A new tool to investigate anorectal disorders in patients with multiple sclerosis: STAR-Q.

Background. - Bowel symptoms are commonly experienced by patients with Multiple sclerosis( PwMS), but no specific questionnaire validated in this population allows a rigorous assessment. Objective. - Validation of a multidimensional questionnaire assessing bowel disorders in PwMS. Methods. - A prospective, multicenter study was conducted between April 2020 and April 2021. The STAR-Q (Symptoms' assessmenT of AnoRectal dysfunction Questionnaire), was built in 3steps. First, literature review and qualitative interviews were performed to create the firstversion, discussed with a panel of experts. Then, a pilot study assessed comprehension, acceptation and pertinence of items. Finally, the validation study was designed to measure contentvalidity, internal consistency reliability (alpha coefficient of Cronbach) and test-retest reliability [intraclass correlation coefficient (ICC)]. The primary outcome was good psychometricproperties with Cronbach's alpha > 0.7 and ICC > 0.7. Results. - We included 231 PwMS. Comprehension, acceptation and pertinence were good. STAR-Q showed a very good internal consistency reliability (Cronbach's alpha = 0.84) and testretest reliability (ICC = 0.89). Final version of STAR-Q was composed of 3 domains correspondingin symptoms (Q1-Q14), treatment and constraints (Q15-Q18) and impact on quality of life( Q19). Three categories of severity were determined (STAR-Q <= 16: minor, between 17 and 20: moderate, and = 21: severe). Conclusions. - STAR-Q presents very good psychometric properties and allows a multidimensional assessment of bowel disorders in PwMS. Level of evidence.- 2 (c) 2023 Elsevier Masson SAS. All rights reserved.