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Validation of the anterior skull base questionnaire 35 in endoscopic pituitary adenoma surgery

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Abstract

Patient quality of life (QOL) is an important metric of surgical success. To guide therapeutic advances in pituitary adenoma surgery, a validated, comprehensive instrument to quantify QOL is required. We aim to evaluate the validity of the 35 item anterior skull base questionnaire (ASBQ-35) in patients undergoing pituitary adenoma surgery. A total of 168 patients undergoing endoscopic resection of pituitary adenomas underwent longitudinal QOL assessment using the ASBQ-35 and the 22-item Sinonasal Outcomes Test (SNOT-22) over the first postoperative year. Validity of the ASBQ-35 was assessed by internal consistency, test–retest reliability, responsiveness to clinical change, and concurrent validity with the SNOT-22. Internal consistency of the ASBQ-35 was excellent, with a Cronbach’s alpha > 0.95 across all timepoints. Test–retest reliability between 3 and 6 months (ICC = 0.82, p < 0.001) and 6 months and 12 months (ICC = 0.78, p < 0.001) was robust. Concurrent validity with SNOT-22 was strong across all timepoints (absolute Pearson r ≥ 0.63, p < 0.001). Mean ASBQ-35 scores were significantly worse at 3 weeks compared to preoperative baseline (mean difference − 0.28, p < 0.01); however, by 12 months, scores had significantly improved (mean difference + 0.24, p < 0.01), indicating that the scale is responsive to clinical change. Each of the 6 domains of the ASBQ, and all 35 component questions, contributed to the discriminative of the ASBQ to measure QOL during the first postoperative year. The ASBQ-35 is a valid, comprehensive tool for assessing QOL after endoscopic pituitary adenoma surgery. Each component of the ASBQ-35 contributed to the overall assessment of QOL during the first postoperative year.

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Monash Health, 246 Clayton Road, Clayton VIC 3168, Melbourne, Australia

    Mendel Castle-Kirszbaum, Jeremy Kam & Tony Goldschlager

  2. Department of Surgery, Monash University, Melbourne, Australia

    Mendel Castle-Kirszbaum & Tony Goldschlager

  3. Department of Neurosurgery, St Vincent’s Health, Melbourne, Australia

    Yi Yuen Wang

  4. Department of Neurosurgery, Royal Melbourne Hospital, Melbourne, Australia

    James King & Jeremy Kam

  5. Department of Surgery, Barwon Health, Geelong, Australia

    Margaret D. Y. Shi

Authors
  1. Mendel Castle-Kirszbaum
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  3. James King
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  4. Jeremy Kam
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  5. Margaret D. Y. Shi
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  6. Tony Goldschlager
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Contributions

MCK: analysis of the data, writing the draft, revision. YYW: data collection, analysis of the data, revision. JK: data collection, analysis of the data, revision. JKam: data collection, analysis of the data, revision. MDYS: analysis of the data, revision. TG: data collection, analysis of the data, revision, study supervision.

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Correspondence to Mendel Castle-Kirszbaum.

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Castle-Kirszbaum, M., Wang, Y.Y., King, J. et al. Validation of the anterior skull base questionnaire 35 in endoscopic pituitary adenoma surgery. Neurosurg Rev 46, 7 (2023). https://doi.org/10.1007/s10143-022-01921-1

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