Translation, Cultural Adaptation, and Validation of the Urdu Version of Irritable Bowel Syndrome Severity Scoring System

Abstract

The Irritable Bowel Syndrome Severity Scoring System (IBS-SSS) is a widely utilized tool for screening and classifying IBS patients according to the severity of their symptoms. This study aimed to translate the IBS-SSS into Urdu, culturally adapt it, and validate it for the Urdu-speaking Pakistani population.  The translation process involved forward translation, reconciliation, backward translation, an expert committee review, and cognitive interviewing to ensure conceptual and semantic precision. The final Urdu-translated scale was administered to 250 participants (146 females and 104 males) aged 18-67 years (M = 35.69, SD = 12.56). Structural validity was assessed using EFA. The IBS-SSS scores were correlated with GSRS-IBS to determine the convergent validity, while the scores of IBS patients were compared with healthy individuals on different severity levels to explore the discriminant validity. The EFA confirmed the scale's unidimensionality with the KMO measure of the adequacy of 0.91 and Bartlet test of sphericity being significant (p > .001). The reliability assessment suggested robust results with Cronbach’s alpha a = 0.96, indicating high inter-item internal consistency, test-retest reliability ranging from 0.89 to 0.98, and the split-half reliability score yielding highly significant results with a = 0.92 (p < 0.01). Convergent validity revealed a moderate to strong correlation with a value of  (r = .65, p < 0.01). For discriminant validity, significant differences in the scores of IBS patients and non-patients were observed, where IBS patients scored higher on all IBS types irrespective of their symptom severity (p < .001). The findings indicated that the Urdu-translated version of IBS-SSS is a reliable and valid tool for the assessment of symptom severity in the Pakistani population with IBS. Future studies should investigate the applicability of the scale across diverse Urdu-speaking populations and IBS subtypes, examining its validity in longitudinal studies.