Ecuadorian Spanish translation and validation of the VELO quality of life instrument.

TitleEcuadorian Spanish translation and validation of the VELO quality of life instrument.
Publication TypeJournal Article
Year of Publication2020
AuthorsRidgell L, Roth CT, Bow M, Hares-Helou R, Arias KMayorga, Pollard SHatch, Hamdan U, Tollefson TT, Skirko JR
JournalInt J Pediatr Otorhinolaryngol
Date Published2020 Nov
KeywordsAdolescent, Child, Child, Preschool, Cross-Sectional Studies, Ecuador, Female, Humans, Male, Prospective Studies, Psychometrics, Quality of Life, Reproducibility of Results, Surveys and Questionnaires, Velopharyngeal Insufficiency

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.

Alternate JournalInt J Pediatr Otorhinolaryngol
PubMed ID32882600
PubMed Central IDPMC7649090
Grant ListUL1 TR000105 / TR / NCATS NIH HHS / United States
UL1 TR002538 / TR / NCATS NIH HHS / United States
Faculty Reference: 
Jonathan Skirko, MD, MHPA, MPH