Measurement properties of the short form 36 and health-related quality of life after intensive care in Morocco

BACKGROUND: Intensive care patients have a health-related quality of life (HRQL) that differs from the normal population. The aim of this study was to evaluate the measurement properties of the Arabic version of the short form (SF)-36 and study the HRQL determinants in adult patients 3 months after discharge from an intensive care unit (ICU). METHODS: A prospective cohort study after ICU discharge. At 3-month follow up, the SF-36 was administered in consultation or by telephone. Multitrait scaling analysis was used to confirm the hypothesized scale structure of the SF-36. Reliability was tested using (i) measuring internal consistency; and (ii) the test-retest reliability assessed using an intraclass correlation coefficient. Construct validity was tested by known-groups comparison using one-way analysis of variance (ANOVA) and analysis of covariance (ANCOVA). RESULTS: A total of 145 survivors answered the SF-36. Item internal convergency was higher than 0.40 (0.77-0.99; 100% scaling success) and item discriminant validity was perfect (100% scaling success) except for physical functioning (81% scaling success). Cronbach's alpha exceeded 0.70 in all eight scales (0.84-0.99). Test-retest reliability conducted in 73 patients was above 0.80. Acceptability to patients appeared reasonable although considerable interview time was required to administer the SF-36. Construct validity was confirmed by lower scores being reported by women, older age and a high level of comorbidities groups. When adjusted for background data, ICU variables were not associated with the SF-36 scores. CONCLUSIONS: The Arabic version of the SF-36 appears to be a robust tool in ICU. Background variables are the only significant determinants of HRQL 3 months after medical ICU discharge.     

Reliability testing of the Danish version of the Kidney Disease Quality of Life Short Form

OBJECTIVE: The questionnaire Kidney Disease Quality of Life Short Form version 1.3 (KDQOL-SF) is valuable for assessing the health-related quality of life in patients treated with chronic dialysis. The aim of this study was to translate and test the reliability of the KDQOL-SF for use in Denmark. MATERIAL AND METHODS: Translation into Danish and back-translation into English were performed. Pilot, field and internal consistency reliability tests were performed. RESULTS: Cronbach's alpha coefficients for the internal reliability test ranged from 0.77 to 0.93 for the eight generic scales. In a test involving all patients, two of the disease-specific scales had Cronbach's alpha coefficients of <0.70 ("social support" = 0.67; and "quality of social interaction" = 0.43). After removing one item from the scale "quality of social interaction", Cronbach's alpha reached 0.63. A test of the scores of peritoneal dialysis (PD) patients discovered low reliability for three disease-specific scales. The KDQOL-SF manual and the Danish manual for the Short Form 36 (SF36) differed in the scoring of four generic scales: "role limitation-physical", "bodily pain", "general health" and "social function". CONCLUSIONS: With the exception of the scale "quality of social interaction" the Danish translation of the KDQOL-SF achieved values in the internal consistency reliability test of the same level as the original U.S. version. When data were stratified according to dialysis treatment, the reliability of PD patients scores was lower. Generic data from the questionnaire SF36 should be scored according to the Danish SF36 manual.     

Psychometric properties and validation of the German-language King's Health Questionnaire in women with stress urinary incontinence

AIMS: The purpose of this study was to evaluate the psychometric properties of and validate the German-language version of the King's Health Questionnaire (KHQ) in women with stress urinary incontinence (SUI). METHODS: A total of 145 women treated for stress incontinence with surgery or physiotherapy completed the the KHQ and the SF-36 before and after treatment. Psychometric analyses of the quality of life (QoL) instruments determined the reliability (Cronbach's alpha), internal and external validity, and responsiveness of the KHQ subscales. RESULTS: The KHQ showed good internal consistency, content validity, and criterion validity as measured by correlation with scores on the SF-36. Cronbach's alpha coefficient ranged from 0.76 to 0.86, indicating a high internal consistency of the subscales. Concerning criterion validity, correlations between the KHQ subscales and the SF-36 were low to moderate. The highest correlation was found between the general health perception subscales of both questionnaires. CONCLUSIONS: The results indicate good psychometric properties for the German-language KHQ.     

Measurement properties of the CESD scale among individuals with spinal cord injury

BACKGROUND: Depression is common after spinal cord injury (SCI), yet it can be difficult and costly to diagnose. Screening tools such as the Center for Epidemiological Studies Depression scale (CESD) can assist with case identification; however, insufficient knowledge of their measurement properties exists to use them in the SCI population. OBJECTIVES: To assess the reliability and validity of the CESD-20 and the CESD-10. SETTING: Tertiary care centre in Vancouver, British Columbia, Canada. METHODS: A 2-week retest study of 47 individuals with traumatic SCI. Subjects >or=19, who had their SCI for >or=1 year and had American Spinal Injury Association Impairment scale ranking of A or B. Short Form-36 (SF-36) subscales and a visual analogue scale for fatigue (VAS-F) were used to assess validity using Pearson's correlations coefficients. Internal consistency was assessed using Cronbach's alpha, retest reliability was assessed using intraclass correlation coefficients (ICCs) and Bland-Altman plots. Normative data are presented based on key demographic and clinical factors. RESULTS: Cronbach's alpha was 0.91 and 0.86 and retest reliability was ICC=0.87 (95% confidence interval (CI) 0.79-0.93) and ICC=0.85 (95% CI 0.75-0.92) for the CESD-20 and CESD-10, respectively. Minimal bias was evident based on the Bland-Altman plots. The strongest correlations were with outcomes representing mental health (r=-0.71), vitality (r=-0.60) and the VAS-F (r=0.57). The weakest correlation was with the physical function score of the SF-36 (r=-0.37). CONCLUSION: The CESD-20 and CESD-10 are quick and easy to use. This study provides evidence in support of the reliability and validity.     

简体中文版功能评分指数在下腰痛患者中的应用及信度效度测量

目的探讨中文版功能评分指数（SC-FRI）对下腰痛患者的应用价值,评估其用于国人的信度和效度。方法按照国际指南将FRI翻译成中文并进行跨文化调试。采用经调试确定的SC-FRI、中文版Oswestry功能障碍指数（SC-ODI）、SF-36健康调查量表（SF-36）和视觉模拟量表（VAS）对2010年12月至2011年3月于长海医院骨科门诊就诊、符合病例选择标准的115例下腰痛患者进行疼痛和功能状态的自我评估。检验其内部一致性、重测信度、同时标准效度和结构效度。结果 SC-FRI有非常高的完成率（96%）,无天花板和地板现象,具有良好的内部一致性（Cronbachα系数=0.897,去除一个条目后为0.851~0.890）和重测信度（组内相关系数ICC=0.948,95%CI=0.917~0.968）。同时标准效度分析证实SC-FRI与SC-ODI、VAS有高度相关性（r=0.958,0.852）;结构效度结果提示SC-FRI和SF-36中的躯体功能、躯体疼痛、社会功能、物理职能、总体健康有较高相关性（r=-0.802,-0.698,-0.573,-0.565,-0.435）。结论 SC-FRI具有十分良好的信度和效度,简单易行,可用于对国内下腰痛患者疼痛和功能状态的评估。     

Subjective health measure used on Chinese patients with neck pain in Hong Kong

STUDY DESIGN: A prospective observational study was conducted on the use of the Chinese version of the Northwick Park Neck Pain Questionnaire. OBJECTIVE: To examine the reliability, validity, and responsiveness of the Chinese version of the Northwick Park Neck Pain Questionnaire in Chinese patients with neck pain in Hong Kong. SUMMARY OF BACKGROUND DATA: There is increasing recognition that patient perspectives are essential both in making medical decisions and in judging the treatment outcomes. A valid Chinese version of a neck disability index questionnaire is urgently needed for effective and reliable evaluation of the treatment outcomes for patients with neck pain. METHODS: Two samples with 532 consecutive adult patients with neck pain from seven physiotherapy outpatient departments in Hong Kong who completed the Northwick Park Neck Pain Questionnaire were observed and measured at different intervals: at the beginning of physiotherapy, at 7 days, at 3 weeks, and 6 weeks after physiotherapy. RESULTS: The questionnaire had good content validity, very good test-retest reliability, and internal consistency (intraclass correlation coefficient, 0.95; Cronbach's alpha, 0.87). It also had good validity (Spearman correlation coefficient of 0.59 when the score was correlated with that of a generic 42-item Chinese health questionnaire) and good responsiveness (effect size of 1.11 at week 6 after treatment began). CONCLUSIONS: The Chinese version of the Northwick Park Neck Pain Questionnaire has been shown to demonstrate very good content validity, a high degree of test-retest reliability, and internal consistency. It also exhibited good construct validity and high sensitivity to changes in severity over time.     

Cross-cultural adaptation and validation of Singapore English and Chinese versions of the Lequesne Algofunctional Index of knee in Asians with knee osteoarthritis in Singapore

OBJECTIVE: To cross-culturally adapt and validate Singapore English and Chinese versions of the Lequesne Algofunctional Index of knee in patients with knee osteoarthritis (OA) in Singapore. METHODS: Singapore English and Chinese versions were cross-culturally adapted from the source English version following standard guideline (including cognitive debriefing). Patients were asked to complete an identical, pretested questionnaire containing the Lequesne index, Short Form 36 Health Survey (SF-36), and EQ-5D twice within 6 days. Reliability was assessed using Cronbach's alpha and intraclass correlation coefficients (ICC). Dimensionality was assessed by principal component factor analysis. Construct validity was tested by item-to-scale correlations and 12 and six a priori hypotheses for convergent and divergent construct validities, respectively. RESULTS: Singapore English and Chinese Lequesne indices were well accepted by patients in pilot testing and were therefore administered to a consecutive sample of 127 English- and 131 Chinese-speaking Singaporeans with knee OA. Acceptable internal consistency was observed for activities of daily living and the global index (alpha=0.72-0.82), and the good test-retest reliability for all scales in both versions (ICC=0.66-0.94). Expected item-to-scale correlations were presented only in activities of daily living in both versions. Factor analysis yielded two factors for both versions. Convergent and divergent construct validities were supported by the presence of hypothesized correlations between the Lequesne index and SF-36 and EQ-5D scales. CONCLUSION: Both versions of the Lequesne index demonstrated acceptable reliability and validity among multiethnic Asian patients with knee OA, which suggests that it could be used as a global index in the health-related quality of life (HRQoL) measurements in Singapore and possibly other Asian countries.     

Validation of the Western Ontario and Mcmaster University osteoarthritis index in Asians with osteoarthritis in Singapore

OBJECTIVE: To assess the reliability and validity of the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) as an outcome measure in Asian patients with knee or hip osteoarthritis (OA) in Singapore. DESIGN: The WOMAC was administered twice 7 days apart to 66 consecutive English-speaking Chinese, Malay or Indian inpatients and outpatients with knee or hip OA seen at a tertiary referral centre through a structured interview, which also assessed demographic and other characteristics. Internal consistency was assessed using Cronbach's alpha, reliability using Spearman's correlations, intraclass correlations and repeatability coefficients, and relationships between WOMAC domains and known determinants of function using Spearman's correlations and the Mann-Whitney U-test. RESULTS: The WOMAC showed good internal consistency (alpha=0.70 to 0.93) and good reliability, with intraclass correlations of 0.83 to 0.90 and mean test-retest score differences of 0.02 to 0.13 points (possible range 4 points). Results of Likert scoring assessment supported the validity of the WOMAC when interpreted in the context of the close association between pain and physical function. Eight of nine a priori hypotheses relating WOMAC Pain and Physical Function scores to known determinants of function were present, supporting construct validity of this scale. CONCLUSION: The WOMAC is a valid and reliable outcome measure in Asian patients with OA in Singapore.     

Psychometric properties of the Cervical Spine Outcomes Questionnaire and its relationship to standard assessment tools used in spine research.

BACKGROUND: The Cervical Spine Outcomes Questionnaire (CSOQ), a disease-specific outcomes instrument, has not been systematically compared with the Short Form-36 (SF-36) or the Neck Disability Index (NDI). PURPOSE: To examine the psychometric properties of the CSOQ and to compare them with those of the SF-36 and NDI. STUDY DESIGN: Prospective analysis of outcomes data in patients undergoing surgery. METHODS: We used telephone surveys (CSOQ) and clinical assessments (SF-36 and NDI) to evaluate 534 patients undergoing anterior cervical decompression and fusion at 23 nationwide sites. The psychometric properties of the CSOQ were analyzed for floor/ceiling effect, internal consistency of items within the CSOQ, and concurrent validity with the SF-36 and NDI. RESULTS: The CSOQ domain scores showed good psychometric properties (Cronbach's alpha >0.70). Only physical symptoms (other than pain) showed a ceiling effect. The CSOQ domain scores had good concurrent validity (Spearman rank correlation coefficient >0.70) with the mental health score of the SF-36 and the total disability score of NDI. CONCLUSIONS: The CSOQ domain scores provide a disease-specific assessment of functional limitations resulting from cervical spine disorders. The domain scores for functional disability and psychological distress provide similar information to that provided by the NDI and SF-36. The CSOQ domain scores for pain severity provide information that is more specific to cervical disc disease than does the physical health score of the SF-36.     

Validation of a Norwegian version of the Burn Specific Health Scale

BACKGROUND: The abbreviated Burn Specific Health Scale (BSHS-A) is an 80-item questionnaire that has proven useful in measuring physical, mental, social and general health in burn survivors. The aim of this study was to adapt the BSHS-A into Norwegian, including assessing reliability and validity. METHODS: Standard procedures for forward and backward translation including discussions with professionals and patients to ensure conceptual equivalence were used. A pilot study (11 burn patients) confirmed that the Norwegian version (BSHS-N) was clear, understandable and easy to self-administer. Subsequently, 95 adults admitted to the Burn Center, Haukeland University Hospital, between 1995 and 2000 entered a validation study by completing the BSHS-N and the general health measure SF-36. Sixty-nine of the 95 (72%) responders completed a retest. RESULTS: The overall internal consistency reliability (Cronbach's alpha=0.97) and the test-retest reliability (ICC=0.95) for the BSHS-N were satisfactory. Tests for criterion validity showed expected patterns for association between comparable domains in the BSHS-N and the SF-36, with correlations ranging from r=0.61 to 0.81. Tests for construct validity showed that patients with full thickness injury (P=0.003), patients hospitalised more than 10 days (P=0.003), patients undergoing more than two operations (P=0.001) and patients unemployed at the time of study (P<0.001), had significantly lower total scores than the rest of the patients. CONCLUSION: BSHS-N seems to be a reliable and valid instrument for use in the Norwegian population. The translation and cross-cultural adaptation of this instrument allows for comparative international studies.     

The MISTELS program to measure technical skill in laparoscopic surgery

BACKGROUND: The McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) is a series of five tasks with an objective scoring system. The purpose of this study was to estimate the interrater and test-retest reliability of the MISTELS metrics and to assess their internal consistency. METHODS: To determine interrater reliability, two trained observers scored 10 subjects, either live or on tape. Test-retest reliability was assessed by having 12 subjects perform two tests, the second immediately following the first. Interrater and test-retest reliability were assessed using intraclass correlation coefficients. Internal consistency between tasks was estimated using Cronbach's alpha. RESULTS: The interrater and test-retest reliabilities for the total scores were both excellent at 0.998 [95% confidence interval (CI), 0.985-1.00] and 0.892 (95% CI, 0.665-0.968), respectively. Cronbach's alpha for the first assessment of the test-retest was 0.86. CONCLUSIONS: The MISTELS metrics have excellent reliability, which exceeds the threshold level of 0.8 required for high-stakes evaluations. These findings support the use of MISTELS for evaluation in many different settings, including residency training programs.     

Validity of the mental health subscale of the SF-36 in persons with spinal cord injury

Study design:Cross-sectional study 5 years after discharge from inpatient rehabilitation.Objective:To examine the psychometric properties of the Mental Health subscale (MHI-5) of the 36-Item Short Form Health Survey (SF-36) in persons with spinal cord injury (SCI).Setting:Eight Dutch rehabilitation centres with specialised SCI units.Methods:Possible floor and ceiling effects were assessed, and Cronbach's α coefficient was calculated to assess internal consistency. Concurrent and divergent validity were assessed using Spearman correlations between the MHI-5 and measures of life satisfaction, neuroticism, vitality, general health, functional independence, participation, lesion characteristics and demographics.Results:There were no floor or ceiling effects, but the total MHI-5 score was slightly skewed (-1.15). Internal consistency was good (α=0.79). Concurrent validity was shown by significant Spearman correlations between the MHI-5 and life satisfaction (0.53), neuroticism (-0.55), vitality (0.53) and general health (0.37). Divergent validity was shown by weak and, in part, non-significant correlations between the MHI-5 and functional independence (0.09), participation (-0.28) and lesion characteristics (range -0.01-0.19).Conclusion:The MHI-5 showed reliability and validity as a measure of mood in persons with SCI, and is a promising measurement instrument to assess mental health problems in this population.     

Validation of the LOCOMO-25 and its minimum clinically important differences in domain scores for Chinese patients with low back pain and neck pain

BackgroundThe 25-question Geriatric Locomotive Function Scale (LOCOMO-25) was developed to assess any decline in mobility functions. This study aims to validate the LOCOMO-25 in Chinese patients with chronic low back pain and/or neck pain.MethodsAdult patients with chronic low back pain and/or neck pain completed the LOCOMO-25, SF-36, EQ-5D-5L, ODI, VAS and/or NDI. Internal consistency was assessed by Cronbach's alpha coefficient (α). Test-retest reliability was assessed by intra-class correlation coefficients. Construct validity was assessed by Spearman correlation tests against other outcome measures. Sensitivity to detect differences between groups was assessed by Mann–Whitney U or Kruskal–Wallis H test, where appropriate. Intergroup comparison was performed further in terms of domain scores and their changes at test-retest.ResultsA total of 111 patients were consecutively recruited. LOCOMO-25 demonstrated excellent internal consistency (α = 0.915) and test-retest reliability (Intraclass correlation: 0.705 to 0.826). LOCOMO-25 was significantly correlated with all domains of SF-36, EQ-5D, ODI, NDI, and VAS (p < 0.01). It was found to be sensitive in differentiating between patients with neural compression (32.8 ± 16.9) and without (21.2 ± 12.7), with history of fall(s) within the previous one year (30.8 ± 16.0) and without (24.2 ± 15.1), requires assistive devices for ambulation (40.6 ± 21.6) or independent (23.6 ± 13.1) and various pain levels (mild: 17.2 ± 10.6; moderate: 23.5 ± 11.7; severe: 38.5 ± 16.5). Patients with neural compression scored significantly higher in the domain of pain and patients requiring assistive devices for ambulation scored significantly higher in the domains of ADL and social functions. The minimum detectable differences for various domains of the LOCOMO-25 score included pain (2.76), activities of daily living (6.07), social function (1.59), and mental health status (2.06).ConclusionsLOCOMO-25 has been validated in Chinese patients with chronic low back and neck pain with satisfactory psychometric properties, and with individual domain minimum clinically important differences. There is adequate internal consistency, test-retest reliability, construct validity and sensitivity to detect differences between patients with/without neural compression, different ambulatory statuses and pain severity.     

生物型髋关节假体位置参数与患者生命质量相关性研究

目的分析初次生物型全髋关节置换术(THA)后假体位置重建情况,探讨假体位置参数与患者生命质量的相关性,总结假体位相参数的安全范围。 方法对南京市六合区人民医院骨科2013年3月至2015年3月52例因股骨颈骨折行初次生物型全髋关节置换术的患者进行2年的前瞻性研究。术后第3天未负重前首次拍摄患侧髋关节正侧位及骨盆正位X线片,分析髋臼及股骨柄假体的位置参数,包括髋臼外展角、髋臼前倾角、股骨头旋转中心、股骨垂直偏距、股骨偏心距、外展肌力臂、重力力臂、股骨柄内外翻、颈干角。术前和术后24个月对患者进行评估健康相关生命质量的SF-36简明健康状况调查量表(SF-36)评分。采用SPSS 17.0软件对量表进行Cronbach's (系数同质性分析、Pearson相关分析、因子分析及t检验以评价其信效度,并评价假体位置参数与SF-36各项评分提高值之间的相关性。 结果52名患者(52髋)均完成了随访,根据THA术后首次X线片获取假体位置参数。除情感职能外,手术前后的SF-36量表内部一致性显示Cronbach's α系数>0.7;重测信度显示相关系数(CC)ICC>0.8;分半信度显示Pearson相关系数>0.874;反应度显示SF-36量表能较好地反应THA患者手术前后的生命质量变化状况;结构效应单因子分析结果示全部36个条目在各自维度上的因子载荷为0.23～0.87(P<0.05),其中3个条目的载荷小于0.30。多因子分析结果χ²/df＝3.16,拟合优度指数(GFI)＝0.892,近似误差均方根(RMSEA)＝0.089,表明SF-36的各拟舍指数均在可被接受水平;证明SF-36的内部结构与其理论架构有很高的一致性。假体位置参数与SF-36各维度的相关系数都为正数,除GH外SF-36各维度与髋臼假体位相参数间相关系数均大于0.6,SF-36各维度与髋关节旋转中心体位相参数间高度相关,SF-36中活力(VT)、社会功能(SF)、情感职能(RE)及精神健康(MH)与股骨垂直偏距间相关系数大于0.7,SF-36中各维度与两侧股骨偏心距比例参数间相关系数均大于0.7,SF-36中SF、MH与外展肌力臂及重力力臂相参数间相关系数大于0.8,余者均大于0.7,SF-36各维度与股骨柄假体位相参数间相关系数在0.329～0.757之间,SF-36中生理功能(PF)、生理职能(RP)、社会功能(SF)与颈干角位相参数间相关系数在大于0.7。 结论SF-36量表信度、效度均较好,可用以评估THA患者生命质量。股骨颈骨折患者的生命质量在各个领域均明显低于正常人,THA术后均得到改善。SF-36各维度可全面反映患者心理、生理及社会生活状态下的生命质量。通过对假体位相参数与SF-36各维度间的相关系数分析认为：髋臼外展角及前倾角的适当范围分别为(45±5)°、(15±5)°;颈干角应控制在(125±10)°内;髋臼假体应置于髋臼解剖位置上,以健侧为参照重建旋转中心;术后患侧肢体长度较健侧缩短不宜超过10 mm;避免减小股骨偏心距、外展肌及重力力臂;尽量保持股骨柄中立位。     

Responsiveness of the Neck Disability Index in patients with mechanical neck disorders

PurposeReport the test-retest reliability, construct validity, minimum clinically important difference (MCID), and minimal detectable change (MDC) for the Neck Disability Index (NDI).Study design/settingCohort study of patients presenting to outpatient physical therapy clinics.Patient sampleNinety-one subjects with a primary complaint of neck pain, with or without concomitant upper extremity (UE) symptoms, who were participants in a randomized clinical trial.Outcome MeasuresNDI and the 15-point Global Rating of Change (GRC) self-report measures.MethodsAll subjects completed the NDI at baseline and at a 3-week follow-up. Additionally, subjects completed the GRC scale, which was used to dichotomize patients into improved or stable groups. Changes in the NDI were used to assess test-retest reliability, construct validity, MCID, and MDC.ResultsTest-retest reliability was moderate for the NDI (intraclass correlation coefficient, 0.64; 95% confidence interval, 0.19–0.84). For the NDI, the MCID was 7.5 points and the MDC was 10.2 points.ConclusionsThe NDI appears to demonstrate adequate responsiveness based on statistical reference criteria when used in a sample that approximates the high percentage of patients with neck pain and concomitant UE referred symptoms. Because the MCID is within the bounds of measurement error, a 10-point change (the MDC) should be used as the MCID.     

Italian version of the Roland Disability Questionnaire,specific for low back pain: cross-cultural adaptation and validation

Over the last 10 years, patient-oriented evaluations using questionnaires have become an important aspect of clinical spinal outcome studies. Any questionnaire must be translated and culturally adapted in order to be used with different language groups, and the translated version must then be evaluated for reliability and validity, which are fundamental attributes of any measurement tool. The Roland Disability Questionnaire, a low back pain disease-specific tool, was submitted to translation into Italian and to cross-cultural adaptation following the Guillemin criteria. It was then validated on 70 patients (37 male and 33 female; mean age 58, range: 28-67) suffering from low back pain as assessed by clinical examination, imaging and also electromyography in cases of suspected neurological impairment. The test-retest reliability, assessed with intraclass correlation, was 0.92 and the internal consistency reached a Cronbach's alpha of 0.82. The Italian version of the Roland Disability Questionnaire satisfied the validation criteria, showing characteristics of reliability and validity similar to previously published versions translated and adapted for other countries.     

Reliability and validity of the Malay version of the Health-Related Quality of Life instrument in a Malaysian population

OBJECTIVE: To validate the Malay version of the Health-Related Quality of Life (Mal-HRQOL-20) questionnaire in patients with and without urinary symptoms in a Malaysian population. PATIENTS AND METHODS: The validity and reliability of the Mal-HRQOL-20 were assessed in patients with and without lower urinary tract symptoms (LUTS). The reliability was evaluated using the test-retest method and the internal consistency using Cronbach's alpha. Sensitivity to change was expressed as the effect size in the score before and after intervention in additional patients with LUTS who underwent transurethral resection of the prostate. RESULTS: The internal consistency was excellent; there was a high degree of internal consistency for each of the 20 items and for the overall score (Cronbach's alpha > or = 0.57 and 0.79, respectively) in the population study. The test-retest correlation coefficient for the 20 item scores was highly significant. The intra-class correlation coefficient was high (> or = 0.55). The sensitivity and specificity were high for the effects of treatment. There was a very significant agreement between scores before and after treatment across all domains in the treatment cohort, but not in the control group. CONCLUSION: The Mal-HRQOL-20 is suitable, reliable, valid and sensitive to clinical change in the Malaysian population.     

Cross-cultural adaptation and validation of the Turkish version of the Functional Index for Hand Osteoarthritis (FIHOA)

BackgroundTo perform reliability and validity study of the Functional Index for Hand Osteoarthritis (FIHOA) in the Turkish language.MethodsFIHOA was translated into Turkish following the principles of cross-cultural adaptation. Our translation was firstly tested in 40 patients with hand osteoarthritis. Adapted FIHOA questionnaire was then administrated to 100 hand OA patients successively with Modified Health Assessment Questionnaire (mHAQ), Numerical Rating Scale (NRS), and Short Form-36 (SF-36). Patients filled out the FIHOA questionnaire one more time after five days for test-retest assessment. Patients were divided into two groups as symptomatic or asymptomatic, with a NRS score of 5 or above defining symptomatic OA. Internal consistency was assessed by Cronbach's alpha and intraclass correlation coefficient (ICC) of test-retest reliability. Spearman correlation analysis was used to determine the correlation and validity between data. External construct validity was assessed using the correlation between FIHOA, mHAQ, hand pain NRS, and negative correlation with SF-36 subgroups.ResultsAccording to the total score, Cronbach-alpha was found as 0.90, while ICC was determined as 0.98 for test-retest reliability. When the correlations between the FIHOA questionnaire, mHAQ, and NRS questionnaires were examined, significant correlations were determined, and negative correlations between FIHOA and SF-36 subgroups were observed.ConclusionTurkish FIHOA is a reliable and valid method for assessing functionality in Turkish patients with hand osteoarthritis.     

简体中文版King健康问卷在膀胱过度活动症患者中应用的信度和效度分析

目的 评价简体中文版King健康问卷(KHQ)在膀胱过度活动症(OAB)患者中应用的信度和效度.方法 采用"WHO-QOL跨文化生活质量研究问卷翻译法"将英文版KHQ翻译成简体中文,随机抽取就诊于泌尿外科门诊的OAB患者,在第0周和第2周对其进行2次简体中文版KHQ问卷调查.通过Cronbach's α系数评价问卷的内部一致性;用组内相关系数(ICC)评价重测信度;计算各问题得分与所属领域得分的Spearman等级相关系数(rs)评价内容效度;用因子分析评价结构效度.结果 48例符合纳入标准的OAB患者参与本研究,40例完成2次调查,男7例,女33例,年龄(49.6±14.3)岁.KHQ各亚量表和各领域均具有较好的内部一致性(Cronbach's α:0.7l8～0.924)、中到高的重测信度(ICC:0.567～0.995,P<0.01)以及中到高的内容效度(r:0.462～0.964,P<0.01).因子分析法显示简体中文版KHQ具有可接受的结构效度.结论简体中文版KHQ具有较好的信度和效度,可作为评估OAB患者生活质量的专用量表.