title: Vancouver Symptom Score for Dysfunctional Elimination Syndrome: Reliability and Validity of the Dutch Version.
abstract: OBJECTIVE
  We sought to establish the reliability and validity of the Dutch version of the Vancouver Symptom Score for Dysfunctional Elimination Syndrome for children with dysfunctional voiding and their parents.
  
  
  METHODS
  For this cross-sectional multicenter study the Vancouver Symptom Score for Dysfunctional Elimination Syndrome was translated and cross-culturally adapted to Dutch following a standardized process. Patients 16 years or younger with dysfunctional voiding and their parents were recruited at pediatric, pediatric urology and pelvic floor physical therapy outpatient clinics. The reference group consisted of children 6 to 16 years old without dysfunctional voiding and their parents. All groups completed questionnaires. The evaluated measurement properties included discriminative ability, internal consistency, test-retest reliability, interrater agreement, criterion validity using the Pediatric Incontinence Questionnaire and construct validity. A cutoff value for diagnosis of dysfunctional voiding was determined.
  
  
  RESULTS
  A total of 50 patients and 60 references and their parents were included in the study. The Vancouver Symptom Score for Dysfunctional Elimination Syndrome showed good discriminative ability. A moderate internal consistency was found (Cronbach alpha 0.37-0.55). Test-retest reliability was moderate to good, and interrater agreement demonstrated good correlation between children and parents (ICC 0.85, 95% CI 0.79-0.89). A weak correlation with the Pediatric Incontinence Questionnaire was found in patients and construct validity was confirmed. Cutoff scores for dysfunctional voiding were 11 and 9 for patients and parents, respectively.
  
  
  CONCLUSIONS
  The Dutch Vancouver Symptom Score for Dysfunctional Elimination Syndrome displayed moderate to good reliability and validity properties for the patient and parent versions. Use of this instrument in clinical practice will support the assessment of dysfunctional voiding and facilitate international reporting of research results.
authors.affiliation: Department of Urology and Pediatric Urology, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: l.thoen@erasmusmc.nl.
authors.forename: Lisette A
authors.initials: LA
authors.lastname: 't Hoen
authors.affiliation: Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Ida J
authors.initials: IJ
authors.lastname: Korfage
authors.affiliation: Department of Pediatrics, Franciscus Gasthuis and Vlietland, Rotterdam, The Netherlands.
authors.forename: Jacintha T C M
authors.initials: JT
authors.lastname: Verhallen
authors.affiliation: Department of Pediatrics, Van Weel Bethesda Hospital, Dirksland, The Netherlands.
authors.forename: Marjan J
authors.initials: MJ
authors.lastname: van Ledden-Klok
authors.affiliation: Department of Urology and Pediatric Urology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Joop
authors.initials: J
authors.lastname: van den Hoek
authors.affiliation: Department of Urology and Pediatric Urology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Bertil F M
authors.initials: BF
authors.lastname: Blok
authors.affiliation: Department of Urology and Pediatric Urology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Jeroen R
authors.initials: JR
authors.lastname: Scheepe
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D011446:Prospective Studies; D011594:Psychometrics; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014177:Translations; D014555:Urination Disorders / Q000175:diagnosis*
keywords: pediatrics; surveys and questionnaires; urination disorders