title: External validation of the SF-36 quality-of-life questionnaire in Italian and Brazilian populations to select patients with colorectal endometriosis for surgery.
abstract: OBJECTIVE
  To evaluate the external validity of the validated French model of the quality-of-life questionnaire (QOL) SF-36 in predicting improvement after colorectal resection for endometriosis.
  
  
  METHODS
  Italian and Brazilian cohort studies (Canadian Task Force classification II-3).
  
  
  METHODS
  Tertiary referral university hospital in Brazil and expert center in endometriosis in Italy.
  
  
  METHODS
  Patients with colorectal endometriosis from an Italian population (n = 63) and a Brazilian population (n = 151).
  
  
  METHODS
  Laparoscopic colorectal resection for treatment of endometriosis.
  
  
  RESULTS
  Preoperative and postoperative evaluations of the Physical Component Summary (PCS) and the Mental Component Summary (MCS) of the SF-36 were performed. Substantial improvement in PCS and MCS was observed after colorectal resection in both populations. In the Brazilian population, the receiver operating curve (ROC) (area under the curve [AUC]) was 0.83 (95% confidence interval [CI], 0.77-0.89) for MCS and 0.78 (95% CI, 0.71-0.83) for PCS, demonstrating good discrimination performance. The mean difference between the predicted and calibrated probabilities was 19.6% for MCS and 32.8% for PCS. In the Italian population, the ROC curve (AUC) was 0.65 (95% CI, 0.52-0.78) for PCS and 0.67 (95% CI, 0.55-0.78) for MCS. The model demonstrated poor discrimination and calibration performance for PCS (p < .001) and MCS (p = .003). The mean difference between the predicted and calibrated probabilities was 17.5% for MCS and 21.8% for PCS.
  
  
  CONCLUSIONS
  Despite the use of validated translations of the SF-36, our results underline the limits of this tool in selection of patients for colorectal resection due to underestimation of predicted quality of life, possibly because of variations in epidemiologic characteristics of the populations.
authors.affiliation: Department of Obstetrics and Gynecology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie Paris VI, Paris, France.
authors.forename: Enora
authors.initials: E
authors.lastname: Laas
authors.affiliation: Department of Obstetrics and Gynecology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie Paris VI, Paris, France.
authors.forename: Chrysoula
authors.initials: C
authors.lastname: Zacharopoulou
authors.affiliation: Minimally Invasive Gynaecological Surgery Unit, S'ant Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Montanari
authors.affiliation: Minimally Invasive Gynaecological Surgery Unit, S'ant Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Seracchioli
authors.affiliation: Department of Obstetrics and Gynecology, University of São Paulo Medical School, Sirio Libanes Hospital, São Paulo, Brazil.
authors.forename: Mauricio S
authors.initials: MS
authors.lastname: Abrão
authors.affiliation: Department of Obstetrics and Gynecology, University of São Paulo Medical School, Sirio Libanes Hospital, São Paulo, Brazil.
authors.forename: Marco A
authors.initials: MA
authors.lastname: Bassi
authors.affiliation: Department of Obstetrics and Gynecology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie Paris VI, Paris, France.
authors.forename: Marcos
authors.initials: M
authors.lastname: Ballester
authors.affiliation: Department of Obstetrics and Gynecology, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie Paris VI, Paris, France. Electronic address: emile.darai@tnn.aphp.fr.
authors.forename: Emile
authors.initials: E
authors.lastname: Daraï
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D003082:Colectomy; D003106:Colon / Q000473:pathology* / Q000601:surgery; D003108:Colonic Diseases / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery; D004715:Endometriosis / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011184:Postoperative Period; D011788:Quality of Life / Q000523:psychology; D012002:Rectal Diseases / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery; D012007:Rectum / Q000473:pathology* / Q000601:surgery; D018570:Risk Assessment; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards; D016896:Treatment Outcome
keywords: Colorectal resection; Endometriosis; Quality-of-life questionnaire; SF-36