title: Validity and reliability of a Lithuanian version of low anterior resection syndrome score.
abstract: BACKGROUND
  Up to 90 % of patients undergoing low anterior resection complain of increased daily bowel movements, urgency, and a variable degree of incontinence. A symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer has recently been developed and validated. The aim of our study was to adapt the low anterior resection syndrome (LARS) scale questionnaire to the Lithuanian language, and assess its psychometric properties.
  
  
  METHODS
  The LARS questionnaire was translated into Lithuanian by the Scientific Advisory Committee of the Medical Outcomes Trust using a standard procedure of double-back translation. The Lithuanian version of the LARS (LARS-LT) questionnaire was completed by 111 patients who underwent low anterior resection with total mesorectal excision in the period from January 1, 2008, to December 31, 2012, at the National Cancer Institute. An anchor question from the Wexner score assessing the impact of bowel function on lifestyle was included. A subgroup of 20 patients completed the LARS-LT questionnaire twice. Validity was tested using a factor analysis, and internal reliability was estimated using the Cronbach's alpha and intraclass correlation coefficients.
  
  
  RESULTS
  Twenty-seven patients (25 %) had no LARS, 26 (24 %) had minor LARS, and 55 (56 %) had major LARS. The response rate was 60.7 %. The LARS-LT showed significantly high reliability and internal consistency [Cronbach's α = 0.88, interclass correlation coefficient-0.86 (0.71-0.98)]. The LARS score showed significant correlations with the lifestyle question (p < 0.05). It could not detect differences between female and male patient groups (p = 0.33), patients' age (p = 0.45), patients who had/had not undergone radiation therapy (p = 0.07), and those in whom the distal edge of the tumor was close to or far from the anal verge (p = 0.17).
  
  
  CONCLUSIONS
  The Lithuanian version of the LARS-LT shows acceptable psychometric properties and can be considered a valuable and specific instrument to assess bowel function in rectal cancer patients, both for research purposes and in clinical practice.
authors.affiliation: Faculty of Medicine, Centre of Oncosurgery, National Cancer Institute, Clinic of Internal, Family Medicine and Oncology, Vilnius University, Vilnius, Lithuania.|Centre of Oncosurgery, National Cancer Institute, 1 Santariskiu Str., 08406, Vilnius, Lithuania.
authors.forename: N E
authors.initials: NE
authors.lastname: Samalavicius
authors.affiliation: Centre of Oncosurgery, National Cancer Institute, 1 Santariskiu Str., 08406, Vilnius, Lithuania. audrius.dulskas@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Dulskas
authors.affiliation: Centre of Oncosurgery, National Cancer Institute, 1 Santariskiu Str., 08406, Vilnius, Lithuania.
authors.forename: M
authors.initials: M
authors.lastname: Lasinskas
authors.affiliation: Centre of Cancer Control and Prevention, National Cancer Institute, Vilnius, Lithuania.
authors.forename: G
authors.initials: G
authors.lastname: Smailyte
mesh_terms: D000368:Aged; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005242:Fecal Incontinence / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D007422:Intestines / Q000503:physiopathology; D008097:Lithuania; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D011594:Psychometrics; D012004:Rectal Neoplasms / Q000523:psychology / Q000601:surgery*; D012007:Rectum / Q000503:physiopathology / Q000601:surgery; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*; D013577:Syndrome
keywords: LARS score; Low anterior resection; Low anterior resection syndrome; Wexner score, TME