Background
Methods
Search strategy
Eligibility criteria
Data extraction
Assessment of methodological quality of included studies
Assessment of measurement properties results
Category | Characteristics | Implications |
---|---|---|
A | Evidence for sufficient content validity (any level) and at least low evidence for sufficient internal consistency | Have potential to be recommended as the most suitable questionnaire for the construct and population of interest |
B | Questionnaire not categorized in A or C | May have the potential to be recommended, but further validation studies are needed |
C | High quality evidence for an insufficient measurement property | Should not be recommended |
Data analysis and synthesis
Ethical approval
Results
Study selection
Characteristics of included studies and questionnaires
Included studies (n = 80) | N | % |
---|---|---|
Continent | ||
North America | 38 | 47.5 |
Europe | 26 | 32.5 |
Asia | 8 | 10.0 |
Oceania | 6 | 7.5 |
Other | 2 | 2.5 |
Year of publication | ||
< 2005 | 24 | 30.0 |
2005–2010 | 14 | 17.5 |
> 2010 | 42 | 52.5 |
Study design | ||
Experimental or quasi-experimental | 28 | 35.0 |
Other study designs, patient experience/satisfaction is an outcome | 47 | 58.7 |
Study on the development or validation of a questionnaire | 5 | 6.2 |
Administration of questionnairesa | 75 | |
Self-reported | 70 | 93.3 |
By telephone | 3 | 4.0 |
Not reported | 2 | 2.7 |
Availability of the questionnairea | ||
Yes | 32 | 42.7 |
No | 43 | 57.3 |
Original language of the questionnairea | ||
English | 61 | 81.3 |
Spanish | 4 | 5.3 |
Chinese | 2 | 2.7 |
Korean | 2 | 2.7 |
Other | 6 | 8.0 |
Origin of the questionnaire useda | ||
Development of a new questionnaire for the study | 51 | 68.0 |
Derived from an existing questionnaire | 12 | 16.0 |
Use of an existing questionnaire | 8 | 10.7 |
Not reported | 4 | 5.3 |
Aspects/interventions assesseda | ||
Bowel preparation | 11 | 14.7 |
Bowel relaxant | 1 | 1.3 |
Colonoscopy | 32 | 42.7 |
Diet | 1 | 1.3 |
Stool test | 13 | 17.3 |
Pre-colonoscopy consultation | 2 | 2.7 |
Sigmoidoscopy | 12 | 16.0 |
CT-colonography | 2 | 2.7 |
Whole screening program | 1 | 1.3 |
Characteristic of validated questionnaires
Questionnaire (Reference) | Country | Language/ translation | Mode of administration | Intervention assessed | Construct (according to authors) | Dimensions/Domains | Number of items |
---|---|---|---|---|---|---|---|
CSSQP Brotons 201932 | Spain | Spanish English translation | Self-reported | Colonoscopy after a positive fecal occult blood test in colorectal cancer screening | 1. Satisfaction 2.Safety | 1. Satisfaction scale: -Information -Care -Service and facilities 2. Safety scale -Information gaps -Safety incidents | -Satisfaction scale: 15 -Safety scale: 3 |
Patient Satisfaction Scale with Bowel Preparation Hatoum 201633 | USA | English No translation | Self-reported | Bowel preparation | 1.Satisfaction with bowel preparation 2. Acceptance or refusal of future use of the preparation | 1. Current satisfaction: -Difficulty using bowel-cleansing preparations -Ability to consume preparations -Acceptability of taste -Overall experience 2. Acceptance or refusal of future use of the same bowel preparation | 6 |
Post procedure endoscopy questionnaire Peña 200535 | USA | English Translation not reported | Self-reported | Gastrointestinal endoscopy (upper and lower) | Satisfaction | 1. Anxiety 2. Pain or discomfort 3. Distress or suffering 4. Physical needs met 5. Emotional needs met 6. Overall satisfaction 7. Willingness to repeat if necessary | 7 |
SmGHAA-9 m Sánchez del Río 200534 | Spain | Spanish English translation | By telephone by an interviewer | Gastrointestinal endoscopy (upper and lower) | Satisfaction | 1.Waiting times 2. Personal manners 3. Information received 4. Discomfort 5. Overall rating 6. Willingness to repeat if necessary | 7 |
Screening Flexible Sigmoidoscopy Assessment Questionnaire. Schoen 200036 | USA | English Translation not reported | Self-reported | Screening sigmoidoscopy | Satisfaction | 1. Convenience and accessibility 2. Staff interpersonal skills 3. Physical surroundings 4. Technical competence 5. Pain and discomfort 6. Expectations and beliefs 7. General satisfaction | 18 |
Questionnaire (Reference) | Population | Disease characteristics | Questionnaire administration | ||||
---|---|---|---|---|---|---|---|
N | Age Mean (SD) Range (%) | Gender | Disease | Setting | Moment of administration | Response rate | |
CSSQP32 | 505 | 60.7 (5.2) | 38.6% female | Women and men who had undergone a colonoscopy after a positive fecal occult blood test within the colorectal cancer screening program | 2 hospitals | The day after the colonoscopy and return to a mailbox | 74.9% (378/505) |
Patient Satisfaction Scale with Bowel Preparation33 | 1.211 | 56 | 61% female | Women and men (18–80 years) scheduled for an elective outpatient colonoscopy | University hospitals, academic medical centers, private clinics | Prior to the colonoscopy | 98.7% (1195/1211) |
Post- procedure questionnaire35 | 148 | 21–40 (18%) 41–60 (64%) 61–80 (17%) > 80 (1%) | 63% female | Women and men (≥18 years) who underwent routine procedures (gastric endoscopy, colonoscopy, sigmoidoscopy) | 1 hospital | After the procedure | 89,7% (148/165) |
SmGHAA-9 m34 | 485 | 51 (16) | 57% female | Women and men scheduled for an endoscopic procedure (colonoscopy or gastroscopy) | 2 hospitals: one private (the source of most patients) | By telephone 3 weeks after the procedure | 93,8% (455/485) |
Screening Flexible Sigmoidoscopy Assessment Questionnaire36 | 1.221 | 61.8 (6.1) | 45.5% female | Women and men who underwent screening flexible sigmoidoscopy | 2 hospitals. 97% of participants were participants in an RCT | After the sigmoidoscopy, prior to discharge or returned by mail | 100% |
Methodological quality of studies
Measurement property | CSSQP32 | Patient Satisfaction Survey33 | Post procedure questionnaire35 | SmGHAA-9 m34 | Screening Flexible Sigmoidoscopy Assessment Questionnaire36 | ||
---|---|---|---|---|---|---|---|
Content validity | Asking patients | Relevance | D | D | D | D | – |
Comprehensiveness | D | D | D | D | – | ||
Comprehensibility | D | D | D | D | D | ||
Asking experts | Relevance | – | D | D | – | D | |
Comprehensiveness | – | D | D | – | D | ||
Internal structure | Structural validity | A | – | A | – | A | |
Internal consistency | V | D | V | D | V | ||
Cross-cultural validity | – | – | – | – | – | ||
Other measurement properties | Reliability | – | – | – | I | A | |
Measurement error | – | – | – | – | A | ||
Criterion validity | – | – | – | – | – | ||
Construct validity | Convergent validity | – | D | – | – | V | |
Known groups validity | V | – | – | – | – | ||
Responsiveness | Comparison with gold standard | – | – | – | – | – | |
Comparison with other instruments | – | – | – | – | V | ||
Comparison between subgroups | – | – | – | – | – | ||
Comparison before and after intervention | – | – | – | – | – |
Measurement properties of PROMs
PROMs measuring satisfaction with screening endoscopy
Questionnaire | Context of use | Measurement property | Methodolo-gical qualitya | Ratingb | Quality of Evidence | Recommen-dationc |
---|---|---|---|---|---|---|
CSSQP32 | Screening colonoscopy | Content validity | Doubtful | (+) Based on review ratings. Development and validation study not provide enough information to judge relevance, comprehensiveness or comprehensibility | Moderate Serious RoB (content validity and development study of doubtful quality) | A |
Structural validity | Adequate | (?) A confirmatory factor analysis was not conducted | * | |||
Internal consistency | Very good | (+) Cronbach’s alpha 0.86 (≥0.7) Spearman-Brown coefficient 0.85 | High No RoB | |||
Construct validity | Very good | (?) No hypothesis defined | High No RoB | |||
Patient Satisfaction Scale with Bowel Preparation33 | Bowel preparation | Content validity | Doubtful | (−) Relevance doubtful, comprehensiveness (−) and comprehensibility (−) as patients and professionals were not asked | Low Very serious RoB (no content validity study, development study of doubtful quality) | B |
Internal consistency | Doubtful | (+) Cronbach’s alpha 0.79 (≥0.70) | Low Very serious RoB (one study of doubtful quality) | |||
Construct validity | Doubtful | (?) Results in accordance with hypothesis, associated with narra-tives, but no correlations calculated | * | |||
Post-procedure questionnaire35 | Upper and lower endoscopy | Content validity | Doubtful | (+) Relevance, comprehensiveness and comprehensibility were (+) | Low Serious RoB (content validity and development study of doubtful quality) and indirectness | A |
Structural validity | Adequate | (?) No results of exploratory factor analysis | * | |||
Internal consistency | Very good | (+) Cronbach’s alpha ≥0.7 for 4 of 8 items analyzed | Low Serious RoB (one study of adequate quality) and indirectness | |||
SmGHAA-9 m34 | Upper and lower endoscopy | Content validity | Inadequate | (−) Relevance, comprehensiveness, and comprehensibility rated (−) | Very low Serious RoB (no content validity study and development study of inadequate quality). Indirectness | B |
Internal consistency | Doubtful | (+) Cronbach’s alpha ≥0.7 | Very low Very serious RoB (one study of doubtful quality) and indirectness | |||
Reliability | Inadequate | (+) Weighted kappa of 0.78 | Very low Extremely serious RoB (one study of inadequate quality) and indirectness | |||
Screening Flexible Sigmoidoscopy Assessment Questionnaire36 | Screening sigmoidoscopy | Content validity | Doubtful | (+/−) Relevance (+) by reviewers, comprehensiveness (−) and comprehensibility (+/−) | Low Serious RoB (content validity and development studies of doubtful quality) and indirectness | B |
Structural validity | Adequate | (?) Comparative fit index, Tucker-Lewis index, Root Mean Square Error of approximation or Standardized root mean residuals not reported | * | |||
Internal consistency | Very good | (+) Cronbach’s alpha 0.87 for overall satisfaction and 0.84 for pain and discomfort scale | Moderate No serious RoB but indirectness | |||
Reliability | Adequate | (+) Pearson correlation coefficient 0.82 (≥0.7) | Low Serious RoB (only one study of adequate quality) and indirectness | |||
Measurement error | Adequate | (?) Minimal important change not defined | * | |||
Construct validity | Very good | (?) Results in accordance with hypothesis and associated with narratives, but no correlations calculated | * | |||
Responsiveness | Very good | (+) responses in accordance to narratives | Moderate No RoB but indirectness |