Development and Validation of the Stanford Obstetric Recovery Checklist (STORK): A Delphi Consensus and Multicenter...

Area of Science:

• Obstetrics and Gynecology
• Patient-Reported Outcome Measures
• Postpartum Care

Background:

• Existing patient-reported outcome measures (PROMs) for postpartum recovery lack content validity and population-specific design.
• A need exists for a validated instrument to assess outpatient postpartum recovery.

Purpose of the Study:

• To develop and evaluate the Stanford Obstetric Recovery Checklist (STORK) as a patient-reported outcome measure for outpatient postpartum recovery.
• To assess the validity, reliability, and responsiveness of the STORK in a multicenter cohort study.

Main Methods:

• The STORK was developed through a 3-phase process including literature review, expert Delphi rounds, and cognitive debriefing with postpartum individuals.
• A prospective, 3-center US longitudinal cohort study evaluated STORK in 498 postpartum individuals.
• Validity, reliability, and responsiveness were assessed using established psychometric methods, including factor analysis, correlation with established scales, Cronbach's alpha, and change over time analysis.

Main Results:

• The STORK demonstrated excellent validity, with a 4-factor model showing good fit (RMSR=0.05) and significant correlations with global health and quality of life measures.
• Reliability was high (Cronbach's α=0.92, split-half ρ=0.98), and the measure was responsive to changes in recovery across different delivery modes.
• The STORK effectively discriminated between patients reporting good and poor recovery (P<.001).

Conclusions:

• The Stanford Obstetric Recovery Checklist (STORK) is a valid, reliable, and responsive patient-reported outcome measure for outpatient postpartum recovery.
• The STORK has the potential to improve the assessment and management of postpartum recovery in clinical practice.
• Further clinical trials are warranted to establish the full clinical utility of the STORK.