Development and Preliminary Testing of the Staffordshire Questionnaire for Adolescent Idiopathic Scoliosis (SQ-AIS): Content and Face Validity

Abstract

Introduction: Adolescent Idiopathic Scoliosis (AIS) is a structural spinal deformity with implications for health-related quality of life (HR-QoL). The Scoliosis Research Society-22 revised (SRS-22r) questionnaire is the standard for HR-QoL assessment. However, studies have identified limitations with the SRS-22r, including content and face validity issues, reliability concerns, and language appropriateness. This study aimed to develop and validate a patient-reported questionnaire, the Staffordshire Questionnaire for Adolescent Idiopathic Scoliosis (SQ-AIS), to assess the impact of AIS on HR-QoL. Methods: The SQ-AIS comprises six domains: general health, pain, function/activity, self-image/appearance, mental health, and intervention. Individuals with AIS aged 10–19 years and clinicians from a range of countries with expertise in AIS contributed to the testing process. Face validity and clinical applicability were assessed using Likert scales, while content validity was evaluated through a categorical binary variable (yes/no). Results: Involving 8 AIS patients and 43 clinicians, face validity scores demonstrated an acceptable level of understanding (≥ 4/5) for both individuals with AIS and clinicians. Most individuals with AIS (85.71%) and clinicians (80.95%) affirmed that the questionnaire sufficiently covers various aspects of scoliosis, indicating a satisfactory level of content validity. Ratings for applicability to clinical practice indicated an acceptable level of practical relevance (≥ 4/5). Discussion and Conclusion: The SQ-AIS emerges as a valid and promising tool to overcome existing challenges in AIS-related outcome assessment. Pending further validation studies, the favorable reception from the international community of clinicians suggests its potential as a new benchmark for evaluating AIS impact on HR-QoL and monitoring scoliosis management.