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A new tool to investigate anorectal disorders in patients with multiple sclerosis: STAR-Q
E Tan1, N Turmel2, J Kerdraon3
1Sorbonne university, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Tenon hospital, 4, rue de la Chine, 75020 Paris, France; Department of neuro-urology, Tenon hospital, 4, rue de la Chine, 75020 Paris, France; Clinical investigation center,1429 Inserm, Raymond-Poincarré hospital, 104, boulevard Raymond-Poincaré, 92380 Garches, Hospital-University Group, AP-HP, Paris-Saclay University, Paris, France.
Background:
Bowel symptoms are commonly experienced by patients with Multiple sclerosis (PwMS), but no specific questionnaire validated in this population allows a rigorous assessment.
Objective:
Validation of a multidimensional questionnaire assessing bowel disorders in PwMS.
Methods:
A prospective, multicenter study was conducted between April 2020 and April 2021. The STAR-Q (Symptoms' assessmenT of AnoRectal dysfunction Questionnaire), was built in 3 steps. First, literature review and qualitative interviews were performed to create the first version, discussed with a panel of experts. Then, a pilot study assessed comprehension, acceptation and pertinence of items. Finally, the validation study was designed to measure content validity, internal consistency reliability (alpha coefficient of Cronbach) and test-retest reliability [intraclass correlation coefficient (ICC)]. The primary outcome was good psychometric properties with Cronbach's α>0.7 and ICC>0.7.
Results:
We included 231 PwMS. Comprehension, acceptation and pertinence were good. STAR-Q showed a very good internal consistency reliability (Cronbach's α=0.84) and test-retest reliability (ICC=0.89). Final version of STAR-Q was composed of 3 domains corresponding in symptoms (Q1-Q14), treatment and constraints (Q15-Q18) and impact on quality of life (Q19). Three categories of severity were determined (STAR-Q≤16: minor, between 17 and 20: moderate, and≥21: severe).
Conclusions:
STAR-Q presents very good psychometric properties and allows a multidimensional assessment of bowel disorders in PwMS.
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