Creation and Validation of the Harmonized Arabic Version of the Expanded Practice Index Composite for Clinical Practice (EPIC-CP)
Mohannad Awad, MD1, Luke Hallgarth, MD1, Ghassan Barayan, MD1, Mohammed Shahait, MD2, Ramiz Abu-Hijlih, MD2, Ala'a Farkouh, MD2, Raed Azhar, MD3, Musab Alghmadi, MD3, Ahmad Bugis, MD3, Said Yaiesh, MD4, Saad Aldousari, MD5, Alaeddin Barham, MD6, Mohamed Saed, MD6, Ayman Moussa, MD6, Waleed Hassen, MD6, Shelly Naud, MS, PhD7, Mark Plante, MD1, Richard Grunert, MD1.
1University of Vermont Medical Center, BURLINGTON, VT, USA, 2King Hussein Cancer Center, Amman, Jordan, 3King Abdulaziz University, Jeddah, Saudi Arabia, 4Mubarak Al-Kabeer Hospital, Kuwait, Kuwait, 5Kuwait University, Kuwait, Kuwait, 6Surgical Subspecialties Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates, 7University of Vermont, BURLINGTON, VT, USA.
BACKGROUND: The Expanded Practice Index Composite for Clinical Practice (EPIC-CP) is a validated patient reported outcome (PRO) widely used for assessing the quality of life in prostate cancer (PCa) patients. It is used internationally and has been translated and, in turn, validated into several languages in addition to English. Our goal from this study was to create and validate a translated Arabic version of the EPIC-CP.
METHODS: Using the established protocol as defined by the Professional Society for the Health Economics and Outcomes Research (ISPOR) for translating patient care questionnaires, a harmonized translated Arabic version of EPIC-CP was created. The questionnaire was tested in native Arabic speakers from 4 different Arabic countries (Saudi Arabia, United Arab Emirates, Jordan and Kuwait). Cronbach’s alpha and interclass coefficient correlations (ICC) analyses were used to test the internal consistency and test-retest reliability, respectively. In addition, PCa characteristics were collected for participants.
RESULTS: In total, 168 PCa patients participated in the study (39 from Saudi Arabia, 23 from United Arab Emirates, 65 from Jordan, and 41 from Kuwait). Fifty-two (31%) participants repeated the questionnaire for test-retest reliability analysis. The median age of patients included in the study was 66 (IQR 61-71). Median PSA was 9.8 (IQR 6-19). Most patients had grade group 2 PCa at diagnosis (31%), clinical stage cT1 (42%), managed primarily by urology (79%), and primary treatment was radical prostatectomy (71%). The total Cronbach’s alpha coefficient was 0.84 demonstrating an acceptable internal consistency. The total ICC was also acceptable at 0.64.
CONCLUSIONS: The Arabic version of the EPIC-CP is reliable and valid tool for assessing health-related quality of life for Arabic PCa patients. To our knowledge this is the first generated Arabic template of any EPIC version, therefore filling a major need in the Arabic community where PCa rates have risen over the previous decades.
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