gms | German Medical Science

Objective: The subarachnoid haemorrhage outcome tool (SAHOT) is the first subarachnoid haemorrhage-specific scientifically robust outcome measure. We aimed to adapt the SAHOT into German and test its psychometric properties for subarachnoid haemorrhage patients in Germany.

Methods: Forward and backward translations were conducted according to current guidelines. We studied 81 prospectively collected patients with non-traumatic subarachnoid haemorrhage. SAHOT, Quality of Life after Brain Injury (QOLIBRI), Hospital Anxiety and Depression Scale (HADS) and EuroQol questionnaire (EQ-5D) were administered after discharge. SAHOT was readministered within 3 days and 3 to 4 months following neurorehabilitation. We assessed internal consistency by Cronbach’s α and validity by Pearson correlations, comparing SAHOT scores with those obtained from established scales. Responsiveness was evaluated by effect sizes.

Results: The German version revealed no major changes in back translation. Semantic equivalence was assessed after revision of the reconciled forward translation. Pilot testing with a cognitive interview of the patients and a final review indicated no need for adjustment of the questionnaire. Internal consistency was excellent regarding psychological distress (α=0.90) and good for the other domains (α=0.85–0.87). The observed floor and ceiling effects were small (1.3%-9.0%). Test–retest reliability indicated stability with an intraclass correlation coefficient of 0.875 (0.865-0.884; 95% CI). All domains correlated moderately with established measures (p<0.01). The cognitive domain was moderately sensitive to change following therapy (Cohen`s d >0.5) and the other three domains were strongly sensitive to change (Cohen`s d >0.8).

Conclusion: The German version of the SAHOT is a reliable and valid instrument. It is especially suited for use in future clinical studies and individual assessment in patients after subarachnoid haemorrhage in Germany.