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Measurement properties of the childhood bladder and bowel dysfunction questionnaire
Marieke L van Engelenburg-van Lonkhuyzen1,2, Esther M J Bols3, Caroline H G Bastiaenen1,2
1Department of Epidemiology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands.
Insights
The Childhood Bladder and Bowel Dysfunction Questionnaire (CBBDQ) demonstrates excellent validity and reliability in children aged 5-12. This 18-item tool is suitable for parent self-administration, offering a quick and effective assessment.
Area of Science:
- Pediatric gastroenterology
- Urology
- Health outcomes research
Background:
- Childhood bladder and bowel dysfunction (BB D) is a common concern.
- The Childhood Bladder and Bowel Dysfunction Questionnaire (CBBDQ) previously showed feasibility and structural validity.
- Further evaluation of measurement properties according to COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) was needed.
Purpose of the Study:
- To evaluate the remaining measurement properties of the CBBDQ.
- To confirm the validity, reliability, and responsiveness of the CBBDQ using COSMIN standards.
- To establish the interpretability of the CBBDQ scores.
Main Methods:
- A prospective cohort study included 172 parents of children aged 5-12 years.
- Area Under the Curve (AUC) was calculated for criterion validity, responsiveness, and interpretability.
- Intra-class correlation coefficients (ICCagreement) were used for construct validity and test-retest reliability.
Main Results:
- The CBBDQ demonstrated excellent criterion validity (AUC: 0.98) and test-retest reliability (ICCagreement: 0.94).
- Convergent validity was good (ICCsagreement: 0.76 and 0.74), while divergent validity was fair (ICCagreement: 0.52).
- Responsiveness was fair (AUC: 0.74) at 6 months, with a minimal important change of 4.5 and a cut-off value of 11.
Conclusions:
- The 18-item CBBDQ meets COSMIN standards for validity, reliability, and responsiveness.
- The questionnaire is suitable for parent self-administration and is time-efficient.
- Interpretability aspects of the CBBDQ scores are reported to aid in understanding clinical significance.
Objectives:
The childhood bladder and bowel dysfunction questionnaire (CBBDQ) was previously found feasible, structurally valid, with good internal consistency. The purpose of this study was to evaluate the remaining measurement properties according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN).
Methods:
A prospective cohort study among parents of children aged 5-12 years was conducted. Calculated were the area under the curve (AUC) (criterion validity, responsiveness, interpretability) and intra-class correlation coefficients (ICCagreement ) (construct validity and test-retest reliability).
Results:
One hundred and seventy-two parents were included from March 2019 to April 2021. Correlating the bladder subscales of the CBBDQ with the Vancouver symptom score for dysfunctional elimination (VSSDES) and proxy-reported pediatric incontinence quality of life (p-PinQ) showed convergent validity (ICCsagreement : 0.76 and 0.74). Divergent validity was found when correlating the bowel subscales of the CBBDQ with the VSSDES (ICCagreement : 0.52). Excellent criterion validity (AUC: 0.98); excellent test-retest reliability (ICCagreement : 0.94) and, at 6 months, fair responsiveness (AUC: 0.74) were found. The minimal important change was 4.5, with cut-off value of 11.
Conclusion:
The CBBDQ has been developed according to COSMIN standards. The items were defined using the consensus-based ICCS standards and Rome-III criteria. The measurement properties were identified using enough participants. Although interpretability is not considered a measurement property, interpretability aspects are reported here as they refer to what instrument scores mean. The 18-item-CBBDQ met the measurement properties of validity, reliability, and responsiveness, as defined by COSMIN. The CBBDQ is suitable for self-administration by parents, and completion takes little time.
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