The Arabic Translation and Validation of the ICI Vaginal Symptoms Questionnaire Wael Agur MD MRCOG Consultant Urogynaecologist Honorary Senior Clinical Lecturer University of Glasgow 2 nd Annual 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 Sea / See Level Vaginal atrophy High expectations Pelvic Organ Prolapse

And the Iceberg Pelvic Organ Prolapse Under-diagnosisOver-diagnosis Vaginal atrophy High expectations ‘Loose’ vagina Inspired by Pescatori et al 2006, A prospective evaluation of occult disorders in obstructed defecation using the ‘iceberg diagram’. Colorectal Disease. Sexual Matters Chronic constipation Reduced sensations Vaginal digitation ‘Sore’ vagina ‘Tight’ vagina Sea / See Level

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:

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)

Stability –Scores remain similar after 4 weeks with no treatment (2012/2013) Responsiveness –Significant change in scores following treatment ( ) Internal consistency –Correlation between questions –Cronbach’s alpha coefficient of (0.7–0.8) Validation Protocol-2

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