The Arabic Translation and Validation
of the ICI Vaginal Symptoms
Questionnaire
Wael Agur
MD MRCOG
Consultant Urogynaecologist
Honorary Senior Clinical Lecturer
University of Glasgow
2ndAnnual International Meeting of the RCOG Egyptian Representative Committee
Cairo, March 2012
Objectives
• Importance of Questionnaire Use
• Why the ICIQ-VS?
• Translation and Validation Protocol
Objectives
• Importance of Questionnaire Use
• Why the ICIQ-VS?
• Translation and Validation Protocol
The Surgical Ship
Pelvic Organ
Prolapse
Sea / See Level
High expectations
Vaginal atrophy
And the Iceberg
Pelvic Organ
Prolapse
Sexual Matters
Sea / See Level
High expectations
Vaginal atrophy
‘Loose’ vagina
‘Tight’ vagina
‘Sore’ vagina
Over-diagnosis
Chronic constipation
Vaginal digitation
Reduced
sensations
Under-diagnosis
Inspired by Pescatori et al 2006, A prospective evaluation of occult disorders in obstructed defecation using the ‘iceberg diagram’.
Colorectal Disease.
Symptoms and Scores
Clinical need for a VS-Q
• Currently, no clear data on the exact
prevalence of prolapse in the Arab world
• Social, cultural and environmental factors are
believed to contribute to a ‘culture of
silence’ and is likely to imply a high, unmet
need for services
Younis N, Khattab H, Zurayk H, El-Moelhy M, Farag A. A community study of gynaecological and related
morbidities in rural Egypt. Studies in Family Planning 1993, 24:175-186.
Clinical need for a VS-Q
• To provide Arabic-speaking women and their
health professionals with a validated
questionnaire in their own language
• To enable them to express their bothersome
issues on a confidential, self-completed form
Research need for a VS-Q
√
Objectives
• The importance of questionnaire use
• Why the ICIQ-VS?
• The translation and validation protocol
VS Questionnaires
Copyright ©The ICIQ Group
Arabic ICIQ-VS
Aim
To develop the first validated
questionnaire in the Arabic language
assessing vaginal symptoms in clinical
practice and research contexts in the
Middle-East
Objectives
• The importance of questionnaire use
• Why the ICIQ-VS?
• The translation and validation protocol
Translation Protocol
• Literal translation and adaptation
– to formal Arabic by a bilingual native Arabic
speakers (completed)
• Back translation
– to English by a bilingual native English
speakers (by mid March 2012)
• Review(s) of translations
– Panel of native English & Arabic speakers
(May 2012)
Validation Protocol-1
• Content validity
– Face validation
– 20 patients in Egypt and Saudi Arabia
(Aug 2012)
• Construct validity
– relationships to underlying VS theories
– difference between community-based
(n=50) women and those attending urogyn
clinics (n=120)
Validation Protocol-2
• Stability
– Scores remain similar after 4 weeks with
no treatment (2012/2013)
• Responsiveness
– Significant change in scores following
treatment (2012-2013)
• Internal consistency
– Correlation between questions
– Cronbach’s alpha coefficient of (0.7–0.8)
Considerations
• Ethics
– North Bristol REC, UK
– Individual Institutions
• Funding
– The ICIQ Group
– Ayrshire Urogynaecology Fund
Conclusion
• Questionnaire use is important in both
clinical practice and research contexts.
• The Arabic ICIQ-VS has the potential to
prove reliable and valid and be widely
used to empower Arabic-speaking women
to better express symptoms and monitor
treatment
Thank you
wael.agur@gla.ac.uk