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Pua YH, Koh SSM, Terluin B, Woon EL, Chew ESX, Yeo SJ, Chen JY, Liow LMH, Clark R, Thumboo J. Effect of Context Specificity on Response to the Shortened WOMAC Function Scale in Patients Undergoing Total Knee Arthroplasty. Arch Phys Med Rehabil 2024:S0003-9993(24)00993-6. [PMID: 38723858 DOI: 10.1016/j.apmr.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/01/2024] [Accepted: 05/02/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVE To determine, in patients undergoing total knee arthroplasty (TKA), whether increasing context specificity of selected items of the shortened version of the Western Ontario and McMaster Universities Osteoarthritis Index function (WOMAC-F) scale (ShortMAC-F) (1) enhanced the convergent validity of the ShortMAC-F with performance-based mobility measures (ii) affected mean scale score, structural validity, reliability, and interpretability. DESIGN Secondary analysis of randomized clinical trial data. SETTING A tertiary teaching hospital. PARTICIPANTS Patients undergoing TKA (N=114). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The ShortMAC-F was modified by specifying the "ascending stairs" and "rising from sitting" items to enquire about difficulty in performing the tasks without reliance on compensatory strategies, whereas the modified "level walking" item enquired about difficulty in walking 400 m. Before and 12 weeks after TKA, patients completed the WOMAC-F questionnaire, modified ShortMAC-F questionnaire, knee pain scale questionnaire, sit-to-stand test, fast gait speed test, and stair climb test. Interpretability was evaluated by calculating anchor-based substantial clinical benefit estimates. RESULTS The modified ShortMAC-F correlated significantly more strongly than ShortMAC-F or WOMAC-F with pooled performance measures (differences in correlation values, 0.12-0.14). Increasing item context specificity of the ShortMAC-F did not influence its psychometric properties of unidimensionality (comparative fit and Tucker-Lewis indices, >0.95; root mean square error of approximation, 0.05-0.08), reliability (Cronbach's α, 0.75-0.83), correlation with pain intensity (correlation values, 0.48-0.52), and substantial clinical benefit estimates (16 percentage points); however, it resulted in lower mean score (4.5-4.8 points lower). CONCLUSIONS The modified ShortMAC-F showed sufficient measurement properties for clinical application, and it seemed more adept than WOMAC-F at correlating with performance-based measures in TKA.
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Affiliation(s)
- Yong-Hao Pua
- Department of Physiotherapy, Singapore General Hospital, Singapore; Medicine Academic Programme, Duke-NUS Graduate Medical School, Singapore.
| | | | - Berend Terluin
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Department of General Practice, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ee-Lin Woon
- Department of Physiotherapy, Singapore General Hospital, Singapore
| | | | - Seng-Jin Yeo
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
| | | | | | - Ross Clark
- Research Health Institute, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Julian Thumboo
- Medicine Academic Programme, Duke-NUS Graduate Medical School, Singapore; Department of Rheumatology and Immunology, Singapore General Hospital, Singapore; Health Services Research & Evaluation, SingHealth Office of Regional Health, Singapore
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Kwan YH, Fenwick E, Leung YY, Fong W, Woon TH, Xiang L, Lamoureux E, Thumboo J. Establishing language and ethnic equivalence for health-related quality of life item banks and testing their efficiency via computerised adaptive testing simulations. PLoS One 2024; 19:e0298141. [PMID: 38394320 PMCID: PMC10890744 DOI: 10.1371/journal.pone.0298141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/17/2024] [Indexed: 02/25/2024] Open
Abstract
PURPOSE We aimed to (1) establish linguistic and ethnic equivalence (i.e. lack of bias) for the items in the English and Chinese versions of the Singapore Health and Well Being (SHAWS) Physical Functioning (PF), Positive Mindset (PM) and Social Relationship (SR) item banks (IBs); and (2) evaluate the preliminary efficiency of these IBs using Computer Adaptive Testing (CAT) simulations. METHODS In this cross-sectional study, 671, 670, and 672 subjects answered 55, 48 and 30 items of the PF, PM, and SR IBs, respectively. Rasch analysis was conducted to assess each IB's psychometric properties, particularly the presence of differential item functioning (DIF) for language and ethnicity. A set of performance criteria related to removing items that displayed notable DIF were employed. CAT simulations determined the mean number of items for high, moderate, and moderate-low measurement precisions (stopping rule: SEM 0.300, 0.387. 0.521, respectively). RESULTS Half of subjects were >50 years old (40.9% PF, 42.1% PM, 41.4% SR), Chinese (50.7% PF, 51.0% PM, 50.6% SR) and female (50.0% PF. 49.4% PM, 52.8% SR) respectively. Rasch analysis revealed 4 items with DIF for the PF IB, 9 items with DIF for the PM IB and 2 items with DIF for the SR IB. In CAT simulations, the mean number of items administered was 8.5, 21.6 and 14.5 for the PF, PM and SR IBs, respectively (SEM 0.300), 5.1, 13.0, 8.0 for PF, PM and SR IBs, respectively (SEM 0.387) and 3.1, 5.3 and 4.1 for PF, PM and SR IBs, respectively (SEM 0.521). CONCLUSION The PF, PM and SR IBs to measure health-related quality of life revealed minimal DIF for language and ethnicity after remedial efforts. CAT simulations demonstrated that these IBs were efficient, especially when the stopping rule was set at moderate precision, and support the implementation of the SHAWS IBs into routine clinical care.
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Affiliation(s)
- Yu Heng Kwan
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Centre of Population Health and Implementation Research, SingHealth Regional Health System, Singapore, Singapore
| | - Eva Fenwick
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore
- The University of Melbourne, Melbourne, Australia
| | - Ying Ying Leung
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Warren Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Ting Hui Woon
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Ling Xiang
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
| | - Ecosse Lamoureux
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore
- The University of Melbourne, Melbourne, Australia
| | - Julian Thumboo
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Centre of Population Health and Implementation Research, SingHealth Regional Health System, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
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Razmjou H, Denis S, Robarts S, Falconer J, Anunciacion M, Nunn A, Wainwright A, Dickson P, Najafi R, Murnaghan J. Virtual performance measure in osteoarthritis: An innovative transformation of patient care. OSTEOARTHRITIS AND CARTILAGE OPEN 2023; 5:100410. [PMID: 37829082 PMCID: PMC10565872 DOI: 10.1016/j.ocarto.2023.100410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023] Open
Abstract
Objectives The purpose of this study was to develop and establish reliability and validity of a virtual performance measure (VPM) score that encompassed 10 videos in patients with osteoarthritis of the knee joint. Patients' experience and satisfaction were documented. Design Forty videos were chosen for 10 functional tasks, with four videos showing increasing difficulty for each task. Patients were requested to choose the video that best reflected their own situation. Clinical and radiological findings and self-report and performance measures were completed. Results Data of 100 patients, 70 (70%) females, mean age: 65 ± 9 were examined. The Cronbach's alpha coefficient that examined internal consistency of the VPM score was 0.92. The intraclass correlation value of 0.82 was obtained for test-retest reliability. Factor analysis showed three distinct domains. There was moderate correlations between the VPM score and the self-report and actual performance measures ranging from r = 0.46 to 0.66. The VPM summated score of 10 activities was able to differentiate between candidates and non-candidates for knee arthroplasty, with the area under the curve value of 0.90 indicating excellent predictive validity. The overall patient experience and satisfaction was positive with 67% of participants feeling that virtual care could have an impact on minimizing physical presence in the clinic or hospital. Conclusions The VPM is a reliable and valid outcome measure in patients with osteoarthritis of the knee joint. This digital tool has the potential to transform osteoarthritis care by providing a valid remote measurement of real-life functional limitations and reduce the burden of time consuming in-person tests.
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Affiliation(s)
- Helen Razmjou
- Bone and Joint Program, Holland Orthopedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Suzanne Denis
- Bone and Joint Program, Holland Orthopedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Susan Robarts
- Bone and Joint Program, Holland Orthopedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - James Falconer
- Bone and Joint Program, Holland Orthopedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Mark Anunciacion
- Bone and Joint Program, Holland Orthopedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Andrea Nunn
- Bone and Joint Program, Holland Orthopedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Amy Wainwright
- Bone and Joint Program, Holland Orthopedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Patricia Dickson
- Bone and Joint Program, Holland Orthopedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Roxana Najafi
- Bone and Joint Program, Holland Orthopedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - John Murnaghan
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
- Division of Orthopedic Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada
- Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Canada
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do Nascimento CD, Peter WF, Ribeiro IM, Moreira BDS, Lima VP, Kirkwood RN, Bastone ADC. Cross-cultural validity of the Animated Activity Questionnaire for patients with hip and knee osteoarthritis: a comparison between the Netherlands and Brazil. Braz J Phys Ther 2021; 25:767-774. [PMID: 34247947 DOI: 10.1016/j.bjpt.2021.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 04/30/2021] [Accepted: 06/08/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The Animated Activity Questionnaire (AAQ) was developed in the Netherlands to assess activity limitations in individuals with hip/knee osteoarthritis (HKOA). The AAQ is easy to implement and minimizes the disadvantages of questionnaires and performance-based tests by closely mimicking real-life situations. The AAQ has already been cross-culturally validated in six other countries. OBJECTIVE To assess the cross-cultural validity, the construct validity, the reliability of the AAQ in a Brazilian sample of individuals with HKOA, and the influence of formal education on the construct validity of the AAQ. METHODS The Brazilian sample (N = 200), mean age 64.4 years, completed the AAQ and the Western Ontario and McMaster Universities Index (WOMAC). A subgroup of participants performed physical function tests and completed the AAQ twice with a one-week interval. The Dutch sample (N = 279) was included to examine Differential Item Functioning (DIF) between the scores obtained in the Netherlands and Brazil. For this purpose, ordinal regression analyses were used to evaluate whether individuals with the same level of activity limitations from the two countries (the Dutch as the reference group) scored similarly in each AAQ item. To evaluate the construct validity, correlation coefficients were calculated between the AAQ, the WOMAC domains, and the performance-based tests. To evaluate reliability, the Cronbach's alpha coefficient, the intraclass correlation coefficient, and the standard error of measurement (SEM) were calculated. RESULTS The AAQ showed significant correlations with all the WOMAC domains and performance-based tests (rho=0.46-0.77). The AAQ showed high internal consistency (Cronbach's alpha=0.94), excellent test-retest reliability (ICC2,1 = 0.98), and small SEM (2.25). Comparing to the scores from the Netherlands, the AAQ showed DIF in two items, however, they did not impact on the total AAQ score (rho=0.99). CONCLUSION Overall, the AAQ showed adequate cross-cultural validity, construct validity, and reliability, which enables its use in Brazil and international/multicenter studies.
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Affiliation(s)
- Clarissa Daniela do Nascimento
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brazil
| | - Wilfred F Peter
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden and Amsterdam Rehabilitation Research Center
- Reade, Amsterdam, the Netherlands
| | - Icaro Martins Ribeiro
- Department of Physical Therapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brazil
| | - Bruno de Souza Moreira
- Postgraduate Program in Public Health, Faculty of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Vanessa Pereira Lima
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brazil
| | | | - Alessandra de Carvalho Bastone
- Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brazil; Department of Physical Therapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brazil.
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dos JR, Protázio JB, Muribeca-de-Castro AM, Pinheiro JS, Takahasi HY, Pires FDO, de Souza SAR, Fidelis-de-Paula-Gomes CA, Rêgo AS, Bassi-Dibai D, Dibai-Filho AV. Brazilian version of the Self-Estimated Functional Inability because of Pain questionnaire for musculoskeletal injuries relating to dance and sport: translation and cross-cultural adaptation. SAO PAULO MED J 2020; 138:11-18. [PMID: 32321100 PMCID: PMC9673844 DOI: 10.1590/1516-3180.2019.0375.r1.08102019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 10/08/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Self-Estimated Functional Inability because of Pain (SEFIP) is a questionnaire specifically designed to measure musculoskeletal pain or discomfort. OBJECTIVE To perform translation and cross-cultural adaptation of the SEFIP for dancers (SEFIP-dance), for use in Brazilian Portuguese. In addition, as a secondary objective, we adapted the translated version of SEFIP-dance for use among athletes or exercise practitioners (SEFIP-sport). DESIGN AND SETTING Questionnaire translation and cross-cultural adaptation study conducted at a public university. METHODS The Brazilian version of the SEFIP-dance questionnaire was developed following the processes of translation (involving two translators with Brazilian Portuguese as their mother tongue and fluency in English), backtranslation (involving two translators with English as their mother tongue and fluency in Brazilian Portuguese), committee review and pre-testing. SEFIP-sport was developed following the processes of content and face validation. RESULTS SEFIP-dance was applied to 30 dancers, of mean age 22.38 years (standard deviation [SD] = 3.41), among whom 14 were men (46.66%). The participants understood 100% of the SEFIP-dance items and alternatives. SEFIP-sport was applied to 30 athletes or physical exercise practitioners, of mean age 25.09 years (SD = 8.93), among whom 25 were men (86.33%). The participants understood 100% of the -SEFIP-sport items and alternatives. CONCLUSION The Brazilian Portuguese versions of SEFIP-dance, translated and cross-culturally adapted for dancers, and SEFIP-sport, adapted for athletes or physical exercise practitioners, were shown to have adequate levels of understanding.
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Affiliation(s)
- Jodimar Ribeiro dos
- Undergraduate Student, Department of Physical Education, Universidade Federal do Maranhão (UFMA), São Luís (MA), Brazil.
| | - Jhonata Botelho Protázio
- Undergraduate Student, Department of Physical Education, Universidade Federal do Maranhão (UFMA), São Luís (MA), Brazil.
| | - Aila Maria Muribeca-de-Castro
- Undergraduate Student, Department of Physical Education, Universidade Federal do Maranhão (UFMA), São Luís (MA), Brazil.
| | - Jocassia Silva Pinheiro
- Undergraduate Student, Department of Physical Education, Universidade Federal do Maranhão (UFMA), São Luís (MA), Brazil.
| | - Henrique Yuji Takahasi
- PT. Master’s Student, Postgraduate Program on Physical Education, Universidade Federal do Maranhão (UFMA), São Luís (MA), Brazil.
| | - Flavio de Oliveira Pires
- PT. Professor, Department of Physical Education, Universidade Federal do Maranhão (UFMA), São Luís (MA), Brazil.
| | - Sergio Augusto Rosa de Souza
- PhD. Professor, Department of Physical Education, Universidade Federal do Maranhão (UFMA), São Luís (MA), Brazil.
| | | | - Adriana Sousa Rêgo
- PhD. Professor, Postgraduate Program on Program Management and Healthcare Services, Universidade Ceuma, São Luís (MA), Brazil.
| | - Daniela Bassi-Dibai
- PhD. Professor, Postgraduate Program on Program Management and Healthcare Services, Universidade Ceuma, São Luís (MA), Brazil.
| | - Almir Vieira Dibai-Filho
- PhD. Professor, Postgraduate Program on Physical Education, Universidade Federal do Maranhão (UFMA), São Luís (MA), Brazil.
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Peter WF, Poolman RW, Scholtes VAB, de Vet HCW, Terwee CB. Responsiveness and interpretability of the Animated Activity Questionnaire for assessing activity limitations of patients with hip or knee osteoarthritis. Musculoskeletal Care 2019; 17:327-334. [PMID: 31402572 DOI: 10.1002/msc.1418] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/18/2019] [Accepted: 06/20/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE The aim of the study was to determine the responsiveness and interpretability of the Animated Activity Questionnaire (AAQ), an online questionnaire in which osteoarthritis patients select animations that best match their performance of daily activities. METHODS A longitudinal study was carried out, in which 94 patients with hip or knee osteoarthritis were assessed at baseline, and 3 and 6 months after treatment (conservative and surgical). Responsiveness was assessed by means of testing hypotheses about expected correlations between change in AAQ, a Global Rating Scale of change (GRS) and change in the Activities of Daily Living subscale of the Hip disability or Knee injury and Osteoarthritis Outcome Score (H/KOOS), and a combination of performance-based tests (the 30 s chair-stand test, the timed up-and-go test and the nine-step stair climbing test). The minimal important change (MIC) was estimated by means of the receiving operating characteristics (ROC) method. RESULTS The correlations of the AAQ with the H/KOOS were as expected, but other correlations were lower than anticipated. The area under the ROC curve was 0.74 at 6 months. At 3 months' follow-up, the correlations were too low to calculate a MIC. A total of 20% of the results at 3 months and 80% of the results at 6 months were in accordance with the hypotheses. The MIC was 9 points at 6 months. CONCLUSIONS The AAQ was sufficiently responsive at the six-months follow-up, but not at the three-month follow-up. The MIC at the 6-month follow-up (9 points) was slightly lower than the smallest detectable change of 14 points found in a previous study.
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Affiliation(s)
- Wilfred F Peter
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Amsterdam Rehabilitation Research Center|Reade, Amsterdam, the Netherlands
| | - Rudolf W Poolman
- Department of Orthopedics, Joint Research, OLVG, Amsterdam, the Netherlands
| | | | - Henrika C W de Vet
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Caroline B Terwee
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
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Dubouis L, Ngueyon-Sime W, Peter W, Vallata A, Epstein J, Rat AC, Agrinier N, Terwee CB, Guillemin F. Comparison of a video versus paper questionnaire on functional limitation in lower limb osteoarthritis. BMC Musculoskelet Disord 2019; 20:507. [PMID: 31679508 PMCID: PMC6825726 DOI: 10.1186/s12891-019-2868-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 10/09/2019] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The video Animated Activity Questionnaire (AAQ) was developed to assess the impact of lower limb osteoarthritis (OA) on daily functional activities. The objective of the study was to compare the video and the HOOS/KOOS paper questionnaires and to assess the effect of order of administration. MATERIAL AND METHODS Patients recruited in the KHOALA cohort were randomized in two groups: AAQ questionnaire first (AAQ-first group) and HOOS (hip)/KOOS (knee) questionnaire first (H/KOOS-first group). Within group differences between AAQ and HOOS/KOOS scores were compared using a Student t-test. The Spearman correlation coefficient between AAQ score and HOOS/KOOS score was calculated in each group then compared, using Fisher z-transformation. RESULTS Among 200 randomized patients, 188 (65.8 years, 66.0% women) completed the questionnaires: 99 in the AAQ-first group and 89 in the H/KOOS-first group. The AAQ score was 85.9 (SD: 13.7) in the AAQ-first versus 87.8 (SD: 13.1) in the H/KOOS-first group (p = 0.34). The H/KOOS score was 72.5 (SD: 21.2) in the AAQ-first versus 73.5 (SD: 18.4) in the H/KOOS-first group (p = 0.71). The Spearman correlation coefficient between AAQ and H/KOOS in the AAQ-first was 0.84[0.77-0.89] and 0.73[0.61-0.81] in H/KOOS-first group. These correlations differed between groups significantly (p = 0.02). CONCLUSION This study found video AAQ and paper HOOS/KOOS questionnaire highly correlated, with a moderate but significant effect of order administration of video and paper questionnaires evidencing a stronger correlation when the videos were viewed first.
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Affiliation(s)
- L Dubouis
- CHRU-Nancy, Inserm, Université de Lorraine CIC Clinical epidemiology, Nancy, France
| | - W Ngueyon-Sime
- CHRU-Nancy, Inserm, Université de Lorraine CIC Clinical epidemiology, Nancy, France
| | - W Peter
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, de Boelelaan 1117, Amsterdam, the Netherlands
| | - A Vallata
- CHRU-Nancy, Inserm, Université de Lorraine CIC Clinical epidemiology, Nancy, France
| | - J Epstein
- CHRU-Nancy, Inserm, Université de Lorraine CIC Clinical epidemiology, Nancy, France.,Université de Lorraine, APEMAC, Nancy, France
| | - A-C Rat
- CHRU-Nancy, Inserm, Université de Lorraine CIC Clinical epidemiology, Nancy, France.,Université de Lorraine, APEMAC, Nancy, France
| | - N Agrinier
- CHRU-Nancy, Inserm, Université de Lorraine CIC Clinical epidemiology, Nancy, France.,Université de Lorraine, APEMAC, Nancy, France
| | - C B Terwee
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, de Boelelaan 1117, Amsterdam, the Netherlands
| | - F Guillemin
- CHRU-Nancy, Inserm, Université de Lorraine CIC Clinical epidemiology, Nancy, France. .,Université de Lorraine, APEMAC, Nancy, France.
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Peter WF, de Vet HCW, Terwee CB. Reliability of the Animated Activity Questionnaire for assessing activity limitations of patients with hip and knee osteoarthritis. Musculoskeletal Care 2018; 16:363-369. [PMID: 29770556 DOI: 10.1002/msc.1349] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 04/05/2018] [Accepted: 04/06/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The aim of the study was to determine the internal consistency, test-retest reliability and measurement error of the Animated Activity Questionnaire (AAQ) for assessing activity limitations in hip and knee osteoarthritis (HKOA) patients. METHODS A total of 1,177 patients, from six countries (the Netherlands, UK, France, Denmark, Italy and Spain), completed the AAQ, a questionnaire consisting of videos displaying 17 activities with 3-5 levels of performance, from which patients choose the video that best matches their own performance. Unidimensionality was assessed by means of confirmatory factor analysis (CFA), using the following fit indices: the Tucker-Lewis index (TFI) >0.95, comparative fit index (CFI) >0.95, and root mean square error of approximation (RMSEA) <0.06. Cronbach's alpha was computed. In 238 patients who completed the AAQ twice, the intra-class correlation coefficient (ICC) was calculated for test-retest reliability. The standard error of measurement (SEM) and the smallest detectable change (SDC) were calculated as parameters of measurement error. RESULTS The fit indices for unidimensionality were CFI 0.957, TLI 0.950, and RMSEA 0.144. Cronbach's alpha was 0.95. ICC for test-retest reliability was 0.93 (95% confidence interval 0.91 to 0.95), ranging from 0.85 to 0.98 across countries. SEM and SDC were 4.9 and 13.6, respectively, on a scale from 0 to 100, and ranging from 2.7 to 6.7, and from 7.5 to 18.4, respectively, across countries. The AAQ appeared to measure slightly more precisely in patients with knee problems and patients without prosthesis. CONCLUSION The AAQ seemed to be unidimensional, and showed good internal consistency and test-retest reliability. The SDC indicated that changes in scores of at least 14% indicate real improvement in activity limitations.
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Affiliation(s)
- W F Peter
- Department of Epidemiology and Biostatistics and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, the Netherlands
| | - H C W de Vet
- Department of Epidemiology and Biostatistics and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - C B Terwee
- Department of Epidemiology and Biostatistics and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
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EFAS Score - Multilingual development and validation of a patient-reported outcome measure (PROM) by the score committee of the European Foot and Ankle Society (EFAS). Foot Ankle Surg 2018; 24:185-204. [PMID: 29933960 DOI: 10.1016/j.fas.2018.05.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND A scientifically sound validated foot and ankle specific score validated ab initio for different languages is missing. The aim of a project of the European Foot and Ankle Society (EFAS) was to develop, validate, and publish a new score(the EFAS-Score) for different European languages. METHODS The EFAS Score was developed and validated in three stages: (1) item (question) identification, (2) item reduction and scale exploration, (3) confirmatory analyses and responsiveness. The following score specifications were chosen: scale/subscale (Likert 0-4), questionnaire based, outcome measure, patient related outcome measurement. For stage 3, data were collected pre-operatively and at a minimum follow-up of 3 months and mean follow-up of 6 months. Item reduction, scale exploration, confirmatory analyses and responsiveness were executed using analyses from classical test theory and item response theory. RESULTS Stage 1 resulted in 31 general and 7 sports related questions. In stage 2, a 6-item general EFAS Score was constructed using English, German, French and Swedish language data. In stage 3, internal consistency of the scale was confirmed in seven languages: the original four languages, plus Dutch, Italian and Polish (Cronbach's Alpha >0.86 in all language versions). Responsiveness was good, with moderate to large effect sizes in all languages, and significant positive association between the EFAS Score and patient-reported improvement. No sound EFAS Sports Score could be constructed. CONCLUSIONS The multi-language EFAS Score was successfully validated in the orthopaedic ankle and foot surgery patient population, including a wide variety of foot and ankle pathologies. All score versions are freely available at www.efas.co.
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