Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Cut-off Scores for International Consultation on Incontinence Modular Questionnaire on Vaginal Symptoms (ICIQ-VS) in Sinhala and Tamil(Sri Lanka College of Obstetricians & Gynaecologists, 2017) Amarasekara, A.M.A.K.G.; Ekanayake, C.D.; Pathmeswaran, A.; Wijesinghe, P.S.; Liyanage, L.L.C.; Kulasinghe, I.R.M.M.; Perera, H.S.S.INTRODUCTION: It is clinically beneficial to have cut-off scores for screening questionnaires, above which a patient can be referred for further evaluation at a specialist center especially in developing countries. OBJECTIVE: To calculate cut off scores for ICIQ-VS-Sinhala and ICIQ-VS- Tamil questionnaires. METHODS: The ICIQ-VS- Sinhala and ICIQ-VS-Tamil was administered to women attending the gynaecology clinics at North Colombo teaching hospital, Ragama, District General hospitals, Mannar and Vavuniya. The vaginal symptoms score (VSS), sexual symptoms score (SSS) and the quality of life score (QoL) were analysed against the clinician’s diagnosis of significant prolapse using receiver operating characteristic curves (ROC). Results: The AUC (area under curve) for ROC curves of VSS, SSS and QoL for ICIQ-VS-Sinhala were 0.89 (p<0.001), 0.64 (p<0.02) and 0.75 (p<0.001) respectively. The AUC for ROC curves VSS, SSS and QoL of ICIQ-VS-Tamil were 0.88 (p<0.001), 0.70 (p<0.02) and 0.82 (p<0.001) respectively. The optimal MCIDs for ICIQ-VS-Sinhala were VSS ≥≥ 8 (sensitivity 88.1%, specificity 73.9%), SSS ≥ 1 (sensitivity 59%, specificity 65%), QoL ≥ 3 (sensitivity 77.8%, specificity 60.4%) while for ICIQ-VS-Tamil VSS ≥ 9 (sensitivity 87.1%, specificity 80.9%), SSS ≥ 1 (sensitivity 76.5%, specificity 61.1%) and QoL ≥3 (sensitivity 77.8%, specificity 79.8%). CONCLUSION: Both questionnaires yielded promising cut off scores for VSS, SSS and QoL. Cut-off scores of VSS ≥9, SSS ≥1 and QoL≥3 for ICIQ-VS-Tamil and VSS ≥8, SSS ≥1 and QoL ≥3 for ICIQ-VS-Sinhala can be used as a guide for specialist referral when using ICIQ-VS to screen for pelvic floor dysfunction in Sri Lanka.Item Validation of the Sinhala translation of the International Consultation on Incontinence modular Questionnaire on Vaginal Symptoms (ICIQ-VS)(Sri Lanka College of Obstetricians & Gynaecologists, 2016) Ekanayake, C.D.; Patabendige, M.; Wijesinghe, P.S.; Pathmeswaran, A.; Herath, R.P.; Weerasinghe, N.OBJECTIVE: To translate and validate the International Consultation on Incontinence Modular Questionnaire on vaginal symptoms (ICIQ VS) from English to Sinhala. METHOD: ICIQ-VS questionnaire was translated to Sinhala and a validation study was carried out among women attending the gynaecology clinic at North Colombo teaching hospital, Ragama. RESULTS: Basic demographic characteristics of women with prolapse (n=64) versus women without prolapse (n=135) were as follows; Age 55.8 (SD 13.1) years, median parity 2.5 (IQ1- IQ3=2-4), BMI 23.8 kg/m2 (SD 3.2) versus age 42.6 (SD 13.1), median parity 2 (IQ1-IQ3=1-3), BMI 23.2 kg/m2 (SD 2.9) respectively. Content validity was assessed by the level of missing data which was less than 1% for each item. Internal consistency was assessed using Cronbach’s coefficient alpha scores which ranged from 0.75 to 0.78. Test–retest reliability as assessed by kappa values ranged from 0.54 to 0.80, except for item, ‘vagina too tight’ which demonstrated moderate reliability (kappa 0.41). Construct validity was assessed by the ability of the questionnaire to differentiate between patients and controls. The questionnaire differentiated between patients and controls on vaginal symptoms score (VSS) (p<0.001), sexual symptoms score (SSS) (p<0.05) and quality of life (p<0.001). There was a positive correlation between pelvic organ prolapse quantification system (POP-Q) scores and VSS (rs= 0.61, p<0.001), SSS (rs = 0.22, p<0.01) and quality of life (rs = 0.52, p<0.001). CONCLUSION: The preliminary results for ICI Q VS (Sinhala) validation are satisfactory and once completed it will be invaluable to objectively assess vaginal and sexual symptoms in Sinhala speaking population in Sri Lanka.Item Validation of the international consultation on incontinence questionnaire-vaginal symptoms (ICIQ-VS) in two South- Asian languages(Springer, 2017) Ekanayake, C.D.; Pathmeswaran, A.; Herath, R.P.; Perera, H.S.; Patabendige, M.; Wijesinghe, P.S.INTRODUCTION: The multifaceted nature of pelvic floor disorders means that a systematic evaluation is required for optimal treatment outcome. It is also generally acknowledged that a valid tool is necessary to objectively assess symptoms reported by affected women. METHODS: The International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS) questionnaire was translated to Sinhala and Tamil and a validation study carried out among women attending gynecology clinics at North Colombo Teaching Hospital, Ragama, and the district general hospitals Mannar and Vavuniya. RESULTS: Content validity was assessed by the level of missing answers, which was < 4% and 2% for each item in Sinhala and Tamil, respectively. Construct validity was assessed by the ability of the questionnaire to differentiate between patients and controls. Both differentiated patients from controls on vaginal symptoms score (VSS) (p < 0.001), sexual symptoms score (SSS) (p < 0.01), and quality of life (QoL) (p < 0.001). There was a strong positive correlation between Pelvic Organ Prolapse Quantification (POP-Q) scores and VSS (Sinhala r s = 0.64, p < 0.001, Tamil r s = 0.65, p < 0.001), and QoL (Sinhala r s = 0.49, p < 0.001, Tamil r s = 0.60, p < 0.001). Internal consistency as assessed using Cronbach's coefficient alpha: 0.78 (0.76-0.78) and 0.83 (0.80-0.84) in Sinhala and Tamil, respectively. Test-retest reliability was assessed by weighted kappa scores (Sinhala 0.58-0.88 and Tamil 0.76-0.90). Both questionnaires were sensitive to change and showed that VSS and QoL improved following surgery (Wilcoxon matched-pairs signed-rank test p < 0.001). CONCLUSION: The validated Sinhala and Tamil translations of ICIQ-VS will be useful for assessing vaginal and sexual symptoms among women speaking Sinhala and Tamil.