKCC - BFI问卷的内部一致性、重复性、结构效度和区分效度进行评估。通过与欧洲癌症研究与治疗组织（EORTC）QLQ - C30和QLQ - CR29领域的相关性评估收敛效度。
问卷各子量表的内部一致性良好（Cronbach's α>0.6）。重复性测试显示出极高的再现性（组内相关系数>0.9）。在3份问卷的总分与其各自的每个问题之间检测到高度正相关（rho>0.5），表明其结构有效。通过与EORTC QLQ - C30和CR29的可比领域的相关性，所有问卷均显示出良好的收敛效度。在LARS、COREFO、MSKCC - BFI评分与肿瘤距离和临时造口之间检测到统计学上的显著关联（分别为P<0.001和P = 0.009、P<0.001和P = 0.005、P<0.001和P = 0.002）。此外，COREFO和MSKCC - BFI评分与放射治疗显著相关。LARS评分与所有COREFO和MSKCC - BFI子量表显著相关。
LARS评分、COREFO和MSKCC - BFI问卷的希腊语版本被证明具有良好的心理测量特性，可作为测量LARS的特定有效工具。由于COREFO和MSKCC - BFI问卷更广泛且可能在常规临床实践中适用性较低，与LARS评分相比没有优势，因此LARS评分可能被确立为评估LARS的最简单、完成最快且最具针对性的工具。
