Content Validation of Questionnaire for Survey on Practice Preferences of Indian Anaesthesiologists in Difficult Intubation and “Cannot Intubate, Cannot Ventilate” Situations (CICV)

Introduction: American Society of Anaesthesiologists (ASA) and Difficult Airway Society (DAS) have provided guidelines on management of difficult intubation and Cannot Intubate, Cannot Ventilate (CICV) situations. There have been many advances in equipment available to anaesthesiologist in difficult airway like Supraglottic Airway Devices (SGA), Video-Laryngoscope (VL) and optical stylet. The knowledge and practice of these guidelines are important for patient safety in difficult airway scenario.

Aim: To validate the questionnaire to assess practice preferences in difficult intubation and CICV in Indian anaesthesiologist.

Materials and Methods: This questionnaire-based observational survey was carried out between April 2021 to June 2021 at Department of Anaesthesia, DY Patil School of Medicine, Navi Mumbai, Maharashtra, India. Nineteen questions were framed based on the literature related to difficult intubation and CICV practices. This questionnaire sent to 20 experts to grade each question on relevance, clarity, simplicity and ambiguity on a likert scale of 4 as provided in information sheet. Sixteen out of 20 experts responded. Nineteen questions were framed based on the literature related to difficult intubation and CICV practices. The questionnaire was expanded to 22 questions after pilot testing with 10 senior expert anaesthesiologists suggestion of including the question on apneic oxygenation. The collected responses were used to calculate Item-wise Content Validity Index (I-CVI), Scale-wise Content Validity Index (S-CVI) and Modified Kappa Statistics (MKS) in Microsoft excel sheet.

Results: S CVI for relevance, simplicity, clarity and ambiguity was 0.77, 0.77, 0.77 and 0.73, respectively. S CVI/average or Average Congruency Percentage (ACP) was 0.95, 0.95, 0.95 and 0.94 for relevance, simplicity, clarity and ambiguity, respectively. Question 4, 14, 20, 22 received I-CVI of 0.75 in terms of relevance, clarity, simplicity and ambiguity and modified as per experts instructions.

Conclusion: The survey questionnaire developed to assess practice preferences in difficult intubation and CICV fulfilled the content validity criteria both by qualitative and quantitative analyses.