title: International validation of the low anterior resection syndrome score.
abstract: OBJECTIVE
  The aims of this study were to investigate the convergent and discriminative validity and reliability of the low anterior resection syndrome (LARS) score in an international setting.
  
  
  BACKGROUND
  The LARS score is a simple self-administered questionnaire measuring bowel dysfunction after rectal cancer surgery. The score is intended to be commonly used in international research and clinical practice in the future. Therefore, a thorough validation in an international setting is of utmost importance.
  
  
  METHODS
  The LARS score was translated using methods in keeping with current international recommendations. A total of 801 patients operated for rectal cancer in Sweden, Spain, Germany, and Denmark completed the LARS score questionnaire, including an anchor question assessing the impact of bowel function on quality of life. A subgroup of 218 patients completed the LARS score twice. Data were analyzed per country.
  
  
  RESULTS
  The LARS score has demonstrated a high convergent validity in terms of a high correlation between LARS score and quality of life (P < 0.001). Sensitivity ranged from 67.7% to 88.3% and specificity from 58.1% to 86.3%. The LARS score was able to discriminate between groups of patients differing with regard to radiotherapy, surgery, and age (P < 0.05). The score also demonstrated high reliability at test-retest with narrow limits of agreement and no statistically significant difference between scores at the first and second test.
  
  
  CONCLUSIONS
  The Swedish, Spanish, German, and Danish versions of the LARS score have proven to be valid and reliable tools for measuring LARS in European rectal cancer patients.
authors.affiliation: *Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark †General and Digestive Surgery, Colorectal Unit, Bellvitge University Hospital, Barcelona, Spain ‡Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden §Hospital Valle de Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain ‖Department of Surgery, University Erlangen, Erlangen, Germany.
authors.forename: Therese
authors.initials: T
authors.lastname: Juul
authors.forename: Madelene
authors.initials: M
authors.lastname: Ahlberg
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Biondo
authors.forename: Katrine Jøssing
authors.initials: KJ
authors.lastname: Emmertsen
authors.forename: Eloy
authors.initials: E
authors.lastname: Espin
authors.forename: Luis Miguel
authors.initials: LM
authors.lastname: Jimenez
authors.forename: Klaus E
authors.initials: KE
authors.lastname: Matzel
authors.forename: Gabriella
authors.initials: G
authors.lastname: Palmer
authors.forename: Anna
authors.initials: A
authors.lastname: Sauermann
authors.forename: Loris
authors.initials: L
authors.lastname: Trenti
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Søren
authors.initials: S
authors.lastname: Laurberg
authors.forename: Peter
authors.initials: P
authors.lastname: Christensen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003248:Constipation / Q000175:diagnosis* / Q000209:etiology; D003718:Denmark; D005242:Fecal Incontinence / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013030:Spain; D011795:Surveys and Questionnaires; D013548:Sweden; D013577:Syndrome; D014175:Translating; D055815:Young Adult