Lithuanian version of nasolacrimal duct obstruction symptom scoring questionnaire. Cross‐cultural adaptation and validation. Short‐ and long‐term results

• Published in: Clinical otolaryngology Vol. 45; no. 6; pp. 857 - 861
• Main Authors: Jakštas, Tomas, Balsevičius, Tomas, Vaitkus, Saulius, Padervinskis, Evaldas
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-11-2020
• Subjects: Adaptation; Consistency; Correlation coefficient; Correlation coefficients; dacryocystitis; dacryocystorhinostomy; epiphora; Evaluation; Lacrimal gland and Nasolacrimal duct; nasolacrimal duct obstruction; Questionnaires; Reliability analysis; Statistical analysis; Surgery; symptom score questionnaire; Translation; epiphora; symptom score questionnaire; nasolacrimal duct obstruction; dacryocystitis; dacryocystorhinostomy
• ISSN: 1749-4478; 1749-4486
• DOI: 10.1111/coa.13606

Objectives
The objective of this study was to perform translation, cross‐cultural adaptation and validation of the Lithuanian version of specific nasolacrimal duct obstruction symptom scoring (NLDO‐SS) questionnaire and to evaluate short‐ and long‐term results of endoscopic endonasal dacryocystorhinostomy (EN‐DCRS) procedure.
Design, Setting, Participants
Permission for questionnaire translation, cross‐cultural adaptation and validation was obtained from the authors of the original questionnaire. Translation, validation and cross‐cultural adaptation were carried out according to generally accepted methodology. Validation study of the Lithuanian version of NLDO‐SS (L‐NLDO‐SS) was performed, and short‐ and long‐term results of EN‐DCRS procedure were evaluated according to symptoms. In total, 44 patients were evaluated 2 weeks before the surgical intervention, a day before the surgery and 41 patients 2 months after the surgery, and again 10 months later.
Main outcome measures
We analysed the internal consistency and test‐retest reliability of the L‐NLDO‐SS questionnaire. Cronbach's alpha was used to represent and evaluate internal consistency for ordinal responses. Validity was assessed by comparing scores between a control group of volunteers without NLDO and the NLDO group using Mann‐Whitney test. To test the limiting score on which the sensitivity and specificity curves cross in identifying patients with NLDO, receiver operating characteristic (ROC) curve analysis was used. The pre‐ and post‐operative scores were compared using the paired t‐test.
Results
The results showed an acceptable internal consistency of L‐NLDO‐SS questionnaire, with Cronbach's alpha—.73 in the initial test group and .71 in the retest group. Pearson's correlation coefficient was .94 (P < .001), revealing good correlation between the initial scores and the retest scores. Our sample of healthy individuals had a mean L‐NLDO‐SS score of 11.42 (±12.69) points, and patients being scheduled for EN‐DCRS had a mean L‐NLDO‐SS score of 27.45 (±9.81) points. Post‐operatively mean L‐NLDO‐SS scores improved from 27.45 (±9.81) points to 4.45 (±6.29) points in the short term and to 5.83 (±4.17) in the long term, demonstrating the statistically significant responsiveness of the instrument over both timescales.
Conclusions
Lithuanian version of NLDO‐SS questionnaire is a valid instrument for assessing patients with NLDO in the Lithuanian population. It demonstrated good internal consistency, reproducibility, validity and responsiveness.