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Validation of an obstetric quality of recovery scoring tool (ObsQoR-11) after emergency cesarean delivery
Abstract Number: S4B-5
Abstract Type: Original Research
Introduction: Few robust scoring systems exist to assess recovery following caesarean delivery (CD). We tested a new obstetric quality of recovery scoring tool (ObsQoR-11 - Figure 1) that was originally formulated for elective CD. We present an interim analysis of validation of the ObsQoR-11 following emergency CD.
Methods: The ObsQoR-11 was used in a service evaluation of women who underwent emergency CD. The questionnaire was given to women at 24 and 25 hrs post-delivery. Primary outcome was validity as assessed by: (1) convergent validity (correlation with 100 mm visual analogue scale (VAS) of general health status); (2) discriminant validity (correlation of good and poor recovery, as defined by global VAS of ≥70 versus <70, respectively); and (3) content validity (correlation with length of stay (LOS), blood loss during surgery and maternal age). Secondary outcomes were: reliability (internal consistency measured by Cronbach’s alpha and inter-item correlation and test-retest reliability measured by intra-class correlation) and feasibility (completion rate and time for completion). Data is presented as mean (SD) or median [IQR] as appropriate.
Results: All respondents approached completed the ObsQoR-11 at 24 (77/77) and 25 hrs (12/12). The ObsQoR-11 scores: (1) correlated to VAS (Pearson r=0.63 [0.47, 0.75]; p<0.0001); (2) were significantly higher in women with “good” recovery (mean scores 64.4 (3.37) and 90.76 (2.35) for VAS<70 and ≥70 respectively; p<0.0001); and (3) did not correlate with clinical indicators (LOS r=-0.15, p=0.182; blood loss r=-0.072; p=0.531; age r=0.098, p=0.40). Test reliability was good (Cronbach’s alpha=0.798; inter-item correlation >0.15 in >80% items and intra-class correlation >0.6 for all items) and no floor or ceiling effects (0% highest or lowest scores) were observed. Feasibility was also good as there was 100% rate of successful completion and time to completion was 117.5 secs [90, 169.5; n=34].
Discussion: Interim analysis reveals the ObsQoR-11 to be a valid and reliable tool to assess post-operative recovery after emergency CD. To complete our validation, we aim to evaluate 100 women.
1. Ciechanowicz S et al. Development and validation of an obstetric 'quality of recovery' scoring tool (ObsQoR). Poster presented at 2017 SOAP meeting, Bellevue, Washington
2. McDowell I. Measuring health: A guide to rating scales and questionnaires. 3rd Edition: New York: Oxford University Press, 2006