Psychometric validation of the Danish BREAST-Q reconstruction module

Area of Science:

• Plastic Surgery
• Health Outcomes Research
• Psychometrics

Background:

• Patient-reported outcome measurement instruments (PROMs) are crucial for evaluating breast reconstruction outcomes.
• Psychometric validation is essential for the reliable application of PROMs in clinical practice and research.
• The BREAST-Q, a validated questionnaire for breast surgery, has been translated into Danish.

Purpose of the Study:

• To psychometrically validate the Danish version of the BREAST-Q reconstruction module.
• To assess the acceptability, feasibility, reliability, and validity of the Danish BREAST-Q.

Main Methods:

• The study included women undergoing breast reconstruction from January 2019 to June 2020.
• Psychometric validation employed Rasch Analyses and Classical Test Theory on scales with summated scores and over 40 responses.
• Analyses included reliability, validity, local response dependence, item fit, differential item functioning, and known-groups hypotheses.

Main Results:

• 115 pre-operative and 201 post-operative responses were obtained, validating 120 items across 4 pre-operative and 9 post-operative scales.
• Rasch analyses indicated local response dependence in 8 scales, but Cronbach's α ranged from 0.81-0.95 post-adjustment.
• Item fit was good for 98% of items, and differential item functioning had minimal impact; clinical validity was supported by known-groups analyses.

Conclusions:

• The Danish BREAST-Q reconstruction module demonstrates good acceptability, feasibility, and validity.
• Adequate reliability was confirmed, supporting the use of the Danish BREAST-Q in clinical practice and research within the Danish population.
• This validated instrument enhances the understanding of breast reconstruction's impact on patient quality of life.