Development of the BODY-Q Chest Module Evaluating Outcomes following Chest Contouring Surgery

Abstract

Background: Plastic surgery to improve chest appearance is becoming increasingly popular. The BODY-Q is a patient-reported outcome instrument designed for weight loss and/or body contouring. In this article, the authors describe the development of a new module for masculinizing chest contouring surgery. Methods: Qualitative methods were used to develop the BODY-Q Chest Module, which was subsequently field-tested in Canada, the United States, The Netherlands, and Denmark between June of 2016 and June of 2017. Participants were aged 16 years or older and seen for gynecomastia, weight loss, or transman chest surgery. Data were collected using either a Web-based application or paper questionnaire. Rasch measurement theory analysis was performed. Results: The sample included 739 participants (i.e., 174 gynecomastia, 224 weight loss, and 341 gender-affirming). Rasch measurement theory analysis refined a 10-item chest scale and a five-item nipple scale. All items had ordered thresholds and good item fit, and scales evidenced reliability [i.e., person separation index and Cronbach alpha values were 0.95 and 0.98 (chest scale) and 0.87 and 0.94 (nipple scale), respectively]. Scores for both scales correlated more strongly with similar (satisfaction with the body) versus dissimilar (psychological and social function) BODY-Q scales. The mean scores for the chest and nipple scales were significantly higher (p < 0.001 on independent samples t tests) in participants who were postoperative compared with preoperative. Conclusion: This new BODY-Q Chest Module is a clinically meaningful and scientifically sound patient-reported outcome instrument that can be used to measure outcomes for masculinizing chest contouring surgery.

Comparison of the Moorehead‐Ardelt quality of life questionnaire and the BODY‐Q in Danish patients undergoing weight loss and body contouring surgery

“…For the BODY‐Q, the psychometric findings are in line with the previous Danish psychometric validation of the BODY‐Q . The newly developed scales (stretch marks, male chest and nipple) were also found to be reliable and valid …”

“…5 The newly developed scales (stretch marks, male chest and nipple) were also found to be reliable and valid. 29,30 Our study has some limitations. First, the psychometric comparison was based on different samples.…”

“…The final version of the BODY‐Q included 18 individual functioning scales . Subsequently, a stretch marks scale and a chest module were added . The BODY‐Q was linguistically‐ and psychometrically validated for use in Danish BS and BC patients according to ISPOR and WHO guidelines …”

“…4 Subsequently, a stretch marks scale and a chest module were added. [29][30][31] The BODY-Q was linguistically-and psychometrically validated for use in Danish BS and BC patients according to ISPOR 32 and WHO 33 guidelines. 6,19 Overall, our evaluation of the BODY-Q using the COSMIN methodology for assessing content validity, leads to the conclusion that there is high quality evidence 3 3.2 | Quantitative analysis…”

Validation of the Finnish version of the BODY-Q patient-reported outcome instrument among patients who underwent abdominoplasty

“…8 The original BODY-Q field-test publication included 18 scales and the obesity-specific symptom checklist. 8 More recently, the BODY-Q © has added a Chest Module (chest and nipples scales) field-tested in 689 participants 9 and a stretch marks scale tested with 630 participants. 10 The BODY-Q scales and checklist measure appearance ( n = 12), HRQoL ( n = 6), and experience of health care ( n = 4).…”