Cross-cultural adaptation and validation of the Turkish version of Oxford hip score

Translation, reliability, and validity of the Turkish version of the Victorian Institute of Sports Assessment For Gluteal Tendinopathy (VISA-G) questionnaire in individuals with greater trochanteric pain syndrome

BACKGROUND

Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain.

OBJECTIVE

The objectives of this study were to translate the Victorian Institute of Sports Assessment for Gluteal Tendinopathy (VISA-G) questionnaire into the Turkish language and to examine its reliability and validity.

METHODS

108 individuals (45 female, 63 male) participated in the translation and the reliability and validity analysis. The original VISA-G questionnaire was translated into Turkish language using Beaton guidelines. The Turkish version of the VISA-G, Harris Hip Score (HHS), Oswestry Disability Index (ODI), Oxford Hip Score (OHS), and International Physical Activity Questionnaire (IPAQ) were applied to 108 individuals with GTPS for convergent validity. The VISA-G was retested to investigate its reliability after one week.

RESULTS

The VISA-G had a good correlation with HHS (r = 0.694, p < .001), ODI (r = -0.659, p < .001), OHS (r = 0.678, p < .001), and IPAQ (r = 0.440, p < .001). The reliability and internal consistency were excellent (ICC (2,1) value = 0.943; Cronbach's α = 0.946, respectively). And no floor and ceiling effects were revealed related VISA-G.

CONCLUSION

The Turkish version of the VISA-G has good validity and excellent reliability. It can be used in clinical and research practices in the Turkish population with GTPS.

Cross-Culturally Adapted Versions of Patient Reported Outcome Measures for the Lower Extremity

Background

A large number of patient reported outcome measures (PROMs) have been developed in the English language for various lower extremity orthopaedic pathologies. Twenty different PROMs were recommended for 15 specific musculoskeletal lower extremity pathologies or surgeries. However, the availability of cross-culturally adapted versions of these recommended PROMs is unknown.

Purpose

The purpose of this study was to identify the cross-culturally adapted versions of recommended PROMs for individuals experiencing orthopedic lower extremity pathologies or undergoing surgeries, and to identify the psychometric evidence that supports their utilization.

Study design

Literature Review.

Methods

PubMed, Embase, Medline, Cochrane, CINAHL, SPORTDisucs and Scopus were searched for cross-culturally adapted translated studies through May 2022. The search strategy included the names of the 20 recommended PROMs from previous umbrella review along with the following terms: reliability, validity, responsiveness, psychometric properties and cross-cultural adaptation. Studies that presented a non-English language version of the PROM with evidence in at least one psychometric property to support its use were included. Two authors independently evaluated the studies for inclusion and independently extracted data.

Results

Nineteen PROMS had cross-culturally adapted and translated language versions. The KOOS, WOMAC, ACL-RSL, FAAM, ATRS, HOOS, OHS, MOXFQ and OKS were available in over 10 different language versions. Turkish, Dutch, German, Chinese and French were the most common languages, with each language having more than 10 PROMs with psychometric properties supporting their use. The WOMAC and KOOS were both available in 10 languages and had all three psychometric properties of reliability, validity, and responsiveness supporting their use.

Conclusion

Nineteen of the 20 recommended instruments were available in multiple languages. The PROM most frequently cross-culturally adapted and translated were the KOOS and WOMAC. PROMs were most frequently cross-culturally adapted and translated into Turkish. International researchers and clinicians may use this information to more consistently implement PROMs with the most appropriate psychometric evidence available to support their use.

Level of evidence

3a.

Cross-cultural adaptation and psychometric validation of the Indonesian version of the Oxford Hip Score

Aims

The aim of this study was to perform a cross-cultural adaptation of Oxford Hip Score (OHS) to Indonesian, and to evaluate its psychometric properties.

Methods

We performed a cross-cultural adaptation of Oxford Hip Score into Indonesian language (OHS-ID) and determined its internal consistency, test-retest reliability, measurement error, floor-ceiling effect, responsiveness, and construct validity by hypotheses testing of its correlation with Harris Hip Score (HHS), vsual analogue scale (VAS), and Short Form-36 (SF-36). Adults (> 17 years old) with chronic hip pain (osteoarthritis or osteonecrosis) were included.

Results

A total of 125 patients were included, including 50 total hip arthroplasty (THA) patients with six months follow-up. The OHS questionnaire was translated into Indonesian and showed good internal consistency (Cronbach’s alpha = 0.89) and good reliability (intraclass correlation = 0.98). The standard error of measurement value of 2.11 resulted in minimal detectable change score of 5.8. Ten out of ten (100%) a priori hypotheses were met, confirming the construct validity. A strong correlation was found with two subscales of SF-36 (pain and physical function), HHS (0.94), and VAS (-0.83). OHS-ID also showed good responsiveness for post-THA series. Floor and ceiling effect was not found.

Conclusion

The Indonesian version of OHS showed similar reliability and validity with the original OHS. This questionnaire will be suitable to assess chronic hip pain in Indonesian-speaking patients.

Cite this article: Bone Jt Open 2021;2(9):765–772.

Cross-Cultural Adaptation and Validation of the Turkish Version of the International Hip Outcome Tool - 12

Objectives:

The present study aims to conduct a translation and transcultural adaptation of the International Hip Outcome Tool – 12 (IHOT-12) into Turkish and evaluate the psychometric characteristics of the Turkish version of IHOT-12 (IHOT-12-TR) for validity and reliability in Turkish patients with hip joint disorders.

Methods:

Following the translation and transcultural adaptation procedures, 109 patients completed the IHOT-12-TR and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale. The retest was completed by 40 patients approximately one week after the initial assessments. The psychometric properties of the questionnaire were tested.

Results:

Cronbach’s alpha of 0.927 revealed the internal consistency to be highly satisfactory. The overall Interclass coefficient (ICC) between test and retest was 0.927 (p<0.001). The correlation between IHOT-12-TR and WOMAC scores was strong and statistically significant (r=0.815, p<0.001). The explanatory factor analyses revealed that IHOT-12-TR had a single factor structure, explaining 61.9% of the total variance. There was no floor or ceiling effect on the items and overall scale scores.

Conclusion:

The results of the analyses in this study demonstrated that the Turkish version of the IHOT- 12 scale, the IHOT-12-TR, is a valid and reliable tool to evaluate the functionality of patients with hip pathologies.

Cross-cultural adaptation, and validation of the Turkish version of the Nonarthritic Hip Score

OBJECTIVE

The aim of this study was to translate and cross-culturally adapt the Nonarthritic Hip Score (NAHS) into Turkish and determine the validity and reliability of the translated version in physically active patients with hip pain.

METHODS

Sixty young to middle-aged and physically active patients (34 women and 26 men; mean age=35 years; age range: 18-40 years) with hip pain were included in the study. The original version of the NAHS was first translated into Turkish and back-translated into English by two bilingual translators each. The back-translated version was compared with the initial English version by a committee of the four translators. The Turkish version was then tested with 15 patients with hip pain and 15 healthy individuals. The participants were asked whether they had difficulties in understanding the questions. Subsequently, the questionnaire was accepted for use in the study population. Test-retest reliability and internal consistency were assessed using Intraclass Correlation Coefficient (ICC) and Cronbach's alpha, respectively. The construct validity was determined via the Pearson correlation coefficient between the NAHS and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), modified Harris Hip Score (mHHS), and Short Form-12 (SF-12). Floor and ceiling effects were analyzed. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to test construct validity.

RESULTS

An ICC of 0.994 and Cronbach's alpha value of 0.908 were obtained; thus, the Turkish version of the NAHS was reliable. Neither floor nor ceiling effects (15%) were found in the sub-parameters (8.3-1.7%) and the total score (1.7%) of the NAHS. The EFA test showed that this questionnaire had four factors. Model fit indices in CFA were χ2/df=2.23, Tucker-Lewis index=0.90, comparative fit index=0.91, goodness of fit index=0.63, root mean square error of approximation=0.14 (90% CI: 0.12-0.16). The NAHS total score showed an excellent correlation with WOMAC (r=-0.909), mHHS (r=0.850), and SF-12 (r=0.811) scores.

CONCLUSION

The Turkish version of the NAHS is a valid and reliable questionnaire for young and physically active patients with hip pain.

LEVEL OF EVIDENCE

Level II, Diagnostic study.

Cross-cultural adaptation and validation of a patient-reported hip outcome score

PURPOSE

We aimed to perform psychometric testing for the translated Oxford Hip Score (OHS) for use as a recommended tool to measure treatment outcomes.

METHODS

The original English questionnaire was translated and culturally validated using the instrument developer's guidelines and the ISPOR principles of good practice. One hundred patients completed the form together with the Harris Hip Score (HHS) and EQ-5D-5 L. Fifty patients repeated the form after two days. They were suffering from hip osteoarthritis, had had hip replacement or underwent osteosynthesis for a fracture of the trochanteric region.

RESULTS

The questionnaire had a high degree of reliability with a Cronbach α of 0.917 at the initial completion and 0.917 at the second testing, respectively. The two results were strongly positive and significantly correlated (Pearson's r = 0.947; p < 0.001). The OHS was strongly and significantly correlated with the HHS (Pearson's r = 0.880 initial and r = 0.840 s; p < 0.001) and strongly, positive and significantly correlated with the EQ-5D-5 L VAS (Pearson's r = 0.614 initial and r = 0.704 s; p < 0.001).

CONCLUSIONS

Our study showed that the translation of the OHS is a reliable, reproducible and valid measure of function in patients who undergo treatment for hip pathology.

Evidence for reliability, validity and responsiveness of Turkish version of Hip Outcome Score

BACKGROUND

Hip Outcome Score (HOS), originally developed in English, assesses the severity of hip pathology. To date, no Turkish version of the questionnaire exists.

PURPOSE

The aim of our study was to translate the HOS into Turkish and verify its psychometric properties.

METHODS

The translation and cultural adaptation were performed according to international recommendations in five stages: The HOS was translated into Turkish, consistent with published methodological guidelines. The process included 2 forward translations, followed by the synthesis of these translations, and 2 backward translations, followed by an analysis of the translations and creation of the final version. The measurement properties of the Turkish HOS (internal consistency, construct validity, floor and ceiling effects and responsiveness) were tested in 130 patients.

RESULTS

A committee consisting of the four translators agreed with the final version of the HOS (HOS-Tr). The internal consistency and the test-retest reliability of the HOS-Tr-ADL and HOS-Tr-S subscales were excellent. Correlations between the HOS-Tr and convergent validity of the with HHS and NAHS were fair to good. The responsiveness of the HOS-Tr-ADL and HOS-Tr-S subscales were 3.4 to 1.4 for patients treated with surgically and 0.9 to 1.1 for patients treated with non-surgically.

CONCLUSION

The HOS-Tr is understandable, reliably, valid, and responsive for Turkish-speaking patients with hip pathology.

LEVEL OF EVIDENCE

Level 3 Diagnostic Study.

Cross-cultural adaptation and validation of the Spanish version of the Oxford Hip Score in patients with hip osteoarthritis

Background

Osteoarthritis (OA) of the hip is a disease that entails a major burden for patients and the society as a whole. One way of measuring this burden for the patient is through impact on Health-related Quality of Life (HRQL). The Oxford Hip Score (OHS) is a well-known tool to measure HRQL in patients with OA of the hip. This study aims to assess the psychometric properties of the Spanish-adapted version of the OHS, including its reliability, validity, and sensitivity to change.

Methods

Prospective observational study that included 361 patients diagnosed with hip OA (according to the criterion of the American College of Rheumatology) from 3 different Spanish regions. Their HRQL was assessed using a generic questionnaire, the EQ-5D-5 L, and two specific ones (the Western Ontario and McMaster Universities Osteoarthritis Index, WOMAC, and the OHS) adapted to Spanish. There was a follow-up period of 6 months, and the acceptability, psychometric properties, presence of ceiling and floor effects, validity, reliability, and sensitivity to changes of the OHS were measured.

Results

The OHS was fully answered in 99.4% of cases with no indication of ceiling or floor effects. Its factor structure can be explained in a single dimension. Its discriminative capacity was very good compared to the groups generated by the WOMAC and the EQ-5D-5 L. The correlation between the OHS and dimensions of the WOMAC or EQ-5D-5 L utilities was ≥0.7. Excellent test-retest reliability (ICC = 0.992; CI95%: 0.994–0.998) and internal consistency (Cronbach’s α = 0.928) were observed. The minimal clinically important difference (MCID) was 7.0 points, and the minimum detectable change (MDC) was 5.5 points. The effect size for moderate improvement in perceived HRQL was 0.73, similar to that of WOMAC dimensions and higher than the EQ-5D-5 L.

Conclusions

The Spanish-adapted version of the OHS is a useful, acceptable tool for the assessment of perceived HRQL in patients with hip OA, and has psychometric properties similar to those of the WOMAC that allow for discriminating both a patient’s condition at a given moment and changes that can occur over time.

Electronic supplementary material

The online version of this article (doi:10.1186/s12891-017-1568-3) contains supplementary material, which is available to authorized users.