Validity and Reliability of the Persian Version of Hypospadias Objective Penile Evaluation (HOPE) Questionnaire

Surgical correction of hypospadias is one of the most common pediatric surgeries. Due to the several methods of hypospadias operations, the evaluation of results has always been challenging. Several questionnaires have been designed to reduce the discrepancy in the reports of hypospadias surgery, and the HOPE questionnaire is one of the most common. Based on our search, the reliability and validity of the Persian version of the HOPE (Hypospadias Objective Penile Evaluation) questionnaire have not been assessed yet.

In this cross-sectional study, firstly, the questionnaire "Objective evaluation of penis in hypospadias" was translated by two urologists and an English language expert familiar with medical concepts according to the Backward-Forward translation method into Persian and then again into English, and finally, the questionnaire was sent to experts and compared with the original questionnaire. The quality of translation and content were finalized and corrected. Thereafter, in order to check the form and content validity, the questionnaire was sent to eight experts, and the content validity indices and its content validity ratio were calculated. In order to check the reliability-stability of the re-test, two questionnaires, including images after hypospadias surgery of 42 patients, were delivered to eight specialists in pediatrics, urology, and pediatric surgery to determine the score at a time interval of one week, and finally, the data were analyzed in SPSS software (version 23) using the test-retest method. The Intraclass Correlation Coefficient (ICC) index and its confidence interval were calculated by the scores obtained from twice answering the instrument for each factor and the entire questionnaire. In order to determine internal consistency and reliability, Cronbach's alpha coefficient was calculated for each factor and the entire questionnaire.

In our study, intraclass correlation coefficient values for inter-rater reliability in the HOPE score were calculated at 0.89, indicating the high reliability of this questionnaire in Persian. The internal consistency of the Persian version of the HOPE scale was confirmed, rendering a Cronbach's alpha coefficient of 0.98.

The good validity and reliability of the HOPE scoring system in Persian support its use as a standard objective outcome measure of the cosmetic result after hypospadias surgery.