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Validation of the Dutch-Language Version of the Neurogenic Bowel Dysfunction Score in Patients With Multiple
Tess van Doorn1, Ilse M Groenendijk1, Jeroen R Scheepe1
1Department of Urology, Erasmus Medical Center, Rotterdam, the Netherlands (TvD, IMG, JRS, BFMB).
Background:
Neurogenic bowel dysfunction (NBD), like fecal incontinence and constipation, is a common symptom of disease in patients with multiple sclerosis (MS). The NBD score is a validated symptom-based questionnaire consisting of 10 multiple-choice questions. The aim of this study was to validate the Dutch version of the NBD score in patients with MS, creating an objective measuring tool of bowel dysfunction.
Methods:
Translation and validation of the NBD score was performed according to standardized guidelines. Adult patients with MS visiting a urology department completed a set of questionnaires (test): the NBD score, the Fecal Incontinence Quality of Life scale (FIQL), the Fecal Incontinence Severity Index (FISI), and the EQ-5D 3-Level questionnaire (EQ-5D-3L). After 1 to 2 weeks, the questionnaires were completed again (retest). A control group recruited at a general practitioner's practice completed the questionnaires once. Data were analyzed for measurement properties.
Results:
Sixty-one patients and 50 controls were included. Content validity was adequate, internal consistency was moderate (Cronbach α = 0.57 and 0.41), and reproducibility was excellent (interclass correlation coefficient = 0.78). Criterion validity was confirmed; the NBD score correlated moderately/strongly with the FIQL, FISI, and EQ-5D-3L. The NBD scores in the patient group were significantly higher than those in the control group, demonstrating good construct validity.
Conclusions:
The Dutch version of the NBD score showed moderate to good validity and good reliability for assessment of NBD in patients with MS.
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