Translation and Validation of the Overactive Bladder Symptom Score (OABSS) in Chinese during the COVID-19 Telehealth Surge

Introduction: Overactive bladder (OAB) is a prevalent disease that may affect up to 16% of the population. Barriers to health care exist in the Chinese patient population due to language and cultural differences. Our aim was to create a validated Chinese Overactive Bladder Symptom Score (OABSS) which could capture the full range of OAB symptoms, quantify OAB severity, and be administered both in the clinic and remotely in the wake of the telehealth surge during COVID-19. Methods: The English version of the OABSS was translated into Chinese. The 5th question in the survey served as a proxy for OAB status (OAB-positive and OAB-negative). A hybrid and remote model were created in our translation and validation efforts. In the hybrid model, patients were seen in clinic and called over the phone to readminister the survey. In the remote model, patients were called twice to administer the survey. Internal validity was calculated using Cronbach's coefficient alpha, test-retest reliability was measured using Spearman's correlation, and t-test was used to assess discriminant validity between groups and between visits. Results: A total of 63 patients and 73 patients were included in the final analysis of the hybrid and remote models, respectively. An acceptable degree of internal validity was appreciated in both hybrid and remote models by Cronbach's alpha score of 0.79 and 0.75, respectively. There were strong associations between responses from visit 1 to visit 2 in both models. Spearman's coefficients ranged from 0.43 to 0.91, with all 7 questions and total OAB score showing statistically significant associations (p < 0.001). In both models, no significant differences in total OAB score were seen between visits 1 and 2 in both OAB-positive and OABnegative groups. However, the OAB-positive group had significantly higher mean OAB scores in both visits 1 and 2 compared to the OAB-negative group. Conclusion: Through several methods of determining survey validity, the Chinese version of the OABSS proved to be a useful tool in assessing OAB severity and gives providers an opportunity to assess Chinese speaking patients remotely. As telehealth visits increase in frequency, OAB symptoms can continue to be monitored adequately.