Ecuadorian Spanish translation and validation of the VELO quality of life instrument. (November 2020)

• Record Type: Journal Article
• Authors: Ridgell, Lucille; Roth, Christina T.; Bow, Mikaela; Hares-Helou, Rayyan; Arias, Karina Mayorga; Pollard, Sarah Hatch; Hamdan, Usama; Tollefson, Travis T.; Skirko, Jonathan R.
• Is Part Of: International journal of pediatric otorhinolaryngology. Volume 138(2020:Nov.)
• Publication Date: 2020-11
• Subjects: VPI -- Velopharyngeal insufficiency -- Quality of life -- International -- Translation; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Oto-rhino-laryngologie -- Périodiques; Pédiatrie -- Périodiques; 618.9209751
• DOI: 10.1016/j.ijporl.2020.110312
• Languages: English
• ISSNs: 0165-5876

Abstract

Abstract: Objectives: Adapt the Spanish translation of VPI Effects on Life Outcome (VELO) instrument into Ecuadorian Spanish; test the resulting instrument for reliability and validity. Methods: A cross-sectional, prospective design, set at a humanitarian mission within a community hospital. Linguistic validation: native Ecuadorian-Spanish speakers modified the Spanish VELO to Ecuadorian Spanish. Cognitive interviews were conducted with children with cleft palate (CP) and their parents (n = 50), guiding instrument modifications. An expert panel reviewed changes, resulting in the VELO-Ecuadorian dialect (VELO-Ec). Instrument assessment: 88 participants with CP (88 parents, 46 children) and 33 non-cleft controls (33 adult, 11 children) completed the VELO-Ec, Spanish-Pediatric Voice Handicap Index (pVHI), and Spanish-Intelligibility in Context Scale (ICS). Internal consistency was assessed with Cronbach's alpha; test-retest reliability was assessed by calculating the intraclass correlation coefficient (ICC); standard error of measurement (SEM) was calculated. Concurrent validity was assessed with Pearson correlations of VELO-Ec with pVHI and ICS. Discriminant validity assessment used an established ICS cutoff. Construct validity was assessed by grouping patients by parent report of hypernasality and early vs. late cleft repair (>24 months) using the Wilcoxon Rank-Sum test. Results: VELO-Ec showed excellent internal consistency (alpha 0.96) and test-retest reliability (ICC = 0.85, 95% CI 0.68–0.93, SEM 5.71). It had strong concurrent validity, correlating with ICS (r = 0.75, p < 0.001) and pVHI (r = −0.79, p < 0.001). Discriminant validity was strong with better VELO-Ec scores among subjects with normal vs. abnormal ICS score (median 95 & 61, p < 0.001). Strong construct validity was identified: those with parent-reported hypernasality had worse VELO-Ec scores than those without (median 59 & 75, p < 0.001). Those with repair before or after 24 months had similar VELO-Ec scores (p = 0.882). Conclusion: The VELO-Ec is a valid and reliable measure of VPI-related quality of life, useful to clinicians and researchers treating Ecuadorian CP patients, especially in areas with limited resources such as on humanitarian missions. Highlights: Velopharyngeal insufficiency (VPI) negatively impacts quality of life. VPI Effects on Life Outcomes (VELO) measures VPI specific quality of life. The VELO was translated & adapted to Ecuadoran Spanish, creating the VELO-Ec. The VELO-Ec has excellent reliability & validity.