Cross-Cultural Evaluation of the Dutch FACE-Q Rhinoplasty Questionnaires Using Rasch Analysis

Overview

The English FACE-Q rhinoplasty module was built using Rasch measurement theory and has been translated into Dutch. Before results from the Dutch version can be interpreted, it must also fit the Rasch model. The study evaluated whether the Dutch and English versions are equivalent across cultures by applying that methodology to a prospective consecutive cohort of Dutch speaking patients.

Sections of note

• Rasch analysis performed with Winsteps software on data from 100 consecutive Dutch speaking septorhinoplasty patients.
• The FACE-Q nose and nostrils scales were evaluated.
• New Dutch conversion tables were constructed and compared with the original English ones.
• Psychometric cross validation was performed using receiver operating characteristic analysis.
• Both questionnaires adequately met the requirement of invariance.
• Some issues with item and person fit were found within an acceptable range, along with some local item dependency and differential item functioning.
• Comparison of the Dutch and English conversion tables by ROC analysis showed identical results for both scales.
• The authors conclude the Dutch version corresponds conceptually to the English original.

What it means for a patient

• Scores from the Dutch questionnaire can be read the same way as scores from the English one.
• This matters for comparing rhinoplasty results between countries and pooling them in research.
• The analysis found minor imperfections in how some items behaved, though within an acceptable range.
• This study evaluates a measuring instrument, not any surgical technique or outcome.

Why this paper matters

Patient reported outcome scores are only comparable across languages if the translated instrument measures the same construct on the same scale. This study applies a formal statistical test rather than relying on translation alone. Whether the remaining item level irregularities matter in practice is not resolved.

Terms

• FACE-Q: a family of validated questionnaires measuring patient reported results after facial procedures.
• Rasch analysis: a statistical method testing whether questionnaire items measure a single underlying trait consistently.
• Invariance: the property that a scale behaves the same way across different groups.
• Differential item functioning: when a question behaves differently for one group than another.
• ROC analysis: a method comparing how well two measures classify the same outcome.