Validation of a novel patient satisfaction questionnaire for preoperative fasting in cataract surgery: a discrimination analysis

Preoperative fasting is routinely performed to prevent anaesthesia-related pulmonary aspiration. To capture patients’ experiences with preoperative fasting, a 13-item questionnaire was developed and validated using Rasch analysis and shortened to 6 items. This extension study aims to assess this questionnaire's ability to discriminate between participants with a short versus long duration of fasting and early versus late day surgery. Single-centred cross-sectional study. Subjects were recruited via consecutive sampling of cataract patients on surgery day at Kensington Eye Institute in Toronto from February to December 2019. A validated preoperative fasting questionnaire was administered. Discriminative ability was assessed by comparing responses in patients scheduled for surgery in the morning (8:00 am–12:00 pm) versus afternoon (12:00 pm–3:30 pm) and fasting for short (≤8 hours) versus long (>8 hours) duration. Diagnostic ability of the 6-item questionnaire relative to the 13-item questionnaire was assessed with receiver operating characteristics curve analysis. A total of 164 patients (mean age 70.8 ± 10.0 years; 57% female) were included. Total scores of patients having surgery in the morning were greater (i.e., less fasting-related burden) than in the afternoon (p = 0.04). There was no significant difference in scores between patients fasting for a short versus long duration (p > 0.05). Receiver operating characteristics curve analysis showed excellent diagnostic ability of the 6-item questionnaire relative to the 13-item version (area under the curve = 0.964). The 6-item questionnaire for fasting-related burden has excellent discriminative ability between early versus late surgery patients. The time fasting while awake may be a more relevant predictor of fasting-related burden relative to the total duration of fasting. Le jeûne préopératoire est une pratique courante qui vise à empêcher l'aspiration pulmonaire pendant l'anesthésie. Dans l'optique de mieux connaître l'expérience des patients à cet égard, nous avons mis au point un questionnaire en 13 éléments qui a été raccourci à 6 après avoir été validé au moyen de l'analyse de Rasch. La présente étude de prolongation a pour objectif d’évaluer la capacité du questionnaire pour ce qui est de faire la distinction entre les participants dont le jeûne a été de courte durée et ceux dont le jeûne a été de longue durée, de même qu'entre les patients dont l'intervention a eu lieu en début ou en fin de journé