title: Validation of a Dutch version of the Actionable 8-item screening questionnaire for neurogenic bladder overactivity in multiple sclerosis: an observational web-based study.
abstract: BACKGROUND
  In patients with multiple sclerosis (MS) the impact of urological symptoms on quality of life and daily activities is considerable. Yet, a substantial percentage of patients may not be urologically evaluated and thus fail to be treated concordantly. The 8-item Actionable questionnaire is a validated English screening tool for the detection of neurogenic bladder overactivity in MS. To enable the use of the 8-item Actionable in The Netherlands and Belgium we translated the questionnaire into the Dutch language and investigated the test-retest reliability and the concurrent validity of the Dutch version.
  
  
  METHODS
  The process of translating the English Actionable questionnaire into the Dutch language included forward translations and back-translations. Then, in an online observational study, MS patients completed the Dutch Actionable at Days 1 and 8, and the Multiple Sclerosis Quality of Life 54-Items (MSQoL-54) and Multiple Sclerosis Impact Profile (MSIP) questionnaires at Day 1; the Expanded Disability Status Scale (EDSS) score was assessed by phone at Day 1. For assessment of the test-retest reliability Pearson's correlation coefficient (r) between the Day 1 and Day 8 Actionable scores was calculated. For assessment of the concurrent validity r values were calculated between the Day 1 Actionable score and the EDSS score, the Physical and Mental MSQoL-54 composites, and the MSIP domain and symptom disability scores.
  
  
  RESULTS
  
  
  
  METHODS
  N = 141 (106 female, 35 male) (80 relapsing remitting, 48 progressive, 13 unknown), mean age 47.8 (standard deviation [SD] 10.4) years, mean EDSS score 4.7 (SD 1.8); 137 patients completed the Day 8 assessment. Pearson's r between Actionable scores Day 1 and Day 8: 0.85 (P < .0001). Pearson's r between Actionable score Day 1 and scores for EDSS 0.41 (P < 0.0001), MSQoL-54 Physical -0.31 (P = 0.0002), MSQoL-54 Mental -0.29 (P = 0.0005), MSIP Excretion and Reproductive Functions 0.44 (P < 0.0001), Muscle and Movement Functions 0.39 (P < .0001), Basic Movement Activities 0.37 (P < 0.0001), Activities of Daily Living 0.32 (P < 0.0001), Participation in Life Situations 0.29 (P = 0.0006) and Mental Functions 0.20 (P = 0.0189).
  
  
  CONCLUSIONS
  The Dutch version of the Actionable urological screening tool for MS shows a good test-retest reliability and a good concurrent validity with disabilities and HRQoL.
authors.affiliation: Department of Community and Occupational Medicine, University Medical Centre Groningen, University Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands. p.j.h.jongen@rug.nl.|MS4 Research Institute, Ubbergseweg 34, 6522 KJ, Nijmegen, The Netherlands. p.j.h.jongen@rug.nl.
authors.forename: Peter Joseph
authors.initials: PJ
authors.lastname: Jongen
authors.affiliation: Department of Urology, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. b.blok@erasmusmc.nl.
authors.forename: Bertil F M
authors.initials: BF
authors.lastname: Blok
authors.affiliation: Department of Urology, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. John.Heesakkers@radboudumc.nl.
authors.forename: John P
authors.initials: JP
authors.lastname: Heesakkers
authors.affiliation: MH-Advies and Organisatiebureau, IJselstraat 81, 9406 TR, Assen, The Netherlands. m.a.p.heerings@gmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Heerings
authors.affiliation: Department for Health Evidence, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Wim.Lemmens@radboudumc.nl.
authors.forename: Wim A
authors.initials: WA
authors.lastname: Lemmens
authors.affiliation: Department for Health Evidence, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Rogier.Donders@radboudumc.nl.
authors.forename: Rogier
authors.initials: R
authors.lastname: Donders
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001530:Belgium; D006233:Persons with Disabilities; D005006:Ethnicity; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D009426:Netherlands; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014177:Translations; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis* / Q000209:etiology*