Development and validation of the Epilepsy Surgery Satisfaction Questionnaire (ESSQ‐19)

Abstract

Objective: No validated tools exist to assess satisfaction with epilepsy surgery. We aimed to develop and validate a new measure of patient satisfaction with epilepsy surgery, the 19-item Epilepsy Surgery Satisfaction Questionnaire (ESSQ-19). Methods: An initial 31-item measure was developed based on literature review, patient focus groups, thematic analysis, and Delphi panels. The questionnaire was administered twice, 4-6 weeks apart, to 229 adults (≥18 years old) who underwent epilepsy surgery ≥1 year earlier, at three centers in Canada and one in Sweden. Participants also completed seven validated questionnaires to assess construct validity. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed the factorial structure of the questionnaire. Cronbach alpha and intraclass correlation coefficients (ICCs) assessed the internal consistency and test-retest reliability of the ESSQ-19. Spearman and polyserial correlations assessed construct validity. Results: Median age of participants and time since surgery were 42 years (interquartile range [IQR] = 32-54) and 5 years (IQR = 2-8.75), respectively. EFA and CFA yielded 18 items that segregated into four domains (mean score [SD]), namely, seizure control (76.4 [25]), psychosocial functioning (67.3 [26]), surgical complications (84 [22]), and recovery from surgery (73 [24]), one global satisfaction item, and a summary global score (74 [21]). The domain and summary scores demonstrated good to excellent internal reliability (Cronbach ⍺ range = .84-.95) and test-retest reliability (ICC range = 0.71-0.85). Construct validity was supported by predicted correlations with other instruments. Significance: The ESSQ-19 is a new, valid, and reliable measure of patient satisfaction with epilepsy surgery that can be used in clinical and research settings.

The use of patient-reported measures in epilepsy care: the Calgary Comprehensive Epilepsy Program experience

“…The Treatment Satisfaction Questionnaire for Medication (TSQM) is a widely used PREM that was previously validated in a national panel study of chronic diseases [ 25 ]. In addition, this tool has been used to evaluate satisfaction with ASMs in medically [ 26 ] and surgically treated patients [ 25 ]. This patient-reported measure (PRM) is not considered a PROM as it does not assess outcomes.…”

“…Epilepsy surgery is a crucial, and potentially curative option for those with drug resistant epilepsy. However, until recently, we have not had a PREM for assessing a patient’s satisfaction with surgery [ 25 ]. Therefore, we developed the Epilepsy Surgery Satisfaction Questionnaire (ESSQ-19) [ 25 ].…”

“…However, until recently, we have not had a PREM for assessing a patient’s satisfaction with surgery [ 25 ]. Therefore, we developed the Epilepsy Surgery Satisfaction Questionnaire (ESSQ-19) [ 25 ]. Patients were recruited from three centers in Canada (Calgary, Montreal, and Saskatchewan) and one in Sweden (Gothenburg).…”

Predicting postoperative epilepsy surgery satisfaction in adults using the 19‐item Epilepsy Surgery Satisfaction Questionnaire and machine learning

“…We used data collected through the ESSQ-19 development and validation study. 11 Demographic and clinical data were collected in a standardized fashion at baseline. Demographics, medications, and questionnaires were completed through direct patient report.…”

“…The 19-item Epilepsy Surgery Satisfaction Questionnaire (ESSQ- 19) is a validated and reliable tool to evaluate patient satisfaction with epilepsy surgery. 11 It is a brief, self-administered instrument that has demonstrated utility in different settings across three different languages. Building on this, we postulate that ESSQ-19-based prediction models can be developed for use in the preoperative period by identifying features strongly associated with satisfaction and adjusting their values according to anticipated postoperative scenarios.…”