Clinical validation of the acute cystitis symptom score in the Kazakh language.

Abstract

Background: The Acute Cystitis Symptom Score (ACSS) is an internationally validated patient-reported outcome (PRO) tool for diagnosing and monitoring acute uncomplicated cystitis (AC) in women, available in several language versions. The current study reports the linguistic and clinical validation of the Kazakh version of the ACSS.

Methods: Linguistic validation followed internationally accepted guidelines for the cultural adaptation of PRO instruments. The current validation study included 100 Kazakhspeaking women. All respondents participated in cognitive debriefing to ensure clarity and comprehensibility of the translated PRO. Participants completed diagnostic Part A of the Kazakh version of the ACSS at initial admission and follow- up Part B at each follow-up visit. Descriptive statistics were used to summarise demographic characteristics. The comparative analysis included parametric and nonparametric tests where appropriate. Reliability of the Kazakh version of the ACSS was measured using Cronbach's alpha and splithalf reliability. Diagnostic performance was assessed by sensitivity and specificity. Statistical significance was set at p = 0.05.

Results: Sixty-seven women with AC (mean age 39.24 ± 13.66 years) and 33 without evidence of urinary tract pathology (mean age 44.94 ± 17.99 years) were included in the Patient and Control groups, respectively. No significant demographic differences were observed between groups. Median scores in the "Typical" domain were significantly higher in Patients than in Controls (5.00 vs 0.00). Internal consistency was high for the "Typical" (Cronbach's α = 0.86) and "QoL" (α = 0.91) domains. Split-half reliability analysis showed a correlation coefficient of 0.65, a Spearman-Brown coefficient of 0.79, and a Guttman split-half coefficient of 0.77. The sensitivity and specificity of the Kazakh version of the ACSS, using the predefined cut-off value of 6 based on the "Typical" domain summary score, were 0.85 and 0.90, respectively.

Conclusions: The Kazakh version of the ACSS demonstrates good reliability and strong discriminative ability, supporting its use in the clinical assessment of AC in Kazakh-speaking women.