Validation of the acute kidney injury "Standardized Clinical Assessment and Management Plan" (SCAMP) Spanish translation to guide initiation of kidney replacement therapy.

Abstract

Background: Acute kidney injury (AKI) occurs in up to 50% of critically ill patients, often requiring kidney replacement therapy (KRT). The ideal time to start KRT is not fully standardized, and evidence stands controversial at this point. The overall prognosis of patients may be linked to the timing of KRT initiation. The AKI Standardized Clinical Assessment and Management Plan (SCAMP) tool supported the identification of a strategy to guide KRT decision making and improve clinical outcomes. However, its applicability is limited by the lack of validated translations to other languages.

Methods: We carried out a validation study of the Spanish-translated version of SCAMP, based on translation and cultural adaptation of Health Measurement Tools Guidelines. We developed a Spanish-translated version of SCAMP which was revised for clarity, relevance, and sufficiency of questions by an independent evaluator and applied to a standardized clinical case for validation by 105 practitioners.

Results: We assessed reliability, internal consistency, content and construct validity and feasibility of the performed translation. The Spanish translated AKI-SCAMP meets the criteria for reliability (Cronbach's alpha 0.75). Corrected item-total correlations revealed 18 variables with correlations < 0.3, necessitating individual domain analyses to determine which item needed modifications. Construct validity was evaluated through Main Component Analysis, identifying five optimal components, explaining 84.86% variance.

Conclusions: The Spanish translation of the AKI-SCAMP meets the criteria for reliability, reproducibility, content, and construct validity. This study demonstrated feasibility, as perceived by the evaluating physicians and robust psychometric characteristics in most items, allowing for its application across Spanish-speaking healthcare systems.