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Psychometric Performance of the Stony Brook Scar Evaluation Scale and SCAR-Q Questionnaire in Dutch Children after
Chantal A Ten Kate1, Hilde J H Koese1, M Jenda Hop2
1Department of Pediatric Surgery and Intensive Care Children, Erasmus MC Sophia Children's Hospital, Wytemaweg 80, 3015 CD Rotterdam, The Netherlands.
Insights
The Dutch Stony Brook Scar Evaluation Scale (SBSES) and SCAR-Q showed good feasibility and internal reliability for pediatric surgical scars. However, external reliability and validity were moderate, suggesting combined use for comprehensive patient outcome assessment.
Area of Science:
- Pediatric Surgery
- Patient-Reported Outcome Measures
- Psychometric Evaluation
Background:
- Long-term follow-up is crucial for pediatric surgery survivors.
- Surgical scars significantly impact children's daily lives.
- Patient-reported outcome measurements (PROMs) are vital for assessing scar impact.
Purpose of the Study:
- To evaluate the psychometric performance of the Dutch-translated Stony Brook Scar Evaluation Scale (SBSES) and SCAR-Q.
- To assess feasibility, reliability, and validity in Dutch children with surgical scars.
- To determine the suitability of these instruments for long-term follow-up.
Main Methods:
- English-Dutch translation of SBSES and SCAR-Q.
- Evaluation following COSMIN guidelines for feasibility, reliability, and validity.
- Study included Dutch pediatric patients (<18 years) with surgical scars.
Main Results:
- Both instruments demonstrated good feasibility and internal reliability (Cronbach's alpha > 0.7).
- SBSES showed poor to moderate external reliability (ICC 0.46-0.74).
- SCAR-Q exhibited good external reliability (ICC 0.79-0.93), but validity was poor to moderate for both.
Conclusions:
- The Dutch SBSES and SCAR-Q are feasible and have good internal reliability.
- External reliability and validity require further investigation, potentially due to conceptual differences.
- Combined use of SBSES and SCAR-Q may offer comprehensive insights into scar impact and long-term psychological outcomes in pediatric surgery survivors.
Abstract:
Introduction: The growing population of survivors following pediatric surgery emphasizes the importance of long-term follow-up. The impact of surgical scars on daily life can be evaluated through patient-reported outcome measurements. The Stony Brook Scar Evaluation Scale (SBSES) and SCAR-Q questionnaire are two interesting instruments for this purpose. We evaluated their psychometric performance in Dutch children after pediatric surgery. Methods: After English-Dutch translation, we evaluated-following the COSMIN guidelines-the feasibility, reliability (internal and external), and validity (construct, criterion, and convergent) of the SBSES and SCAR-Q in Dutch patients < 18 years old with surgical scars. Results: Three independent observers completed the SB for 100 children (58% boys, median age 7.3 (IQR 2.5-12.1) years) in whom surgery had been performed a median of 2.8 (0.5-7.9) years ago. Forty-six of these children (61% boys, median age 12.1 (9.3-16.2) years) completed the SCAR-Q. Feasibility and internal reliability (Cronbach's alpha > 0.7) was good for both instruments. For the SB, external reliability was poor to moderate (interobserver variability: ICC 0.46-0.56; intraobserver variability: ICC 0.74). For the SCAR-Q, external reliability was good (test-retest agreement: ICC 0.79-0.93). Validity tests (construct, criterion, and convergent) showed poor to moderate results for both instruments. Conclusions: The Dutch-translated SBSES and SCAR-Q showed good feasibility and internal reliability. External reliability and validity were likely affected by differences in conceptual content between the questionnaires. Combining them would provide insight in the impact of scars on patients. Implementation of these instruments in longitudinal follow-up programs could provide new insights into the long-term psychological outcome after pediatric surgery.
