Bladder cancer index: cross-cultural adaptation into Spanish and psychometric evaluation
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RESEARCH
Open Access
Bladder cancer index: cross-cultural adaptation into Spanish and psychometric evaluation Stefanie Schmidt1,2,3, Ricard Riel4, Albert Frances5, José Antonio Lorente Garin5, Xavier Bonfill3,6,7, María José Martinez-Zapata3,6, Maria Morales Suarez-Varela3,8,9, Javier dela Cruz3,10, José Ignacio Emparanza3,11, María-José Sánchez3,12,13, Javier Zamora3,14, Juan Manuel Ramos Goñi15,16, Jordi Alonso1,2,3, Montse Ferrer1,3,7* and on behalf of the EMPARO-CU Study Group
Abstract Background: The Bladder Cancer Index (BCI) is so far the only instrument applicable across all bladder cancer patients, independent of tumor infiltration or treatment applied. We developed a Spanish version of the BCI, and assessed its acceptability and metric properties. Methods: For the adaptation into Spanish we used the forward and back-translation method, expert panels, and cognitive debriefing patient interviews. For the assessment of metric properties we used data from 197 bladder cancer patients from a multi-center prospective study. The Spanish BCI and the SF-36 Health Survey were self-administered before and 12 months after treatment. Reliability was estimated by Cronbach’s alpha. Construct validity was assessed through the multi-trait multi-method matrix. The magnitude of change was quantified by effect sizes to assess responsiveness. Results: Reliability coefficients ranged 0.75-0.97. The validity analysis confirmed moderate associations between the BCI function and bother subscales for urinary (r = 0.61) and bowel (r = 0.53) domains; conceptual independence among all BCI domains (r ≤ 0.3); and low correlation coefficients with the SF-36 scores, ranging 0.14-0.48. Among patients reporting global improvement at follow-up, pre-post treatment changes were statistically significant for the urinary domain and urinary bother subscale, with effect sizes of 0.38 and 0.53. Conclusions: The Spanish BCI is well accepted, reliable, valid, responsive, and similar in performance compared to the original instrument. These findings support its use, both in Spanish and international studies, as a valuable and comprehensive tool for assessing quality of life across a wide range of bladder cancer patients. Keywords: Urinary bladder neoplasms, Quality of life, Patient outcomes, Validation studies, Psychometrics
Background Bladder cancer is one of the most complex neoplasms in urologic oncology. In men it is the fourth leading cancer location in the European Union and the United States [1,2]. Estimated incidence rates for men are lower in Europe than in the United States (29.1 vs 37.6 per 100,000); however, the rate for Spanish males is among the highest in the European Union (39.0 per 100,000).
* Correspondence: [email protected] 1 Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, 08003 Barcelona, Spain 3 CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Full list of author information is available at the end of the article
Spanish men present about eight times higher
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