The Reflux Symptom Score-12: Cross-cultural Adaptation and Validation for European Portuguese Speakers With Laryngopharyngeal Reflux.

OBJECTIVES: To translate and cross-culturally adapt the 12-item reflux symptom score (RSS-12) to European Portuguese (EP) and determine its clinimetric properties for symptomatic individuals with laryngopharyngeal reflux (LPR). STUDY DESIGN: Multinational cross-sectional cohort study. METHODS: The English RSS-12 was cross-culturally adapted according to the recommendations of the international guidelines. The validation study included the completion of the RSS-12, reflux symptom index, and voice handicap index by symptomatic and asymptomatic subjects with LPR. The RSS-12 was completed a second time by symptomatic subjects. Nine clinimetric properties were analyzed according to the international guidelines for validation of patient-reported outcome measures. RESULTS: The EP RSS-12 is equivalent to the English version (content, depth, and scoring). A total of 155 adults (84 with LPR symptoms) aged 21-78 years participated in the validation study. Statistical analyses revealed high internal consistency (Cronbach alpha >0.90), high test-retest reliability (intraclass correlation coefficient > 0.70, P < 0.001), low measurement error (Standard measure error of 5.21 for RSS and 1.59 for quality of life), good content validity (omission data <1% and item-total correlations > 0.652), good construct validity (61.9% of the total item variance with moderate item loadings), strong concurrent validity with reflux symptom index (rp = 0.772, P < 0.001) and moderate validity with voice handicap index (rp = 0.531, P < 0.001), and significantly known-groups validity (P < 0.001). The EP RSS-12 showed cross-cultural validity with French and Persian versions and high predictive validity with a cut-off value >8 for a sensitivity of 91.7% and a specificity of 91.5%. CONCLUSIONS: The EP RSS-12 retained the features of the English version and is a reliable and valid patient-reported outcome measure for EP individuals with LPR in the study.

Pediatric Voice Handicap Index (pVHI): Validation in European Portuguese Children.

OBJECTIVES: To determine reliability and validity of the European Portuguese pVHI version (pVHI-EP). STUDY DESIGN: Cross-sectional design. METHODS: The pVHI-EP and the talkative and global voice assessment scales were administered to the caregivers of children aged from 3 to 16 years old with and without dysphonia. Reliability (internal consistency and test-retest) was analyzed. The validity analyses performed were: (1) content validity by analyzing the percentage of missing data; (2) construct validity with intraclass correlation coefficients among pVHI-EP domains and overall score; (3) concurrent validity was conducted between pVHI-EP, the caregivers' judgment of the child's voice severity on a visual analog scale and the Speech-Language Pathologist perceptual voice assessment; (4) known-groups validity between children with and without dysphonia, and (5) predictive validity by calculating receiver operating characteristics, sensitivity and specificity and determining cut-off points. RESULTS: A total of 283 children (61.5% boys, mean age 8.3 years) participated in the study. The pVHI-EP showed an excellent internal consistency for the pVHI-EP total data. Strong to moderate test-retest reliability confirms pVHI-EP reproducibility. Excellent to good intraclass correlation coefficients between the pVHI-EP overall and the domains confirms its construct validity. Weak to moderate concurrent validity with visual analog scale and Speech-Language Pathologist perceptual voice assessment was confirmed. The pVHI-EP significantly distinguished two groups of different voice conditions. A cut-off point of 10.5 with 95.9% sensitivity and 92.5% specificity was determined for the overall score of the pVHI-EP. CONCLUSIONS: The pVHI-EP is a reliable and valid caregiver voice outcome tool for EP children with dysphonia.

Self-evaluation of communication experiences after laryngectomy (SECEL): translation and psychometric properties in European Portuguese.

Introduction: The patients' perception of how communication dysfunction may cause a disadvantage is important information for the clinical decision-making process.Objectives: This study aimed to translate the self-evaluation of communication experiences after laryngectomy (SECEL) to the European Portuguese (EP) and to assess its feasibility, acceptability, reliability, and validity.Material and methods: A cross-sectional study was carried out, and a cluster sample of seven ENT outpatient clinics was drawn. The EP-SECEL was filled in by 129 people with laryngectomy, aged 29-81 years and 25 of those completed it in the second time. Patients have also filled in the European Organization for Research Treatment of Cancer Quality of Life Questionnaire (EORCT), the core quality of life questionnaire (QLQ-C30) and the 35-item Head and Neck module (H&N35).Results: The EP-SECEL has the same conceptual meaning, semantics, idiomatic, format and score equivalence as the original one. Psychometric analyses revealed that it is feasible (missing <1%, to fill out took about 15 minutes for most patients), acceptable (floor and ceiling effects inferior to 15%), reliable (excellent internal consistency, Cronbach's alpha = 0.90, and moderate test-retest, Spearman's rhô = 0.64), well-constructed (66% of the total variance is explained by exploratory factor analysis), significantly convergent (correlates with the EORTC QLQ-C30 and H&N35) and validly discriminates people with total and partial laryngectomy as well as people with different primary means-of-communication.Conclusions: This study supports that the EP-SECEL has sufficient psychometric qualities to be considered an adequate tool to be recommended for assessing health-related quality of life among laryngectomy patients.