title: Development and validation of a patient self-assessed questionnaire on satisfaction with communication of the multiple sclerosis diagnosis.
abstract: BACKGROUND
  We describe the development and clinical validation of a patient self-administered tool assessing the quality of multiple sclerosis diagnosis disclosure.
  
  
  METHODS
  A multiple sclerosis expert panel generated questionnaire items from the Doctor's Interpersonal Skills Questionnaire, literature review, and interviews with neurology inpatients. The resulting 19-item Comunicazione medico-paziente nella Sclerosi Multipla (COSM) was pilot tested/debriefed on seven patients with multiple sclerosis and administered to 80 patients newly diagnosed with multiple sclerosis. The resulting revised 20-item version (COSM-R) was debriefed on five patients with multiple sclerosis, field tested/debriefed on multiple sclerosis patients, and field tested on 105 patients newly diagnosed with multiple sclerosis participating in a clinical trial on an information aid. The hypothesized monofactorial structure of COSM-R section 2 was tested on the latter two groups.
  
  
  RESULTS
  The questionnaire was well accepted. Scaling assumptions were satisfactory in terms of score distributions, item-total correlations and internal consistency. Factor analysis confirmed section 2's monofactorial structure, which was also test-retest reliable (intraclass correlation coefficient [ICC] 0.73; 95% CI 0.54-0.85). Section 1 had only fair test-retest reliability (ICC 0.45; 95% CI 0.12-0.69), and three items had 8-21% missed responses.
  
  
  CONCLUSIONS
  COSM-R is a brief, easy-to-interpret MS-specific questionnaire for use as a health care indicator.
authors.affiliation: Neuroepidemiology Unit, Foundation IRCCS Neurological Institute C. Besta, Milan, Italy. solari@istituto-besta.it
authors.forename: A
authors.initials: A
authors.lastname: Solari
authors.forename: K
authors.initials: K
authors.lastname: Mattarozzi
authors.forename: L
authors.initials: L
authors.lastname: Vignatelli
authors.forename: A
authors.initials: A
authors.lastname: Giordano
authors.forename: P M
authors.initials: PM
authors.lastname: Russo
authors.forename: M Messmer
authors.initials: MM
authors.lastname: Uccelli
authors.forename: R
authors.initials: R
authors.lastname: D'Alessandro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003071:Cognition / Q000502:physiology; D003142:Communication; D018450:Disease Progression; D042241:Early Diagnosis; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000523:psychology*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult