From principle to practice: Developing a digital-age clinical artificial intelligence ethics competence framework through early-career doctors' experiences.

Pelvic floor dysfunctions (PFDs) encompass a range of anorectal and pelvic conditions such as fecal incontinence, constipation, hemorrhoids, anal fissures, and pelvic floor dyssynergia that significantly impair quality of life and remain frequently underdiagnosed.[] Their true prevalence is likely underestimated, as many affected individuals do not seek medical care due to embarrassment or fear of invasive assessments.[] Diagnostic accuracy is further challenged by overlapping symptoms and variability in clinical expertise, which complicate the identification of underlying mechanisms such as neuromuscular injury, PFD, or age-related anorectal changes.[] Given this complexity, accurate assessment often requires a combination of clinical evaluation and patient-reported outcome (PRO) measures, particularly because many pelvic floor symptoms cannot be reliably captured through physiological tests alone.[] Historically, clinicians across colorectal surgery, gynecology, urology, and pelvic floor rehabilitation have used disparate instruments, limiting comparability across specialties, and hindering the development of standardized care pathways. To overcome this gap, the International Pelvic Floor Disorders Consortium developed the Initial Measurement of Patient-reported Pelvic Floor Complaints Tool (IMPACT), a unified, domain-specific PRO instrument designed for cross-specialty use.[] The IMPACT Short Form includes separate modules targeting urinary, prolapse, and bowel-related symptoms, including constipation, fecal incontinence, urgency, straining, pain, and prolapse-associated bowel dysfunction. The bowel function short form is particularly valuable for clinicians managing anorectal disorders and PFD because it captures symptom severity, frequency, and impact from the patient’s perspective. However, despite broader validation of the IMPACT tool, a specific gap remains in its psychometric evaluation and cross-cultural adaptation of its bowel function module, which this study seeks to address.