Development of a new patient-reported outcome measure for breast surgery: The BREAST-Q Journal Article


Authors: Pusic, A. L.; Klassen, A. F.; Scott, A. M.; Klok, J. A.; Cordeiro, P. G.; Cano, S. J.
Article Title: Development of a new patient-reported outcome measure for breast surgery: The BREAST-Q
Abstract: BACKGROUND: Measuring patient-reported outcomes has become increasingly important in cosmetic and reconstructive breast surgery. The objective of this study was to develop a new patient-reported outcome measure to assess the unique outcomes of breast surgery patients. METHODS: Patient interviews, focus groups, expert panels, and a literature review were used to develop a conceptual framework and a list of questionnaire items. Three procedure-specific questionnaires (augmentation, reduction, and reconstruction) were developed and cognitive debriefing interviews used to pilot each questionnaire. Revised questionnaires were field tested with 1950 women at five centers in the United States and Canada (response rate, 72 percent); 491 patients also completed a test-retest questionnaire. Rasch measurement methods were used to construct scales, and traditional psychometric analyses, following currently recommended procedures and criteria, were performed to allow for comparison with existing measures. RESULTS: The conceptual framework included six domains: satisfaction with breasts, overall outcome, and process of care, and psychosocial, physical, and sexual well-being. Independent scales were constructed for these domains. This new patient-reported outcome measure "system" (the BREAST-Q) contains three modules (augmentation, reconstruction, and reduction), each with a preoperative and postoperative version. Each scale fulfilled Rasch and traditional psychometric criteria (including person separation index 0.76 to 0.95; Cronbach's alpha 0.81 to 0.96; and test-retest reproducibility 0.73 to 0.96). CONCLUSIONS: The BREAST-Q can be used to study the impact and effectiveness of breast surgery from the patient's perspective. By quantifying satisfaction and important aspects of health-related quality of life, the BREAST-Q has the potential to support advocacy, quality metrics, and an evidence-based approach to surgical practice. ©2009American Society of Plastic Surgeons.
Keywords: adolescent; adult; clinical article; aged; aged, 80 and over; middle aged; patient satisfaction; young adult; postoperative period; united states; outcome assessment; reproducibility; quality of life; sexual satisfaction; mammaplasty; outcome assessment (health care); questionnaires; questionnaire; patient care; preoperative period; pilot study; quantitative analysis; surgeon; measurement; interview; test retest reliability; psychological well being; canada; breast surgery; focus groups; social psychology; psychometrics; psychometry; hospital personnel; evidence based practice center; qualitative analysis; teamwork
Journal Title: Plastic and Reconstructive Surgery
Volume: 124
Issue: 2
ISSN: 0032-1052
Publisher: Lippincott Williams & Wilkins  
Date Published: 2009-08-01
Start Page: 345
End Page: 353
Language: English
DOI: 10.1097/PRS.0b013e3181aee807
PUBMED: 19644246
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 11" - "Export Date: 30 November 2010" - "CODEN: PRSUA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Andrea Pusic
    288 Pusic
  2. Peter G Cordeiro
    247 Cordeiro
  3. Amie Marie Scott
    45 Scott