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Clinical Implementation and Validation of the Arabic Face-Q Rhinoplasty Module
Hani Alanazi1, Almaha A Alqabbani2, Badi F Aldosari3
1Department of Surgical Specialties, College of Medicine Majmaah University Majmaah Kingdom of Saudi Arabia.
Background And Aim:
The Face-Q is a patient-reported outcomes instrument with 43 independent scales; its rhinoplasty module measures patient satisfaction with nasal appearance and adverse effects following aesthetic rhinoplasty. However, no validated Arabic version exists for Middle Eastern populations. This study aimed to validate and culturally adapt the Arabic FACE-Q rhinoplasty module following COSMIN guidelines.
Methods:
A prospective validation study was conducted at King Abdulaziz University Hospital, Riyadh, between November 2019 and March 2020. Fifty Arabic-speaking patients (mean age 30.3 ± 6.8 years; 54% male) undergoing primary rhinoplasty completed the Arabic FACE-Q preoperatively and 3 months postoperatively. We assessed structural validity (confirmatory factor analysis), convergent validity (Average Variance Extracted), discriminant validity (Heterotrait-Monotrait ratio), internal consistency (Cronbach's α, McDonald's ω), test-retest reliability (intraclass correlation coefficient), responsiveness (effect sizes), and measurement error (Standard Error of Measurement, Smallest Detectable Change).
Results:
The three-factor structure was confirmed with acceptable fit (CFI = 0.924, TLI = 0.910, RMSEA = 0.081, SRMR = 0.087). The Arabic module demonstrated strong internal consistency (α: Nose = 0.77, Nostrils = 0.94, Adverse Effects = 0.77; ω: Nose = 0.933, Nostrils = 0.944, Adverse = 0.639) and good test-retest reliability (ICC: Nose = 0.74, Nostrils = 0.77, Adverse Effects = 0.71; all p < 0.001). Convergent validity was confirmed (AVE: Nose = 0.503, Nostrils = 0.809) with good discriminant validity (HTMT ratios < 0.60). Responsiveness analysis showed very large effect sizes (Nose r = 0.871, Nostrils r = 0.788) with significant improvements in satisfaction scores postoperatively (p < 0.001). Smallest Detectable Change values were 6.34 points (Nose) and 2.70 points (Nostrils). However, substantial ceiling effects were observed (Nose 48%, Nostrils 74%).
Conclusion:
The Arabic FACE-Q rhinoplasty module demonstrates good structural validity, excellent reliability, and exceptional responsiveness to surgical change. Despite ceiling effects limiting detection of further improvements, the instrument is suitable for clinical and research use in Arabic-speaking populations.
