The Hebrew version of the FibroFatigue scale: validation of a questionnaire for assessment of fibromyalgia and chronic fatigue syndrome

The objective of this study is to validate a translated Hebrew version of the FibroFatigue Scale (FFS). The Hebrew version of the FFS was administered to 100 patients fulfilling ACR criteria for classification of FM together with the validated Hebrew version of the Fibromyalgia Impact Questionnaire (FIQ), the validated Hebrew version of the Short Form-36 (SF-36) and a Visual Analogue Scale (VAS) measurement of pain, anxiety, depression, morning stiffness and global well being. Test–retest reliability was assessed using Spearman correlations. Internal consistency was evaluated with Cronbach’s α of reliability. Construct validity of the FFS was evaluated by correlations among the FFS, the FIQ and the subscales of the SF-36. Mean duration of symptoms was 10.7 years, and mean age of participants was 53.5 years. Test–retest reliability was between 0.46 and 0.85 for the various FFS items. Internal consistency was 0.89 for the overall FFS. Significant correlations were obtained between the FFS items and the SF-36. These results support the reliability and validity of the data obtained with the Hebrew version of the FSS for detecting and measuring symptom severity in Hebrew speaking patients with FM.     

Reliability and validity of a Norwegian version of the Epworth sleepiness scale

Objective  The objective of this study was to assess the reliability and validity of a Norwegian version of the self-administered Epworth sleepiness scale (ESS). Materials and methods  Two samples responded to the ESS: (1) 226 patients previously evaluated for obstructive sleep apnea, of whom 51 also responded to a retest 2 weeks later, and (2) 37 ambulant patients complaining of excessive daytime sleepiness, who were referred to multiple sleep latency testing (MSLT). We assessed internal consistency reliability with Cronbach’s alpha and test–retest reliability with weighted kappa (Kw) or an intraclass correlation coefficient (ICC). The validity of the Norwegian ESS was assessed by correlating ESS item and total scores with the number of times a patient fell asleep and the mean latency found on the MSLT. Results  Internal consistency reliability, as assessed with Cronbach’s alpha, was 0.84 (n = 154). Test–retest reliability for the eight ESS items ranged from Kw of 0.61 to 0.80 (n = 50) and for the total score. ICC was 0.81.There was only fair to moderate correlation of ESS item and total scores with MSLT variables, mainly in a subset of patients with total ESS score >10. Conclusions  The Norwegian version of the ESS had acceptable internal consistency and test–retest reliability. The association of the ESS items and total score with the MSLT was only fair to moderate, in line with previous studies.     

Validation Study of a Hebrew Version of WOMAC in Patients with Osteoarthritis of the Knee

The aim of the study was to validate a translated version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in Hebrew speaking populations. The WOMAC was translated into Hebrew from its English version and its reliability and validity were studied. Before its use in patients, the Hebrew version was translated back into English by an independent translator and minor amendments were made to satisfy the original English versions designed by Bellamy et al. The Hebrew version of the WOMAC questionnaire was administered to 114 patients with osteoarthritis of the knee. All the subjects were asked about the presence and severity of pain during movement and handicap, using a visual analogue scale (VAS) of pain and handicap. Test–retest reliability was assessed using Pearson’s and intraclass correlation coefficients. Internal consistency was evaluated by Cronbach’s alpha coefficient of reliability. Construct validity was tested by correlating the WOMAC items with VAS of pain and handicap. The test–retest reliability Pearson’s correlation coefficients for the WOMAC items ranged from 0.55 to 0.78 (p<0.01), and the Cronbach’s alpha was 0.97 at time 1 and 0.98 at time 2. Significant correlations (p<0.01) were obtained between the WOMAC items and VAS of pain and handicap. The Hebrew version of WOMAC is a reliable and valid instrument for evaluating the severity of osteoarthritis of the knee in Israeli patients. Received: 4 January 1999 / Accepted: 31 March 1999     

CLINHAQ Scale – Validation of a Hebrew Version in Patients with Fibromyalgia

Assessment of health status in patients with rheumatic disease, including fibromyalgia (FM), using structured questionnaires has become an important approach to evaluate treatment and outcome. The objectives of this study were to validate a translated version of the Clinical Health Assessment Questionnaire (CLINHAQ) to be used by Hebrew-speaking populations, and specifically to evaluate its usefulness in fibromyalgia syndrome (FM). The CLINHAQ was translated into Hebrew and administered to 90 women with FM along with the Hebrew versions of the Fibromyalgia Impact Questionnaire (FIQ) and the Quality of Life (QOL) Scale. The CLINHAQ includes scales of functional disability, helplessness, anxiety and depression, as well as assessment of current health status and satisfaction with this. All subjects were asked about the presence and severity (assessed by visual analogue scale) of current FM symptoms (pain, fatigue, anxiety etc.); a count of 18 tender points was conducted by thumb palpation, and tenderness thresholds were measured by dolorimetry. Test–retest reliability was assessed by Pearson correlation coefficients, and internal consistency was evaluated with Cronbach’s α coefficient of reliability. Construct validity was tested by correlating the CLINHAQ items with measures of symptom severity, count of tender point, tenderness thresholds, physical functioning measured by FIQ, and with a score of QOL. Test–retest reliability coefficients ranged from 0.82 to 0.99, and Cronbach’s α coefficients from 0.725 to 0.929. Significant moderate to high correlations were obtained between most subscales of CLINHAQ and measures of physical functioning, quality of life and severity of FM symptoms. In conclusion, the CLINHAQ is a reliable and valid instrument for measuring health status and physical functioning in Israeli women with FM. Received: 22 June 1999 / Accepted: 24 September 1999     

The validity and reliability of the Turkish version of the Rheumatoid and Arthritis Outcome Score (RAOS) in patients with rheumatoid arthritis

The goal of our study was to develop a Turkish version of the Rheumatoid and Arthritis Outcome Score (RAOS) in patients with rheumatoid arthritis (RA) and to assess its reliability, validity, and sensitivity to change. The Turkish version of RAOS was developed according to cross-cultural guidelines by using the “translation–back translation” method. Fifty-eight patients with RA were assessed with it. To assess its validity, patients were also evaluated with Turkish versions of the Health Assessment Questionnaire, five subscales of Arthritis Impact Measurement Scales, and the Rheumatoid Arthritis Quality of Life questionnaire. Test–retest reliability of the RAOS questionnaire was calculated on 58 patients within 1 week. Construct validity was investigated with use of Spearman’s rank correlation coefficient. Test–retest reliability was assessed with use of the intraclass correlation coefficient (ICC) and Cronbach’s alpha score. Sensitivity to change after the 4-week home-based exercise program was evaluated with paired t test comparisons. The Turkish version of the RAOS met set criteria of reliability and validity. The random ICC for the five subscales ranged from 0.76 to 0.94. Interitem correlation measured by Cronbach’s alpha ranged from 0.81 to 0.94. Correlations were found between RAOS subscales and all of the evaluation parameters (p < 0.01). RAOS subscales showed significant improvements after the 4-week home exercise program except for the symptom and quality of life subscales (p < 0.05). The effect sizes were ranged from 0.20 to 0.37 and were considered small. The results of this study showed that the Turkish version of RAOS was reliable, valid, and responsive in patients with rheumatoid arthritis.     

Validation of the Turkish version of the fatigue severity scale in patients with fibromyalgia

The aim of the study was to investigate the validity and reliability of the Turkish version of the fatigue severity scale (FSS) in fibromyalgia (FM) patients. Sixty-one FM patients and 54 healthy controls were evaluated using the Turkish version of the FSS. Reliability was investigated using test–retest reliability and internal consistency. Concurrent validity was evaluated between the FSS score and the VAS fatigue. Convergent validity was assessed by comparing the FSS score with the scores of VAS pain, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Fibromyalgia Impact Questionnaire (FIQ). Spearman’s rank correlation coefficient was used to evaluate validity. Test–retest reliability and internal consistency of the FSS were excellent in FM patients (ICC: 0.94, Cronbach’s alpha coefficient: 0.85) and in the healthy controls (ICC: 0.90, Cronbach’s alpha coefficient: 0.91). For the concurrent validity, the correlation between the FSS and VAS fatigue was very good in FM group (r: 0.63, P: 0.000) and in the healthy controls (r: 0.94, P: 0.000). For the convergent validity, correlations between the FSS and BDI, BAI, FIQ, pain intensity were moderate to good in both groups (P: 0.000). The Turkish version of the FSS has been proved to be valid and reliable to detect severity of fatigue in FM patients. We recommend the use of it in clinical practice.     

Adaptation and validation of the Osteoarthritis Knee and Hip Quality of Life (OAKHQOL) questionnaire for use in patients with osteoarthritis in Spain

This study aims to adapt and validate the Spanish version of the Osteoarthritis Knee and Hip Quality of Life (OAKHQOL) questionnaire. The OAKHQOL was adapted into Spanish using a forward–backward translation methodology. The Spanish version was then validated in a prospective, mixed-design study of 759 patients with hip or knee osteoarthritis (OA). Patients completed the OAKHQOL, Short Form 36 (SF-36), Western Ontario and McMaster Universities Osteoarthritis Index, and the EQ-5D. The internal consistency was evaluated using Cronbach’s alpha. Convergent validity was assessed by examining correlations between the OAKHQOL and other patient-reported instruments; known groups’ validity was assessed by determining the capacity of the OAKHQOL to discriminate between patients with different levels of disease severity measured using the Lequesne Index. Test–retest reliability was evaluated by calculating the intraclass correlation coefficient (ICC) for all OAKHQOL domains in 409 stable patients with OA. Responsiveness was evaluated by calculating effect sizes among 129 patients undergoing hip or knee replacement. Cronbach’s alpha for the five domains of the OAKHQOL ranged from 0.60 to 0.93 while ICCs ranged from 0.75 to 0.81 for all domains except the two social domains. Statistically significant differences (p < 0.001) were observed between patients with different degrees of disease severity on all domains except “social support”. The instrument showed convergent validity among hypothesized domains (p < 0.001). Results of the study supported that the Spanish version OAKHQOL questionnaire was a valid instrument to measure health-related quality of life in patients with OA of the lower limb.     

Reliability and validity of the Foot and Ankle Outcome Score: a validation study from Iran

The aims of this study were to culturally adapt and validate the Persian version of Foot and Ankle Outcome Score (FAOS) and present data on its psychometric properties for patients with different foot and ankle problems. The Persian version of FAOS was developed after a standard forward–backward translation and cultural adaptation process. The sample included 93 patients with foot and ankle disorders who were asked to complete two questionnaires: FAOS and Short-Form 36 Health Survey (SF-36). To determine test–retest reliability, 60 randomly chosen patients completed the FAOS again 2 to 6 days after the first administration. Test–retest reliability and internal consistency were assessed using intraclass correlation coefficient (ICC) and Cronbach’s alpha, respectively. To evaluate convergent and divergent validity of FAOS compared to similar and dissimilar concepts of SF-36, the Spearman’s rank correlation was used. Dimensionality was determined by assessing item–subscale correlation corrected for overlap. The results of test–retest reliability show that all the FAOS subscales have a very high ICC, ranging from 0.92 to 0.96. The minimum Cronbach’s alpha level of 0.70 was exceeded by most subscales. The Spearman’s correlation coefficient for convergent construct validity fell within 0.32 to 0.58 for the main hypotheses presented a priori between FAOS and SF-36 subscales. For dimensionality, the minimum Spearman’s correlation coefficient of 0.40 was exceeded by most items. In conclusion, the results of our study show that the Persian version of FAOS seems to be suitable for Iranian patients with various foot and ankle problems especially lateral ankle sprain. Future studies are needed to establish stronger psychometric properties for patients with different foot and ankle problems.     

Development and Testing of the Multidimensional Trust in Health Care Systems Scale

Objective  To describe the development and psychometric testing of the Multidimensional Trust in Health Care Systems Scale (MTHCSS). Methods  Scale development occurred in 2 phases. In phase 1, a pilot instrument with 70 items was generated from the review of the trust literature, focus groups, and expert opinion. The 70 items were pilot tested in a sample of 256 students. Exploratory factor analysis was used to derive an orthogonal set of correlated factors. In phase 2, the final scale was administered to 301 primary care patients to assess reliability and validity. Phase 2 participants also completed validated measures of patient-centered care, health locus of control, medication nonadherence, social support, and patient satisfaction. Results  In phase 1, a 17-item scale (MTHCSS) was developed with 10 items measuring trust in health care providers, 4 items measuring trust in health care payers, and 3 items measuring trust in health care institutions. In phase 2, the 17-item MTHCSS had a mean score of 63.0 (SD 8.8); the provider subscale had a mean of 40.0 (SD 6.2); the payers subscale had a mean of 12.8 (SD 3.0); and the institutions subscale had a mean of 10.3 (SD 2.1). Cronbach’s α for the MTHCSS was 0.89 and 0.92, 0.74, and 0.64 for the 3 subscales. The MTHCSS was significantly correlated with patient-centered care (r = .22 to .62), locus of control—chance (r = .42), medication nonadherence (r = −.22), social support (r = .25), and patient satisfaction (r = .67). Conclusions  The MTHCSS is a valid and reliable instrument for measuring the 3 objects of trust in health care and is correlated with patient-level health outcomes.     

Cross-cultural adaptation and validation of the knee and hip health-related quality of life (OAKHQoL) in a Moroccan Arabic-speaking population

The aim of this study was to adapt the knee and hip osteoarthritis quality of life questionnaire (OAKHQoL) into Moroccan Arabic and to determine its psychometric properties. After translation, back-translation and pretesting, the translated version was submitted to an expert committee. The psychometric properties were tested on patients with hip or knee osteoarthritis. Internal consistency was tested using Cronbach’s alpha coefficient (α), and the test–retest reliability using intraclass correlation coefficients (ICC). Construct validity was assessed by examining item-convergent and divergent validity and by comparing the average scores between age groups and walk perimeter groups. The study was conducted on 131 patients (115 with osteoarthritis of the knee and 16 with osteoarthritis of the hip). The “physical activities” (α = 0.93), “mental health” (α = 0.84) and “pain” (α = 0.88) dimensions of the Arabic version were internally reliable. The ICC were adequate to good; 0.83 for “physical activities”, 0.65 for “mental health” and 0.70 for “pain” dimensions. The instrument demonstrated good construct validity; all items exceeded the 0.4 criterion for convergent validity, except items 13 and 41 and most of the correlations between items and their own scale were significantly higher than their correlations with other scales. A semantically equivalent translation has been developed with cultural adaptation of OAKHQoL. It is quite reliable and a valid measure of the effect of osteoarthritis on the quality of life on Moroccan patients.     

Validity, reliability, and comparison of the WOMAC osteoarthritis index and Lequesne algofunctional index in Turkish patients with hip or knee osteoarthritis

To assess validity and reliability of the Western Ontario and McMaster Universities (WOMAC) osteoarthritis (OA) index and Lequesne algofunctional index in Turkish patients with hip or knee OA and to compare the results of the instruments for these two particular sites of involvement. Two disease-specific instruments: WOMAC LK 3.1 and Lequesne indices were administered to 117 outpatients with OA (44 hip and 73 knee) living in Turkey. These indices were administered twice 7–10 days apart to ensure the test–retest reliability. All patients were asked to reply a generic health-related quality-of-life instrument (Short Form-36, SF-36) and a structured interview assessing demographic and other characteristics. Internal consistency and reliability was evaluated by Cronbach’s alpha and intra-class correlation coefficients (ICC). Construct validity was tested by correlating the WOMAC or Lequesne with each other, and also with SF-36 and visual analog scale (VAS). The Cronbach’s alphas of the WOMAC and Lequesne subscales were ranged 0.78–0.95 and 0.51–0.85 for hip and 0.78–0.94 and 0.61–0.71 for knee OA, respectively. Test–retest reliability of the WOMAC and Lequesne subscales yielded ICCs of 0.77–0.94 and 0.51–0.85 for hip and 0.80–0.98 and 0.61–0.71 for knee OA, respectively. WOMAC and Lequesne showed moderate-good correlations between comparable subscales of SF-36 (physical functioning and bodily pain) and weak-moderate correlations between VAS. All subscales and total WOMAC had better internal consistency and more satisfactory concurrent validity compared with Lequesne. Our results indicated that WOMAC is a more reliable index for use in Turkish patients with hip or knee OA than Lequesne.     

Validation of the Turkish version of the foot and ankle outcome score

The objective is to develop a Turkish version of the foot and ankle outcome score (FAOS) and to investigate its validity and reliability. The Turkish version of FAOS was developed after the translation and back-translation. The translated version was pretested on 20 patients with rheumatoid arthritis. Then, the Turkish FAOS was administered to 55 patients having foot and ankle problems. They were also evaluated by using the four subscales of the Turkish version of AIMS2, and the Turkish version of SF-36 questionnaire to test validity. Fifty patients filled out the FAOS for second time to determine test–retest reliability. Construct validity was investigated with use of Spearman’s rank correlation coefficient. Test–retest reliability was assessed with use of the intraclass correlation coefficient (ICC) and Cronbach’s alpha score. The psychometric properties of the Turkish FAOS were generally similar to the original FAOS. The random ICC for the five subscales ranged from 0.70 to 0.96. The Cronbach’s alpha coefficient ranged from 0.79 to 0.97. Construct validity of the FAOS was good. The Turkish FAOS correlated with the SF-36 and AIMS2 scales. The Turkish version of FAOS was valid and reliable instrument to assess the foot and ankle related problems. However, to assess its responsiveness further studies are needed.     

Validation of the World Health Organization disability assessment schedule II (WHODAS-II) in patients with osteoarthritis

The objective of this study is to test the reliability and validity of WHODAS-II (Turkish version) for the assessment of disability in patients with osteoarthritis. This study is designed as follows: the internal construct validity of WHODAS-II in patients with knee osteoarthritis was assessed by Rasch analysis, and external construct validity by association with the Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC) and the Nottingham Health Profile (NHP); reliability was tested by internal consistency, intra-class correlation coefficient (ICC) and test–retest ICC. Our study presents the results of 225 outpatients assessed with mean age 58.4 years (SD 11.1) of whom 80.9% were female. Cronbach’s α, ICC, and test–retest ICC values for the six subscales of WHODAS-II varied between 0.71 and 0.94, 0.71 and 0.94, and 0.87 and 0.97, respectively. Rasch analysis of WHODAS-II indicated that after adjustment for local dependency, satisfactory fit was achieved. Two separate ‘activities’ and ‘participation’ components could also be identified. External construct validity of the scale was confirmed with expected correlations with WOMAC and NHP. This study concludes that WHODAS-II provides a reliable and valid health status instrument for measuring disability and components of ‘activities’ and ‘participation’ in patients with osteoarthritis. Thus, it provides the opportunity to model the consequences of disease according to the International Classification of Functioning, Disability and Health framework.     

Depression and its correlation with in patients pain in the rheumatology service of a Mexican teaching hospital

The depressive symptoms are associated with chronic pain in this study. A cross-sectional study was performed. A visual analog scale was used to register pain intensity. Depressive symptoms were measured using the Center of Epidemiological Studies (CES-Dr) scale as modified by Eaton and reviewed for use in the Mexican population. The study included 245 patients, with a mean age of 46 years, 86.1% of whom were female. The prevalence of some degree of depression was 55.1%. Patients with fibromyalgia had the highest prevalence of symptoms of depression (78.38%) and major depression (29.73%). Stepwise multiple regressions indicated that the best model (r ² = 0.26) to predict the CES-Dr score included the global pain score (P < 0.0001) and education level (P < 0.004). The Cronbach’s alpha of the CES-Dr was high (α = 0.888). There was moderate correlation (r = 0.442), P < 0.0001 of the CES-Dr numeric score with the intensity of global pain.     

Psychometric evaluation of the Moroccan version of the Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for use in patients with ankylosing spondylitis

The objectives of this study are to translate, adapt in the Moroccan cultural context, and validate in patients with ankylosing spondylitis (AS) the Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The cross-cultural adaptation of the BASFI and BASDAI was obtained in accordance with the guidelines for translation of the health status measures. Eighty-five patients with AS were included in the study. The test–retest reliability and the internal consistency were analyzed, and both questionnaires were assessed for external construct validity. Structural validity was analyzed with correlation matrix. Twenty-four-hour test–retest reliability was good: BASFI intraclass correlation coefficient (ICC) = 0.96 (confidence interval (CI) at 95%, 0.93–0.97), BASDAI ICC = 0.93 (CI at 95%, 0.90–0.95). Cronbach’s alpha was 0.90 for the BASFI and 0.86 for BASDAI. The construct validity of the instruments was evaluated. The BASFI showed a strong validity when correlating its results with Schober’s test (r = −0.56), occipital wall distance (r = 0.46), chest expansion (r = −0.46), BASDAI (r = 0.54), Bath Ankylosing Spondylitis Metrology Index (r = 0.70), Bath Ankylosing Spondylitis Global Score (BAS-G; r = 0.58), Bath Ankylosing Spondylitis Radiology Index (r = 0.61), and the radiological changes in sacroiliac joints (r = 0.54). A good correlation was observed between the BASDAI and the spinal pain (r = 0.53), the number of nocturnal awakenings (r = 0.57), the morning stiffness (r = 0.65), the enthesic index (r = 0.47), the BAS-G (r = 0.53), the BASFI (r = 0.54), and the erythrocyte sedimentation rate (r = 0.41; for all p < 0.001). The correlation matrix showed an intermediate correlation between items. The Moroccan version of the BASFI and the BASDAI showed adequate reliability and validity. These instruments can be used in the clinical evaluation of Moroccan and Arabic-speaking patients with AS.     

Reliability and validity studies of the Turkish version of the Epworth Sleepiness Scale

The Epworth Sleepiness Scale (ESS) is a self-administered eight-item questionnaire that is widely used in English speaking countries for assessment of daytime sleepiness in adults. The aim of this study was to investigate the reliability and validity of the ESS in the Turkish language. The Turkish version of the ESS (ESStr) was applied to 194 healthy controls and 150 consecutive subjects attending the sleep centre with symptoms of sleep-disordered breathing. Test–retest reliability of the ESStr was tested in a separate group of 30 subjects. The ESStr scores of 60 subjects with mild to severe obstructive sleep apnoea (OSA) were compared with the ESStr scores of 60 healthy controls matched for age, gender, and body mass index (BMI). Concurrent validity with the Functional Outcomes of Sleep Questionnaire (FOSQtr) was also assessed in 12 subjects. The questionnaire had a high level of internal consistency as measured by Cronbach’s alpha (≥0.86). The test–retest intraclass correlation coefficient was r  = 0.81 (95% confidence interval: 0.64–0.90) (p < 0.001) and Spearman’s correlation coefficient was r = 0.80 (p = 0.01). The control group had lower ESStr scores than subjects with sleep-disordered breathing (3.6 ± 3 vs 12.6 ± 6, respectively; p < 0.001). Subjects with mild sleep-disordered breathing also had lower scores of the ESStr than those with moderate and severe sleep-disordered breathing (10 ± 6.2 vs 14 ± 5. and 10 ± 6.2 vs 16 ± 5.4, respectively; both p < 0.05), but there were no significant differences between moderate and severe subjects with sleep apnoea. There were significant correlations between the ESStr and total FOSQtr and its subscales (r  = −0.22 to r = −0.92; all p  = 0.05). Factor analysis of item scores showed that the ESStr had only one factor. The ESStr is a reliable and valid measure of daytime sleepiness. These features and the simplicity of the ESStr make it a valuable measure for clinical management and research.     

The Safe Functional Motion test is reliable for assessment of functional movements in individuals at risk for osteoporotic fracture

The Safe Functional Motion (SFM) test is a performance-based tool developed to assess functional movements in individuals at risk for osteoporotic fracture. The purpose of this study was to determine the test–retest and inter-rater reliability of the scores on the short form of the SFM test (SFM-SF). A secondary objective was to evaluate the construct convergent validity of the balance domain. Community-dwelling adults with low bone mass (n = 36) completed the SFM-SF on two occasions. During one visit, SFM-SF performance was scored by two testers and additional tests of balance (Timed Up and Go (TUG), Berg Balance Scale (BERG), and Community Balance and Mobility Scale (CBMS)) were completed. Test–retest and inter-rater reliability of the SFM-SF score is excellent (intraclass correlation coefficient ≥ 0.90), and the balance domain score demonstrates acceptable associations with established clinical measures of balance (Spearman’s rho = −0.69, 0.76, and 0.83 for TUG, BERG, and CBMS, respectively). SFM-SF provides reliable measures of functional movements in community-dwelling individuals at risk for osteoporotic fracture.     

Validation of the Spanish Version of the WOMAC Questionnaire for Patients with Hip or Knee Osteoarthritis

The aim of this study was to validate a translated version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire in Spanish patients with hip or knee osteoarthritis (OA). The WOMAC questionnaire and the SF-36 were administered to a sample of 269 patients on the waiting list for hip or knee replacement. We studied the convergent validity and the item-scale correlation using Pearson’s correlation coefficient and Spearman’s π. For the reliability study we used another sample of 58 patients who received the WOMAC twice within 15 days. The Pearson’s, Spearman’s π, and intraclass correlation coefficients were calculated. Internal consistency was measured by Cronbach’s α. The responsiveness study was carried out by resending the two questionnaires to all patients 6 months after surgical intervention; responsiveness was measured by means of the paired t-test, the effect size I and the standardised response mean. The Pearson’s coefficients for the convergent validity ranged from −0.52 to −0.63. The coefficients obtained for the item–scale correlation of the pain area were 0.74 or higher, 0.91 or higher for stiffness, and 0.61 or higher for function. When measuring the test–retest reliability, the coefficients ranged from 0.66 to 0.81. Internal consistency yielded a Cronbach’s α ranging from 0.81 to 0.93. The responsiveness showed an effect size I ranging from 1.5 to 2.2 in patients who underwent hip replacement; for those who underwent knee replacement the range was 1 to 1.8. The standardised response mean ranged from 1.3 to 1.9 for patients with hip OA; those with knee OA ranged from 0.8 to 1.5. The Spanish version of WOMAC is a valid, reliable and responsive instrument in patients with hip or knee OA. Received: 12 November 2001 / Accepted: 21 May 2002 Correspondence and offprint requests to: Dr Antonio Escobar Martínez, Unidad de Investigación, Hospital de Basurto, Avenida de Montevideo, 18, 48013 Bilbao, Spain. Tel: +34 944006000 ext. 5307; Fax: +34 944006180; E-mail: aescobar@hbas.osakidetza.net     

Translation and validation of the Persian version of the Arthritis Impact Measurement Scales 2-Short Form (AIMS2-SF) in patients with rheumatoid arthritis

Cultural adaptation and validation of the Persian version of the Arthritis Measurement Scales 2-Short Form (AIMS2-SF). The translation and cultural adaptation of the original questionnaire was carried out in accordance with published guidelines. Three hundred and fifty consecutive Persian-speaking patients with rheumatoid arthritis (RA) were asked to complete the AIMS2-SF, the Short Form Health Survey (SF-36), and four visual analog scales (VAS) for pain, joint stiffness, and patient’s and physician’s global assessment to test convergent validity. In addition, 90 randomly selected patients were asked to complete the questionnaire 48 h later for the second time. Moderate to high correlation were found between the AIMS2-SF and subscales of the SF-36 and VAS for pain, morning stiffness, and patient’s and physician’s global assessment. Cronbach’s alpha coefficient for the Persian AIMS2-SF scales ranged from 0.74 to 0.89. The Persian AIMS2-SF scales showed excellent test–retest reliability with Intraclass Correlation Coefficient ranging from 0.83–0.93 (p < 0.01). The results of the present study showed that the Persian AIMS2-SF has reasonably good convergent validity, internal consistency, and test–retest reliability in patients with RA. It can now be applied in clinical settings and future outcome studies in Iran.