Development and feasibility of a Japanese electronic S³-NIV questionnaire in routine respiratory care

Electronic patient-reported outcome (ePRO) measures are increasingly used in respiratory care, yet evidence regarding their feasibility and measurement performance in real-world clinical settings remains limited. The S³-NIV questionnaire is a brief patient-reported outcome tool assessing respiratory symptoms, sleep quality, and side effects in patients receiving non-invasive ventilation (NIV). This study aimed to develop a Japanese electronic version of the S³-NIV questionnaire and to evaluate its feasibility and internal consistency.

The S³-NIV questionnaire was translated into Japanese according to ISPOR Translation and Cultural Adaptation guidelines. After linguistic validation, a web-based electronic version was developed. A cross-sectional observational feasibility study was conducted in patients with chronic respiratory failure receiving home NIV. The Japanese electronic version of the Severe Respiratory Insufficiency (SRI) questionnaire was used as a comparator. Internal consistency was assessed using Cronbach's alpha coefficients.

Seven patients successfully completed the electronic questionnaires, confirming technical feasibility. Internal consistency was acceptable to high for the S³-NIV total score and respiratory symptoms subscore (Cronbach's alpha = 0.79 and 0.92, respectively), whereas the sleep and side-effects subscore showed low internal consistency (alpha = 0.31). Several subscales of the electronic SRI questionnaire also demonstrated low alpha coefficients.

Although the Japanese translation of the S³-NIV questionnaire was linguistically validated and electronically feasible, reduced internal consistency was observed in specific subscales. Similar findings in the electronic SRI questionnaire suggest that factors related to mode of administration may influence measurement properties; however, this hypothesis requires confirmation in adequately powered equivalence studies.