Alexandre Danilovic, Daniel Gabriele Sucupira, Oliver Wiseman, Fabio Cesar Miranda Torricelli, Giovanni Scala Marchini, Carlos Batagello, Rodrigo Perrela, Fabio Carvalho Vicentini, William C Nahas, Eduardo Mazzucchi
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Abstract
Purpose: There is currently no validated instrument in Brazil specifically designed to assess the quality of life (QoL) of patients with ureteral stones. The Cambridge Ureteral Stone Patient-Reported Outcome Measure (CUSP) is a self-administered questionnaire that evaluates the QoL impact of ureteral stones over the preceding seven days. This study aimed to translate, culturally adapt, and validate the CUSP for Brazilian Portuguese (Br-CUSP) for clinical and research applications.
Materials and methods: The CUSP questionnaire was translated into Portuguese according to Guillemin's cross-cultural adaption guidelines. Patients with and without ureterolithiasis completed both the Br-CUSP and SF-12 questionnaires. Psychometric validation included assessment of internal consistency, test-retest reliability, convergent validity, and discriminant validity.
Results: A total of 156 participants completed both questionnaires. No inconsistencies emerged during univariate analysis. Confirmatory factor analysis supported the six-factor model with satisfactory fit indices. All factor loadings exceeded 0.50. Internal consistency was high across all domains (Cronbach's α = 0.72 - 0.98; McDonald's ω = 0.73 - 0.98). Test-retest reliability demonstrated strong temporal stability. Inter-domain correlations (Spearman's p = 0.45 - 0.82) supported structural coherence. Convergent validity was confirmed through inverse correlations with SF-12 scores. Discriminant validity was demonstrated by significant score differences between patients with and without ureteral stone, with large effect sizes.
Conclusions: The Brazilian Cambridge Ureteral Stone Patient-Reported Outcome Measure is a valid, reliable tool for assessing health-related quality of life in Brazilian patients with ureteral stones. Its implementation can enhance both clinical assessment and research into patient-centered outcomes in urolithiasis.
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