A new tool to investigate anorectal disorders in patients with multiple sclerosis: STAR-Q

E Tan; N Turmel; J Kerdraon; A Guinet-Lacoste; J-G Prévinaire; E Castel-Lacanal; A Even; C Chesnel; C Hentzen; G Amarenco

doi:10.1016/j.purol.2023.02.006

A new tool to investigate anorectal disorders in patients with multiple sclerosis: STAR-Q

Prog Urol. 2023 Jul;33(7):362-369. doi: 10.1016/j.purol.2023.02.006. Epub 2023 Mar 9.

Authors

E Tan¹, N Turmel², J Kerdraon³, A Guinet-Lacoste⁴, J-G Prévinaire⁵, E Castel-Lacanal⁶, A Even⁷, C Chesnel⁸, C Hentzen⁸, G Amarenco⁸

Affiliations

¹ Sorbonne university, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Tenon hospital, 4, rue de la Chine, 75020 Paris, France; Department of neuro-urology, Tenon hospital, 4, rue de la Chine, 75020 Paris, France; Clinical investigation center,1429 Inserm, Raymond-Poincarré hospital, 104, boulevard Raymond-Poincaré, 92380 Garches, Hospital-University Group, AP-HP, Paris-Saclay University, Paris, France. Electronic address: eliane.tan@aphp.fr.
² Sorbonne university, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Tenon hospital, 4, rue de la Chine, 75020 Paris, France; Department of neuro-urology, Tenon hospital, 4, rue de la Chine, 75020 Paris, France; Department of physical and rehabilitation, Casanova hospital, 11, rue Danielle-Casanova, 93205 Saint-Denis, France.
³ Department of physical and rehabilitation, Mutualiste center, Kerpape, BP 78, 56275 Ploemeur, France.
⁴ Department of physical and rehabilitation, Henry-Gabrielle HCL hospital, 20, routes de Vourles, 69230 St-Genis-Laval, France.
⁵ Department of physical and rehabilitation, Calvé center, fondation Hopale, 62600 Berck-sur-Mer, France.
⁶ Department of physical and rehabilitation, INSERM/UPS, ToNIC (Toulouse NeuroImaging Center), Purpan university hospital center, pavillon Baudot, place du Docteur-Baylac, 31024 Toulouse, France.
⁷ Neurourology and andrology unit, department of physical medicine and rehabilitation, UMR 1179 Inserm, Raymond-Poincarré hospital, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
⁸ Sorbonne university, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Tenon hospital, 4, rue de la Chine, 75020 Paris, France; Department of neuro-urology, Tenon hospital, 4, rue de la Chine, 75020 Paris, France.

PMID: 36906431
DOI: 10.1016/j.purol.2023.02.006

Abstract

Background: Bowel symptoms are commonly experienced by patients with Multiple sclerosis (PwMS), but no specific questionnaire validated in this population allows a rigorous assessment.

Objective: Validation of a multidimensional questionnaire assessing bowel disorders in PwMS.

Methods: A prospective, multicenter study was conducted between April 2020 and April 2021. The STAR-Q (Symptoms' assessmenT of AnoRectal dysfunction Questionnaire), was built in 3 steps. First, literature review and qualitative interviews were performed to create the first version, discussed with a panel of experts. Then, a pilot study assessed comprehension, acceptation and pertinence of items. Finally, the validation study was designed to measure content validity, internal consistency reliability (alpha coefficient of Cronbach) and test-retest reliability [intraclass correlation coefficient (ICC)]. The primary outcome was good psychometric properties with Cronbach's α>0.7 and ICC>0.7.

Results: We included 231 PwMS. Comprehension, acceptation and pertinence were good. STAR-Q showed a very good internal consistency reliability (Cronbach's α=0.84) and test-retest reliability (ICC=0.89). Final version of STAR-Q was composed of 3 domains corresponding in symptoms (Q1-Q14), treatment and constraints (Q15-Q18) and impact on quality of life (Q19). Three categories of severity were determined (STAR-Q≤16: minor, between 17 and 20: moderate, and≥21: severe).

Conclusions: STAR-Q presents very good psychometric properties and allows a multidimensional assessment of bowel disorders in PwMS.

Keywords: Bowel dysfunction; Multiple sclerosis; Quality of life; Qualité de vie; Questionnaire; Sclérose en plaques; Troubles anorectaux.

Publication types

Multicenter Study

MeSH terms

Humans
Multiple Sclerosis* / complications
Multiple Sclerosis* / diagnosis
Pilot Projects
Prospective Studies
Psychometrics / methods
Quality of Life
Rectal Diseases*
Reproducibility of Results
Surveys and Questionnaires