Validation of a Patient-Completed Caprini Risk Assessment Tool for Spanish, Arabic, and Polish Speakers

Abstract

Targeted prophylaxis for venous thromboembolism (VTE) using the Caprini risk score (CRS) is effective reducing postoperative VTE. Despite its availability as preventive strategy, risk scoring remains underutilized. Critics to the CRS contend the time it takes to complete, and its limitation to English language. Aim is to create and validate patient-completed CRS tools for Spanish, Arabic, and Polish speakers. We translated the first patient-completed CRS to Spanish, Arabic, and Polish. We conducted a pilot study followed by the validation study. Using PASS version 11, we determined that a sample size of 37 achieved a power of 80%, to detect a difference of 0.1 between the null hypothesis correlation of 0.5 and the alternative hypothesis correlation of 0.7 using a 2-sided hypothesis test, significance level of .05. We tabulated and categorized scores using SPSS version 23 to estimate k, linear correlation, and Bland Altman test. k value >0.8 was defined as "almost perfect agreement." From 129 recruited patients, 50 (39%) spoke Spanish, 40 (31%) spoke Arabic, and 39 (30%) spoke Polish; average age 51 (16.69) years, 58 (45%) were men, with less than college education (67%). Mean (standard deviation) CRS was 5 (3.90), the majority (63%) above moderate VTE risk. We report excellent agreement comparing physician and patient results (k ¼ 0.93) and high correlation 0.97 (P < .01) for the overall score. Bland Altman did not show trend for extreme values. We created and validated the first Spanish, Arabic, and Polish versions of the patient-completed CRS, with excellent correlation and agreement when compared to CRS-trained physician-completed form. Based on these results, the physician needs to calculate the body mass index. Completing the form was not time-consuming.

Asia-Pacific venous thromboembolism consensus in knee and hip arthroplasty and hip fracture surgery: Part 1. Diagnosis and risk factors

“…A case series of an Asian population, after joint arthroplasty without VTE prophylaxis, showed that 3.07% of female patients developed VTE, whereas only 0.32% of male patients developed VTE [ 31 ]. This and other findings show that female sex is a significant risk factor for VTE in the Asian population [ 39 ]. Similarly, a study that used the Korean Health Insurance Review and Assessment Service database showed that females had a higher relative risk for DVT than males [ 48 ].…”

“…The Caprini score provides a consistent, accurate, and efficacious method for risk stratification and selection of prophylaxis methods [ 38 ]. It has been validated in many versions, such as Spanish, Arabic, and Polish [ 39 ]. To date, there have been a few attempts to validate the Caprini risk score of an Asian population [ 40 , 41 ].…”

Clinical Validation of the Chinese Version of Patient Completed Caprini Risk Assessment Form

“…Similarly, physicians only need to calculate BMI value, and the time for patients to fill the form was also about 6 minutes. 22 …”

Direct Comparison of Patient-completed and Physician-completed Caprini Scores for Plastic Surgery Patients

“…Another limitation is our choice to only validate in English, as the assessed tool has been validated in English, Spanish, Arabic, and Polish. 15 Finally, we chose provider-completed scores as the gold standard for Caprini score (eg, this was the standard for comparison). However, as the study’s principal investigator has completed thousands of Caprini scores, 2,3,6,16–19 we consider this to be a valid choice.…”