Cross-cultural adaptation and validation of the Peripheral Artery Questionnaire: Korean version for patients with peripheral vascular diseases

The Peripheral Artery Questionnaire (PAQ), as developed in US English, is a validated scale to evaluate the health status of patients with peripheral artery disease (PAD). The aim of this study was to translate the PAQ into Korean and to evaluate its reliability and validity. A multi-step process of forward-translation, reconciliation, consultation with the developer, back-translation and proofreading was conducted. The test-retest reliability was evaluated at a 2-week interval using the intra-class correlation coefficient (ICC). The validity was assessed by identifying associations between Korean PAQ (KPAQ) scores and Korean Health Assessment Questionnaire (KHAQ) scores. A total of 100 PAD patients were enrolled: 63 without and 37 with severe claudication. The reliability of the KPAQ was adequate, with an ICC of 0.71. There were strong correlations between KPAQ's subscales. Cronbach's alpha for the summary score was 0.94, indicating good internal consistency and congruence with the original US version. The validity was supported by a significant correlation between the total KHAQ score and KPAQ physical function, stability, symptom, social limitation and quality of life scores (r = -0.24 to -0.90; p < 0.001) as well as between the KHAQ walking subscale and the KPAQ physical function score (r = -0.55, p < 0.001). Our results indicate that the KPAQ is a reliable, valid instrument to evaluate the health status of Korean patients with PAD.     

Cross-cultural adaptation and validation of a European Portuguese version of the 8-item Morisky medication adherence scale

Introduction and Objective

The 8-Item Morisky Medication Adherence Scale (MMAS-8) is one of the most widely used instruments to assess medication adherence, but a validated European Portuguese version of MMAS-8 does not exist. Our aim was to develop and validate a European Portuguese version of the MMAS-8.

Cross-cultural validation of the CHO-KLAT and HAEMO-QoL-A in Canadian French

Summary. Multi‐site studies are necessary in the field of haemophilia to ensure adequate sample sizes. Quality of life (QoL) instruments need to be harmonized across languages and cultures to facilitate their inclusion. The purpose of this study was to adapt the Canadian Haemophilia Outcomes – Kids Life Assessment Tool (CHO‐KLAT^©) and HAEMO‐QoL‐A^© to French for Canada. The CHO‐KLAT and the HAEMO‐QoL‐A are haemophilia‐specific measures of QoL for boys and men respectively. Both measures originated in English, were translated into Canadian French by clinicians with expertise in haemophilia care, back‐translated by expert translators and harmonized by a multi‐disciplinary team. The harmonized versions were evaluated through a cognitive debriefing process with 6 boys with haemophilia, their parents and 10 men with haemophilia. The final versions were validated in a sample of 19 boys with haemophilia, 19 parents, and 22 men with haemophilia along with a generic QoL scale: the PedsQL for children; and the SF‐36 for adults. The translation and cognitive debriefing processes resulted in a preliminary version that maintained the intent of the original questions. The validation study estimated the mean score for the child‐reported CHO‐KLAT at 71.9 (SD 10.4), and the adult‐reported HAEMO‐QoL‐A at 79.1 (SD 21.3). The CHO‐KLAT correlated 0.64 with the PedsQL and the HAEMO‐QoL‐A correlated 0.78 with the SF‐36 physical component summary score. The French‐Canadian version of the CHO‐KLAT and HAEMO‐QoL‐A are valid. These measures are available for use in multi‐site haemophilia trials and clinical practices to capture QoL data from French Canadians.     

Adaptation and validation of the Turkish version of the Nasal Obstruction Symptom Evaluation scale

Background

The Nasal Obstruction Symptom Evaluation (NOSE) scale is a questionnaire used to assess the quality of life in patients with nasal obstruction. The aim of this study was to validate the Turkish translation of the NOSE questionnaire.

Methods

The NOSE questionnaire was translated into Turkish and then back to English. Fifty patients with septal deviation leading to nasal obstruction and 50 healthy subjects without any nasal complaints and pathologies were recruited into the study. The Cronbach α was used to test internal consistency. The Mann‐Whitney U test was used to compare the NOSE scores of the 2 groups. Psychosomatic features (reliability, repeatability, validity, responding) were evaluated by concerning the criteria as test‐retest procedure, self consistency, within‐score and inter‐score correlation and sensitivity of responding between the 2 groups.

Results

There was no statistically significant difference between patients and healthy subjects in terms of age, gender, and body mass index. Test‐retest results among control subjects also did not demonstrate significant difference and the Cronbach α value of the NOSE scale was found to be 0.966. There was a positive correlation among every question of the NOSE scale and it was statistically significantly different from the control group. Total scores of the NOSE scale were significantly higher than the control group.

Conclusion

The Turkish version of the NOSE scale is a valid tool for assessing patients with septal deviation and measuring the subjective severity of nasal obstruction.     

Cross-cultural adaptation and validation of an argentine Spanish version of the Stanford childhood health assessment questionnaire

Objectives . To translate into Argentine Spanish and cross-culturally adapt the Childhood Health Assessment Questionnaire (CHAQ) and validate the adapted instrument in Argentine patients with juvenile rheumatoid arthritis (JRA). Methods . Five bilingual Argentine pediatric rheumatologists translated into Argentine Spanish and cross-culturally adapted the United States English CHAQ. Pretesting was done in a sample of 23 parents using a probe question technique. Parents of 70 patients with JRA and 21 healthy children (controls) participated in the validation phase. All were from Argentina. Results . The mean disability index (DI) scores for patients with systemic, polyarticular, or pauciarticular onset JRA were 0.64, 0.32, and 0.1, respectively. Healthy controls averaged 0.2. Intercomponent correlations were between 0.4 and 0.9, suggesting internal consistency, but also some redundancy. Test-retest reliability, studied at a 1-week interval, was moderate (mean DI 0.44 [in clinic] and 0.29 [one week later], Pearson's correlation = 0.82). We compared CHAQ scores from 15 parents with those of their children >10 years of age. Significantly higher DI scores were given by patients than their respective parents (P > 0.019), but the pairwise scores (parent–patient) were highly correlated (r = 0.986). Conclusions . Cross-cultural adaptation of the US CHAQ to Argentina required few changes. Although DI scores for all patient subgroups were higher than for controls subjects, the scores were low, particularly for those with pauciarticular disease. Prospective studies designed to examine the sensitivity to change and predictive validity will help to assess further the usefulness of the adapted CHAQ in the Argentine population.     

Cross-cultural adaptation and validation of the Chinese version of the Health Assessment Questionnaire for the Spondyloarthropathies (HAQ-S)

The Health Assessment Questionnaire for Spondyloarthropathies (HAQ-S) is a commonly used questionnaire to evaluate function and health status of patients with ankylosing spondylitis (AS). The objective of this study was to cross-culturally adapt the HAQ-S into Chinese and then to evaluate its reliability and validity. The Chinese version of the HAQ-S was obtained with a five-step procedure of translation and cross-cultural adaptation. All invited patients met the New York criteria for AS, and a total of 103 patients finally participated in this study. Intraclass correlation coefficient (ICC) was used to evaluate the test-retest and inter-rater reliability of the HAQ-S. Internal consistency of the questionnaire was evaluated by Cronbach’s alpha coefficient. Spearman’s correlation coefficient was calculated to assess the construct validity between the HAQ-S and Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), Bath AS Metrology Index (BASMI), and the laboratory parameters (erythrocyte sedimentation rate, ESR; C-reactive protein, CRP). Test-retest and inter-rater reliability were excellent with intraclass correlation coefficients of 0.987 (p < 0.05) and 0.982 (p < 0.05), respectively. The overall internal consistency of the HAQ-S was found satisfactory (Cronbach’s alpha = 0.914). The Chinese version of the HAQ-S correlated good with the BASFI (r = 0.749, p < 0.01), and moderate with the BASDAI (r = 0.581, p < 0.01) and the BASMI (r = 0.425, p < 0.01). But, the adapted questionnaire correlated poorly with ESR (r = 0.298, p < 0.01) or CRP (r = 0.283, p < 0.01). The Chinese version of the HAQ-S is reliable and valid for the evaluation of Chinese-speaking patients with AS.     

Cross-cultural adaptation and validation of the Japanese version of the Childhood Health Assessment Questionnaire (CHAQ)

To assess cross-cultural adaptation, and to validate the parent's version of a health-related quality-of-life instrument, the Childhood Health Assessment Questionnaire (CHAQ) was investigated after its translation into Japanese. A total of 132 subjects were enrolled: 63 patients with juvenile idiopathic arthritis (JIA) (34 systemic and 29 polyarticular) and 69 healthy children. The CHAQ distinguished clinically between healthy subjects and the two JIA subtypes of patients. The average disability index (DI) scores for systemic JIA (sJIA) and polyarticular JIA (pJIA) patients and healthy subjects were 1.5, 1.2, and 0.0, respectively. All variables in the questionnaire were shown to be significant (P < 0.001). Patients with pJIA showed better correlation than those with sJIA. Significant correlation was seen in the polyarticular group with CRP, ESR, parents' VAS, the number of joints with pain, and the number of active joints. However, there was even a negative correlation between DI and parent's assessment of overall well-being for the sJIA group. The Japanese version of the CHAQ was a reliable and valid tool for the functional assessment of children with pJIA. Functional ability, as assessed by the CHAQ, may not be the main consideration of sJIA patients' parents when assessing their child's status.     

Cross-cultural adaptation and validation of the Brazilian version of the Scleroderma Health Assessment Questionnaire (SHAQ)

The Scleroderma Health Assessment Questionnaire (SHAQ) is a feasible multisystem specific tool that has been extensively used as an additional assessment for systemic sclerosis (SSc). The aim of this study is to cross-culturally adapt and validate the Brazilian version of the SHAQ. Construct validity was assessed based on the correlations between SHAQ and both the Medical Outcomes Survey Short Form 36 version 2 (SF-36v2?) and the Health Assessment Questionnaire Disability Index (HAQ-DI). The correlation between the SHAQ and disease severity was assessed by Spearman's correlation coefficient. The reproducibility of the SHAQ was evaluated by the intraclass correlation coefficient (ICC). Among the 151 consecutive outpatients evaluated, 59 % had limited SSc subtype. The overall disease severity visual analog scale (VAS) of the SHAQ was statistically significantly correlated to HAQ-DI, pain VAS, and the SF-36v2? physical component summary score (r?=?0.595, r?=?0.612, and r?=??0.582, respectively; p?<?0.001). Further analysis of all SF-36v2? components revealed statistically significant correlations between overall disease severity VAS and bodily pain (r?=??0.621, p?<?0.001), vitality (r?=??0.544, p?<?0.001), physical function (r?=??0.510, p?<?0.001), and role limitation-physical dimensions (r?=??0.505, p?<?0.001). Moreover, digestive, pulmonary, and overall disease severity VASs were statistically significantly correlated to the number of organs involved (r?=?0.178, p?=?0.029; r?=?0.214, p?=?0.008; r?=?0.282, p?<?0.001). We also demonstrated high reproducibility for SHAQ (ICC?=?0.757, 95 % confidence interval?=?0.636–0.842). The Brazilian version of the SHAQ demonstrated both construct and discriminant validities as well as good reproducibility.     

Cross-cultural adaptation and validation of the osteoporosis assessment questionnaire short version (OPAQ-SV) for Chinese osteoporotic fracture females

Clinical Rheumatology - The Osteoporosis Assessment Questionnaire Short Version (OPAQ-SV) was cross-culturally adapted to measure health-related quality of life in Chinese osteoporotic fracture...     

Cross-cultural adaptation and validation of the Thai version of the Rheumatoid Arthritis Disease Activity Index (RADAI)

The objective of this study was to translate and evaluate the psychometric properties of the Thai version of the Rheumatoid Arthritis Disease Activity Index (RADAI) in patients with rheumatoid arthritis (RA). We translated and modified the original RADAI into the Thai version. A total of 116 Thai patients with RA were consecutively recruited. For test–retest reliability, 115 patients undertook RADAI questionnaires for 2 consecutive days. To test construct validity, the correlation of the single RADAI items and RADAI total scores with measures of disease activity and functional status was evaluated. Reliability was assessed using Cronbach’s alpha and intra-class correlation (ICC). The number of missing items and time-to-complete questionnaire were collected to estimate its feasibility. The RADAI significantly correlated with disease activity measured by the Clinical Disease Activity Index (CDAI) (r = 0.71), the Disease Activity Score 28 (DAS28) (r = 0.56), patient global assessment of disease activity (r = 0.71), and physician global assessment of disease activity (r = 0.66) and functional status measured by the Health Assessment Questionnaire (r = 0.52). The RADAI had a moderate internal consistency (Cronbach’s alpha = 0.69) and high test–retest reliability (ICC = 0.83). Ninety-one percentage completed questionnaires without missing an item. Mean time-to-complete questionnaire (±SD) was 4.82 (±1.86) min. The Thai RADAI questionnaire is valid, reliable, and easy to use for assessing disease activity in daily practice and epidemiologic research. Its psychometric properties were comparable to the original version.     

Cross-cultural adaptation and validation of the RhinAsthma Patient Perspective (RAPP) in Spanish

Objectivethe RhinAsthma Patient Perspective (RAPP) is the only available tool to assess HRQoL in daily practice. The aim of this study is to cross-culturally validate the RAPP in Spanish.MethodsThe RAPP was translated into Spanish. Adult patients receiving usual care for asthma and allergic rhinitis (AR) were recruited consecutively and assessed twice with a four-week interval between visits to test the psychometric properties of the questionnaire.Results149 patients (62.8% female) with a mean age of 37.7 years completed the study. Exploratory and confirmatory factor analysis confirmed the uni-dimensional structure of the questionnaire. Internal consistency (0.73 at visit 1; 0.87 at visit 2), convergent and discriminant validity (p < .05 at both visits) were satisfactory. Reliability was confirmed by an ICC of 0.69 and a CCC of 0.74. Responsiveness was supported by a significant association with VAS (r = 0.28, p < 0.003) and ACT (r = −0.35, p < 0.01). The minimal clinical difference (MID) value in the analyzed population was 2.ConclusionsThe Spanish version of RAPP was demonstrated to have satisfactory psychometric properties and is a valid, reliable and responsive tool for the assessment of asthma and AR HRQoL in clinical practice.     

Cross-cultural adaptation and validation of the Italian Spine Youth Quality of Life (ISYQOL) questionnaire's Arabic version

Health-related quality of life (HRQOL) assessment is considered among the most relevant outcome measures following conservative and surgical interventions for various spinal conditions. Several questions are available to evaluate HRQOL in these conditions. A more recent Italian Spine Youth Quality of Life (ISYQOL) questionnaire was developed for this purpose and showed high validity in measuring HRQOL.To translate and adapt the ISYQOL questionnaire into Arabic language (ISYQOL-Ar) and evaluate its validity and reliability, and to correlate it with the validated revised Scoliosis Research Society (SRS-22r)''s Arabic questionnaire in a cross-sectional multicenter study.The ISYQOL was translated, back-translated, and reviewed by an expert committee. Reliability assessment for the questionnaire domains was performed using Cronbach''s alpha. For construct validation, the Pearson''s correlation coefficient was used.A total of 115 patients were enrolled in the study and completed the ISYQOL-Ar and Arabic SRS-22r questionnaires. A total of 72 patients (63%) completed the first set of questionnaires, and 2 weeks later, 63 patients (55%) completed both sets of questionnaires, with 15.8 a mean age, 39.5° mean Cobb angle of 88.9% females. ISYQOL-Ar showed excellent validity, good reliability, and internal consistency for spine health and brace wear, with Cronbach''s alpha > 0.6, similar to SRS-22r in the same cohort. The correlation was significant between ISYQOL-Ar and Arabic SRS-22r (Pearson''s coefficient = 0.708, P < .001).The ISYQOL-Ar questionnaire is a reliable and valid outcome measure for the assessment of young patients with spinal deformity among the Arabic-speaking population.     

Transcultural adaptation and testing psychometric properties of the Korean version of the Foot and Ankle Outcome Score (FAOS)

This study was performed to translate and transculturally adapt the English version of the Foot and Ankle Outcome Score (FAOS) into a Korean version, and to test psychometric properties of the Korean FAOS in terms of internal consistency, test–retest reliability, convergent validity, and dimensionality. Translation and transcultural adaptation of FAOS into a Korean version was performed according to internationally recommended guidelines. Internal consistency (N?=?294) and test–retest reliability (N?=?21) were evaluated. Convergent validity was analyzed using correlation with pain visual analogue scale (VAS) score. All subscales, except for the quality of life (Q) subscale (Cronbach’s alpha, 0.615), showed satisfactory internal consistency (Cronbach’s alpha?>?0.7). Cronbach’s alpha of function in daily living (ADL) was highest (0.962), which might represent the redundancy of the items. All five subscales showed satisfactory reliability with ADL subscale showing the highest ICC (intraclass correlation coefficient; 0.851) and Q subscale the lowest ICC (0.718). Pain VAS score showed the highest correlation with pain (P) subscale of FAOS (r?=?0.675, p?<?0.001) and the lowest correlation with Q subscale (r?=?0.495, p?<?0.001). In the dimensionality test, a factor analysis was performed using the total items to rank their relative significance, which showed seven components solution. Considerable portion of the items showed a similar dimension according to their original subscales, except for ADL items. Translation and transcultural adaptation of FAOS into the Korean language was performed successfully. The items were understandable, and the subscales showed satisfactory test–retest reliability. Some minor revision might be needed to enhance the internal consistency of Q subscale and reduce the redundancy of ADL subscale.