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Published in: Aesthetic Plastic Surgery 3/2014

01-06-2014 | Original Article

The Body-QoL®: Measuring Patient Reported Outcomes in Body Contouring Surgery Patients

Authors: Stefan Danilla, Carlos Dominguez, Pedro Cuevas, María Elsa Calderón, Marco Antonio Rios, Patricio Andrades, Susana Benitez, Cristian Erazo, Rolando Shulz, Sarah Al-Himdani, Sergio Sepúlveda

Published in: Aesthetic Plastic Surgery | Issue 3/2014

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Abstract

Background

This study aimed to design a new patient-reported outcome (PRO) instrument to measure patient satisfaction after body-contouring procedures such as liposculpture, abdominoplasty, body-lift, thigh-lift, and arm-lift.

Methods

Phase 1a involved an extensive literature review, 16 in-depth patient interviews, and expert focus groups with 5 plastic surgeons to develop a conceptual framework for the outcomes deemed important for body image and preliminary PRO instruments. In phase 1b, the preliminary instrument was tested with a second independent sample of 29 patients with whom simple interviews were additionally performed. In the second sample, scale reliability was calculated.

Results

In phase 1a, the domains identified for the conceptual framework included clothing and body image, sexual and affective life, self-image and self-esteem, social relationships, and physical symptoms. In phase 1b, the scale internal consistency was 91.5 %.

Conclusions

When psychometric evaluation is completed, the Body-Shape-Related Quality of Life instrument and its subscales will provide a reliable tool for plastic surgeons, researchers, and patients to use in measuring the impact and effectiveness of body-contouring procedures from the patient’s perspective.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-B
Literature
1.
go back to reference Zimerman A (2013) Evidence-based medicine: a short history of a modern medical movement. Virtual Mentor 15:71–76PubMedCrossRef Zimerman A (2013) Evidence-based medicine: a short history of a modern medical movement. Virtual Mentor 15:71–76PubMedCrossRef
2.
go back to reference Jeffrey A, Timothy C (2005) History and development of evidence-based medicine. World J Surg 29:547–553CrossRef Jeffrey A, Timothy C (2005) History and development of evidence-based medicine. World J Surg 29:547–553CrossRef
3.
go back to reference Manary MP, Boulding W, Staelin R, Glickman SWN (2013) The patient experience and health outcomes. Engl J Med 368:201–203CrossRef Manary MP, Boulding W, Staelin R, Glickman SWN (2013) The patient experience and health outcomes. Engl J Med 368:201–203CrossRef
4.
go back to reference Sackett DL, Straus S, Richardson WS, Rosenberg W, Haynes B (2000) Evidence-based medicine: how to practice and teach EBM, 2nd edn. Churchill Livingstone, Edinburgh Sackett DL, Straus S, Richardson WS, Rosenberg W, Haynes B (2000) Evidence-based medicine: how to practice and teach EBM, 2nd edn. Churchill Livingstone, Edinburgh
5.
go back to reference Saldanha OR, Pinto EB, Matos WN Jr, Lucon RL, Magalhães F, Bello EM (2001) Lipoabdominoplasty without undermining. Aesthet Surg J 21:518–526PubMedCrossRef Saldanha OR, Pinto EB, Matos WN Jr, Lucon RL, Magalhães F, Bello EM (2001) Lipoabdominoplasty without undermining. Aesthet Surg J 21:518–526PubMedCrossRef
6.
go back to reference Lockwood TE (2004) Maximizing aesthetics in lateral-tension abdominoplasty and body lifts. Clin Plast Surg 31:523–537PubMedCrossRef Lockwood TE (2004) Maximizing aesthetics in lateral-tension abdominoplasty and body lifts. Clin Plast Surg 31:523–537PubMedCrossRef
7.
go back to reference Andrades P, Prado A, Danilla S, Guerra C, Benitez S, Sepulveda S, Sciarraffia C, De Carolis V (2007) Progressive tension sutures in the prevention of postabdominoplasty seroma: a prospective, randomized, double-blind clinical trial. Plast Reconstr Surg 120:935–946PubMedCrossRef Andrades P, Prado A, Danilla S, Guerra C, Benitez S, Sepulveda S, Sciarraffia C, De Carolis V (2007) Progressive tension sutures in the prevention of postabdominoplasty seroma: a prospective, randomized, double-blind clinical trial. Plast Reconstr Surg 120:935–946PubMedCrossRef
8.
go back to reference Hurwitz DJ, Holland SW (2006) The L brachioplasty: an innovative approach to correct excess tissue of the upper arm, axilla, and lateral chest. Plast Reconstr Surg 117:403–411PubMedCrossRef Hurwitz DJ, Holland SW (2006) The L brachioplasty: an innovative approach to correct excess tissue of the upper arm, axilla, and lateral chest. Plast Reconstr Surg 117:403–411PubMedCrossRef
9.
go back to reference Richter DF, Stoff A (2011) The scarpa lift: a novel technique for minimal invasive medial thigh lifts. Obes Surg 21:1975–1980PubMedCrossRef Richter DF, Stoff A (2011) The scarpa lift: a novel technique for minimal invasive medial thigh lifts. Obes Surg 21:1975–1980PubMedCrossRef
10.
go back to reference Prado A, Andrades P, Danilla S, Leniz P, Castillo P, Gaete F (2006) A prospective, randomized, double-blind, controlled clinical trial comparing laser-assisted lipoplasty with suction-assisted lipoplasty. Plast Reconstr Surg 118:1032–1045PubMedCrossRef Prado A, Andrades P, Danilla S, Leniz P, Castillo P, Gaete F (2006) A prospective, randomized, double-blind, controlled clinical trial comparing laser-assisted lipoplasty with suction-assisted lipoplasty. Plast Reconstr Surg 118:1032–1045PubMedCrossRef
11.
go back to reference Nagy MW, Vanek PF Jr (2012) A multicenter, prospective, randomized, single-blind, controlled clinical trial comparing VASER-assisted lipoplasty and suction-assisted lipoplasty. Plast Reconstr Surg 129:681–689CrossRef Nagy MW, Vanek PF Jr (2012) A multicenter, prospective, randomized, single-blind, controlled clinical trial comparing VASER-assisted lipoplasty and suction-assisted lipoplasty. Plast Reconstr Surg 129:681–689CrossRef
12.
go back to reference Hurwitz D, Smith D (2012) Treatment of overweight patients by radiofrequency-assisted liposuction (RFAL) for aesthetic reshaping and skin tightening. Aesthetic Plast Surg 36:62–71PubMedCrossRef Hurwitz D, Smith D (2012) Treatment of overweight patients by radiofrequency-assisted liposuction (RFAL) for aesthetic reshaping and skin tightening. Aesthetic Plast Surg 36:62–71PubMedCrossRef
13.
go back to reference Pusic A, Klassen A, Scott A, Klok J, Cordeiro P, Cano S (2009) Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q. Plast Reconstr Surg 124:345–353PubMedCrossRef Pusic A, Klassen A, Scott A, Klok J, Cordeiro P, Cano S (2009) Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q. Plast Reconstr Surg 124:345–353PubMedCrossRef
14.
go back to reference Klassen AF, Cano SJ, Scott A, Snell L, Pusic A (2010) Measuring patient-reported outcomes in facial aesthetic patients: development of the FACE-Q. Facial Plast Surg 26:303–309PubMedCrossRef Klassen AF, Cano SJ, Scott A, Snell L, Pusic A (2010) Measuring patient-reported outcomes in facial aesthetic patients: development of the FACE-Q. Facial Plast Surg 26:303–309PubMedCrossRef
15.
go back to reference Cuevas P, Calderón M, Erazo C, Benítez S, Andrades P, Sepúlveda S, Danilla S (2013) Mamoplastía de reducción: resultados desde la perspectiva del paciente. Validación lingüística y psicométrica del breast Q reduction and mastopexy module instrument. Rev Chilena Cirugía 65:146–149CrossRef Cuevas P, Calderón M, Erazo C, Benítez S, Andrades P, Sepúlveda S, Danilla S (2013) Mamoplastía de reducción: resultados desde la perspectiva del paciente. Validación lingüística y psicométrica del breast Q reduction and mastopexy module instrument. Rev Chilena Cirugía 65:146–149CrossRef
16.
go back to reference Scientific Advisory Committee of the Medical Outcomes Trust (2002) Assessing health status and quality of life instruments: attributes and review criteria. Qual Life Res 11:193–205CrossRef Scientific Advisory Committee of the Medical Outcomes Trust (2002) Assessing health status and quality of life instruments: attributes and review criteria. Qual Life Res 11:193–205CrossRef
18.
go back to reference Harris DL, Carr AT (2001) The Derriford Appearance Scale (DAS59): a new psychometric scale for the evaluation of patients with disfigurements and aesthetic problems of appearance. Br J Plast Surg 54:216–222PubMedCrossRef Harris DL, Carr AT (2001) The Derriford Appearance Scale (DAS59): a new psychometric scale for the evaluation of patients with disfigurements and aesthetic problems of appearance. Br J Plast Surg 54:216–222PubMedCrossRef
19.
go back to reference Carr T, Moss T, Harris D (2005) The DAS24: a short form of the Derriford Appearance Scale DAS59 to measure individual responses to living with problems of appearance. Br J Health Psychol 10:285–298PubMedCrossRef Carr T, Moss T, Harris D (2005) The DAS24: a short form of the Derriford Appearance Scale DAS59 to measure individual responses to living with problems of appearance. Br J Health Psychol 10:285–298PubMedCrossRef
20.
go back to reference Hopwood P, Fletcher I, Lee A, Al-Ghazal S (2001) A body image scale for use with cancer patients. Eur J Cancer 37:189–197PubMedCrossRef Hopwood P, Fletcher I, Lee A, Al-Ghazal S (2001) A body image scale for use with cancer patients. Eur J Cancer 37:189–197PubMedCrossRef
21.
go back to reference Cooper P, Taylor M, Cooper Z, Fairbaum G (1987) The development and validation of the body shape questionnaire. Int J Eat Disord 6:485–494CrossRef Cooper P, Taylor M, Cooper Z, Fairbaum G (1987) The development and validation of the body shape questionnaire. Int J Eat Disord 6:485–494CrossRef
22.
go back to reference Niero M, Martin M, Finger T, Lucas R, Mear I, Wild D, Glauda L, Patrick DL (2002) A new approach to multicultural item generation in the development of two obesity-specific measures: the Obesity and Weight Loss Quality of Life (OWLQOL) questionnaire and the Weight-Related Symptom Measure (WRSM). Clin Ther 24:690–700PubMedCrossRef Niero M, Martin M, Finger T, Lucas R, Mear I, Wild D, Glauda L, Patrick DL (2002) A new approach to multicultural item generation in the development of two obesity-specific measures: the Obesity and Weight Loss Quality of Life (OWLQOL) questionnaire and the Weight-Related Symptom Measure (WRSM). Clin Ther 24:690–700PubMedCrossRef
23.
go back to reference Kolotkin RL, Head S, Hamilton M, Tse CK (1995) Assessing impact of weight on quality of life. Obes Res 3:49–56PubMedCrossRef Kolotkin RL, Head S, Hamilton M, Tse CK (1995) Assessing impact of weight on quality of life. Obes Res 3:49–56PubMedCrossRef
24.
go back to reference Kolotkin RL, Head S, Brookhart A (1997) Construct validity of the impact of weight on quality of life questionnaire. Obes Res 5:434–441PubMedCrossRef Kolotkin RL, Head S, Brookhart A (1997) Construct validity of the impact of weight on quality of life questionnaire. Obes Res 5:434–441PubMedCrossRef
25.
go back to reference Kolotkin RL, Crosby RD, Kosloski KD, Williams GR (2001) Development of a brief measure to assess quality of life in obesity. Obes Res 9:102–111PubMedCrossRef Kolotkin RL, Crosby RD, Kosloski KD, Williams GR (2001) Development of a brief measure to assess quality of life in obesity. Obes Res 9:102–111PubMedCrossRef
26.
go back to reference Kolotkin RL, Crosby RD (2002) Psychometric evaluation of the impact of weight on quality of life-lite questionnaire (IWQOL-lite) in a community sample. Qual Life Res 11:157–171PubMedCrossRef Kolotkin RL, Crosby RD (2002) Psychometric evaluation of the impact of weight on quality of life-lite questionnaire (IWQOL-lite) in a community sample. Qual Life Res 11:157–171PubMedCrossRef
27.
go back to reference Coriddi MR, Koltz PF, Chen R, Gusenoff JA (2011) Changes in quality of life and functional status following abdominal contouring in the massive weight loss population. Plast Reconstr Surg 128:520–526PubMedCrossRef Coriddi MR, Koltz PF, Chen R, Gusenoff JA (2011) Changes in quality of life and functional status following abdominal contouring in the massive weight loss population. Plast Reconstr Surg 128:520–526PubMedCrossRef
28.
go back to reference Davis Sears E, Burns PB, Chung KC (2007) The outcomes of outcome studies in plastic surgery: a systematic review of 17 years of plastic surgery research. Plast Reconstr Surg 7:2059–2065CrossRef Davis Sears E, Burns PB, Chung KC (2007) The outcomes of outcome studies in plastic surgery: a systematic review of 17 years of plastic surgery research. Plast Reconstr Surg 7:2059–2065CrossRef
29.
go back to reference Kosowski TR, McCarthy C, Reavey PL, Scott AM, Wilkins EG, Cano SJ, Klassen AF, Carr N, Cordeiro PG, Pusic AL (2009) A systematic review of patient-reported outcome measures after facial cosmetic surgery and/or nonsurgical facial rejuvenation. Plast Reconstr Surg 6:1819–1827CrossRef Kosowski TR, McCarthy C, Reavey PL, Scott AM, Wilkins EG, Cano SJ, Klassen AF, Carr N, Cordeiro PG, Pusic AL (2009) A systematic review of patient-reported outcome measures after facial cosmetic surgery and/or nonsurgical facial rejuvenation. Plast Reconstr Surg 6:1819–1827CrossRef
30.
go back to reference Reavey PL, Klassen AF, Cano SJ, McCarthy C, Scott A, Rubin JP, Shermak M, Pusic AL (2011) Measuring quality of life and patient satisfaction after body contouring: a systematic review of patient-reported outcome measures. Aesthet Surg J 31:807–813PubMedCrossRef Reavey PL, Klassen AF, Cano SJ, McCarthy C, Scott A, Rubin JP, Shermak M, Pusic AL (2011) Measuring quality of life and patient satisfaction after body contouring: a systematic review of patient-reported outcome measures. Aesthet Surg J 31:807–813PubMedCrossRef
31.
go back to reference Pusic AL, Lemaine V, Klassen AF, Scott AM, Cano SJ Patient-reported outcome measures in plastic surgery: use and interpretation in evidence-based medicine. Plast Reconstr Surg 3:1361–1367 Pusic AL, Lemaine V, Klassen AF, Scott AM, Cano SJ Patient-reported outcome measures in plastic surgery: use and interpretation in evidence-based medicine. Plast Reconstr Surg 3:1361–1367
32.
go back to reference Kazis L, Anderson J, Meenan R (1989) Effect sizes for interpreting changes in health status. Med Care 27:178–189CrossRef Kazis L, Anderson J, Meenan R (1989) Effect sizes for interpreting changes in health status. Med Care 27:178–189CrossRef
33.
go back to reference Alsarraf R, Larrabee WF Jr, Anderson S, Murakami CS, Johnson CM Jr (2001) Measuring cosmetic facial plastic surgery outcomes. Arch Facial Plast Surg 3:198–201PubMedCrossRef Alsarraf R, Larrabee WF Jr, Anderson S, Murakami CS, Johnson CM Jr (2001) Measuring cosmetic facial plastic surgery outcomes. Arch Facial Plast Surg 3:198–201PubMedCrossRef
34.
go back to reference Cano S, Klassen A, Pusic A (2009) The science behind quality-of-life measurement: a primer for plastic surgeons. Plast Reconstr Surg 123:98–106CrossRef Cano S, Klassen A, Pusic A (2009) The science behind quality-of-life measurement: a primer for plastic surgeons. Plast Reconstr Surg 123:98–106CrossRef
35.
go back to reference Fitzpatrick R, Jenkinson C, Klassen A, Goodcare T (1999) Methods of assessing health-related quality of life and outcome for plastic surgery. Br J Plast Surg 52:251–255PubMedCrossRef Fitzpatrick R, Jenkinson C, Klassen A, Goodcare T (1999) Methods of assessing health-related quality of life and outcome for plastic surgery. Br J Plast Surg 52:251–255PubMedCrossRef
36.
go back to reference Cano S, Browne J, Lamping D (2004) Patient-based measures of outcome in plastic surgery: current approaches and future directions. Br J Plast Surg 57:1–11PubMedCrossRef Cano S, Browne J, Lamping D (2004) Patient-based measures of outcome in plastic surgery: current approaches and future directions. Br J Plast Surg 57:1–11PubMedCrossRef
37.
go back to reference Thoma A, Veltri K, Khuthaila D, Rockwell G, Duku E (2004) Comparison of the deep inferior epigastric perforator flap and free transverse rectus abdominis myocutaneous flap in postmastectomy reconstruction: a costeffectiveness analysis. Plast Reconstr Surg 113:1650–1661PubMedCrossRef Thoma A, Veltri K, Khuthaila D, Rockwell G, Duku E (2004) Comparison of the deep inferior epigastric perforator flap and free transverse rectus abdominis myocutaneous flap in postmastectomy reconstruction: a costeffectiveness analysis. Plast Reconstr Surg 113:1650–1661PubMedCrossRef
38.
go back to reference Efficace F, Bottomley A, Osoba D, Gotay C, Flechtner H, D’haese S, Zurlo A (2003) Beyond the development of health-related quality-of-life (HRQOL) measures: a checklist for evaluating HRQOL outcomes in cancer clinical trials: Does HRQOL evaluation in prostate cancer research inform clinical decision making? J Clin Oncol 21:3502–3511PubMedCrossRef Efficace F, Bottomley A, Osoba D, Gotay C, Flechtner H, D’haese S, Zurlo A (2003) Beyond the development of health-related quality-of-life (HRQOL) measures: a checklist for evaluating HRQOL outcomes in cancer clinical trials: Does HRQOL evaluation in prostate cancer research inform clinical decision making? J Clin Oncol 21:3502–3511PubMedCrossRef
39.
go back to reference Pusic AL, Chen CM, Cano S, Klassen A, McCarthy C, Collins ED, Cordeiro PG (2007) Measuring quality of life in cosmetic and reconstructive breast surgery: a systematic review of patient-reported outcomes instruments. Plast Reconstr Surg 120:823–837PubMedCrossRef Pusic AL, Chen CM, Cano S, Klassen A, McCarthy C, Collins ED, Cordeiro PG (2007) Measuring quality of life in cosmetic and reconstructive breast surgery: a systematic review of patient-reported outcomes instruments. Plast Reconstr Surg 120:823–837PubMedCrossRef
40.
go back to reference Draaijers LJ, Tempelman FR, Botman YA, Tuinebreijer WE, Middelkoop E, Kreis RW, van Zuijlen PP (2004) The patient and observer scar assessment scale: a reliable and feasible tool for scar evaluation. Plast Reconstr Surg 113:1960–1967PubMedCrossRef Draaijers LJ, Tempelman FR, Botman YA, Tuinebreijer WE, Middelkoop E, Kreis RW, van Zuijlen PP (2004) The patient and observer scar assessment scale: a reliable and feasible tool for scar evaluation. Plast Reconstr Surg 113:1960–1967PubMedCrossRef
41.
go back to reference Boyce MB, Browne JP (2013) Does providing feedback on patient-reported outcomes to healthcare professionals result in better outcomes for patients? A systematic review. Qual Life Res 9:2265–2278CrossRef Boyce MB, Browne JP (2013) Does providing feedback on patient-reported outcomes to healthcare professionals result in better outcomes for patients? A systematic review. Qual Life Res 9:2265–2278CrossRef
42.
go back to reference Bausewein C, Simon ST, Benalia H, Downing J, Mwangi-Powell FN, Daveson BA, Harding R, Higginson IJ (2011) PRISMA: implementing patient-reported outcome measures (PROMs) in palliative care: Users’ cry for help. Health Qual Life Outcomes 20:27CrossRef Bausewein C, Simon ST, Benalia H, Downing J, Mwangi-Powell FN, Daveson BA, Harding R, Higginson IJ (2011) PRISMA: implementing patient-reported outcome measures (PROMs) in palliative care: Users’ cry for help. Health Qual Life Outcomes 20:27CrossRef
43.
go back to reference Wilson J, Arshad F, Nnamoko N, Whiteman A, Ring J, Roy B (2013) Patient-reported outcome measures: An online system empowering patient choice. J Am Med Inform Assoc. doi:10.1136/amiajnl-2012-001183 Wilson J, Arshad F, Nnamoko N, Whiteman A, Ring J, Roy B (2013) Patient-reported outcome measures: An online system empowering patient choice. J Am Med Inform Assoc. doi:10.​1136/​amiajnl-2012-001183
44.
go back to reference Howell D, Liu G (2011) Can routine collection of patient reported outcome data actually improve person-centered health? Healthc Pap 11:42–47PubMedCrossRef Howell D, Liu G (2011) Can routine collection of patient reported outcome data actually improve person-centered health? Healthc Pap 11:42–47PubMedCrossRef
45.
go back to reference McGrail K, Bryan S, Davis J (2011) Let’s all go to the PROM: the case for routine patient-reported outcome measurement in Canadian healthcare. Healthc Pap 11:8–18PubMedCrossRef McGrail K, Bryan S, Davis J (2011) Let’s all go to the PROM: the case for routine patient-reported outcome measurement in Canadian healthcare. Healthc Pap 11:8–18PubMedCrossRef
Metadata
Title
The Body-QoL®: Measuring Patient Reported Outcomes in Body Contouring Surgery Patients
Authors
Stefan Danilla
Carlos Dominguez
Pedro Cuevas
María Elsa Calderón
Marco Antonio Rios
Patricio Andrades
Susana Benitez
Cristian Erazo
Rolando Shulz
Sarah Al-Himdani
Sergio Sepúlveda
Publication date
01-06-2014
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 3/2014
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-014-0302-x

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