Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.
Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, CA, USA.
Int J Pediatr Otorhinolaryngol. 2020 Nov;138:110312. doi: 10.1016/j.ijporl.2020.110312. Epub 2020 Aug 13.
Adapt the Spanish translation of VPI Effects on Life Outcome (VELO) instrument into Ecuadorian Spanish; test the resulting instrument for reliability and validity.
A cross-sectional, prospective design, set at a humanitarian mission within a community hospital. Linguistic validation: native Ecuadorian-Spanish speakers modified the Spanish VELO to Ecuadorian Spanish. Cognitive interviews were conducted with children with cleft palate (CP) and their parents (n = 50), guiding instrument modifications. An expert panel reviewed changes, resulting in the VELO-Ecuadorian dialect (VELO-Ec).
88 participants with CP (88 parents, 46 children) and 33 non-cleft controls (33 adult, 11 children) completed the VELO-Ec, Spanish-Pediatric Voice Handicap Index (pVHI), and Spanish-Intelligibility in Context Scale (ICS). Internal consistency was assessed with Cronbach's alpha; test-retest reliability was assessed by calculating the intraclass correlation coefficient (ICC); standard error of measurement (SEM) was calculated. Concurrent validity was assessed with Pearson correlations of VELO-Ec with pVHI and ICS. Discriminant validity assessment used an established ICS cutoff. Construct validity was assessed by grouping patients by parent report of hypernasality and early vs. late cleft repair (>24 months) using the Wilcoxon Rank-Sum test.
VELO-Ec showed excellent internal consistency (alpha 0.96) and test-retest reliability (ICC = 0.85, 95% CI 0.68-0.93, SEM 5.71). It had strong concurrent validity, correlating with ICS (r = 0.75, p < 0.001) and pVHI (r = -0.79, p < 0.001). Discriminant validity was strong with better VELO-Ec scores among subjects with normal vs. abnormal ICS score (median 95 & 61, p < 0.001). Strong construct validity was identified: those with parent-reported hypernasality had worse VELO-Ec scores than those without (median 59 & 75, p < 0.001). Those with repair before or after 24 months had similar VELO-Ec scores (p = 0.882).
The VELO-Ec is a valid and reliable measure of VPI-related quality of life, useful to clinicians and researchers treating Ecuadorian CP patients, especially in areas with limited resources such as on humanitarian missions.
将西班牙语版 VPI 对生活结果的影响（VELO）量表改编为厄瓜多尔西班牙语版；测试所得量表的信度和效度。
采用横断面、前瞻性设计，在社区医院的人道主义任务中进行。语言验证：母语为厄瓜多尔西班牙语的人将西班牙语 VELO 改编为厄瓜多尔西班牙语版。对腭裂儿童（CP）及其父母（n=50）进行认知访谈，指导仪器修改。专家小组审查了变更情况，最终形成了 VELO-厄瓜多尔方言（VELO-Ec）。
88 名 CP 患儿（88 名家长，46 名儿童）和 33 名非腭裂对照组（33 名成人，11 名儿童）完成了 VELO-Ec、西班牙语-小儿语音障碍指数（pVHI）和西班牙语-语境内可懂度量表（ICS）。采用 Cronbach's alpha 评估内部一致性；通过计算组内相关系数（ICC）评估重测信度；计算测量标准误差（SEM）。通过 VELO-Ec 与 pVHI 和 ICS 的 Pearson 相关评估同时效度。采用已建立的 ICS 临界值评估判别效度。采用 Wilcoxon 秩和检验，根据父母报告的鼻音过度和早期与晚期腭裂修复（>24 个月）对患者进行分组，评估结构效度。
VELO-Ec 具有极好的内部一致性（alpha 0.96）和重测信度（ICC=0.85，95%CI 0.68-0.93，SEM 5.71）。它具有很强的同时效度，与 ICS（r=0.75，p<0.001）和 pVHI（r=-0.79，p<0.001）相关。判别效度很强，与正常 ICS 评分相比，异常 ICS 评分的患者 VELO-Ec 评分更高（中位数 95 和 61，p<0.001）。结构效度很强：有父母报告鼻音过度的患者 VELO-Ec 评分低于无鼻音过度的患者（中位数 59 和 75，p<0.001）。24 个月之前或之后进行修复的患者 VELO-Ec 评分相似（p=0.882）。
VELO-Ec 是一种评估与 VPI 相关生活质量的有效且可靠的工具，对治疗厄瓜多尔 CP 患者的临床医生和研究人员有用，特别是在资源有限的地区，如人道主义任务。
