Validation of the Chinese (Mandarin) Version of the Oxford Knee Score in Patients with Knee Osteoarthritis.
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ABSTRACT:
SUBMITTER: Lin K
PROVIDER: S-EPMC5670067 | biostudies-literature | 2017 Dec
REPOSITORIES: biostudies-literature
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Validation of the Chinese (Mandarin) Version of the Oxford Knee Score in Patients with Knee Osteoarthritis.
Lin Kai K Bao Liangxiao L Wang Jian J Fujita Kimie K Makimoto Kiyoko K Liao Xiaoyan X
Clinical orthopaedics and related research 20170907 12
<h4>Background</h4>With the increasing number of patients with knee osteoarthritis undergoing TKAs in China, there is a clear need for a valid, short, joint-specific patient-reported outcome measure such as the Oxford Knee Score (OKS).<h4>Questions/purposes</h4>To test the translated and cross-culturally adapted Chinese (Mandarin) version of the Oxford Knee Score (OKS-CV) and its (1) reliability, (2) construct validity, (3) dimensionality, and (4) responsiveness.<h4>Methods</h4>Three native Chin ...[more]
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Project description:BackgroundKnee osteoarthritis (KOA) primarily presents with symptoms of pain and compromised functionality. Pain is a subjective manifestation that necessitates the employment of reliable evaluation tools for practical assessment, thereby enabling the formulation of appropriate interventional strategies. The Brief Pain Inventory (BPI) is a widely utilized questionnaire for evaluating the status of chronic pain. The purpose of the present study is to translate the short form of BPI into Chinese version (BPI-CV) and conduct cross-cultural adaptation to evaluate the psychometric characteristics of BPI-CV in KOA patients.MethodsBPI-CV was translated and cross-culturally adapted according to internationally recognized guidelines. A cohort comprising 150 patients diagnosed with KOA successfully completed the demographic questionnaire, BPI-CV, Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and the EuroQoL Group's five-dimension questionnaire (EQ-5D). Internal consistency and test-retest analysis were used to evaluate the reliability. The internal consistency of the scale items was evaluated by calculating the Cronbach's α value (> 0.7). We chose to employ two scales commonly used in the evaluation of KOA patients: the disease-specific WOMAC scale and the universal EQ-5D scale. Construct validity was determined through Pearson correlation analysis, comparing BPI scores with those obtained from the WOMAC and EQ-5D scales. Exploratory factor analysis was used to structural validity.ResultsThe BPI-CV was well accepted with no ceiling or floor effect. Cronbach's α for assessing internal consistency was 0.894. Test-retest reliability was excellent with an ICC of 0.852 (95%CI 0.785-0.905). The BPI-CV showed moderate to strong correlations with the pain dimension (r = 0.496-0.860) and the functional interference dimension (r = 0.517-0.712) of the WOMAC and the EQ-5D (r = 0.527-0.743). Three factors resulted using exploratory factor analysis: pain severity, activity interference, and emotional interference, accounting for 79.0% of the total variance. Standard error of measurement was 0.539.ConclusionBPI-CV has good feasibility, reliability, and validity. It can be recommended for KOA patients in mainland China.
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Project description:ObjectivesTo assess the validity of the Oxford Knee Score (OKS) for use in patients undergoing non-operative management for their knee osteoarthritis (OA) within the National Health Service (NHS).DesignObservational cohort study.SettingSingle orthopaedic centre in England.Participants134 patients undergoing non-operative management for knee OA.Main outcome measuresOKS, the Intermittent and Constant Osteoarthritis Pain (ICOAP), the Knee Injury and Osteoarthritis Score-Physical Function Short Form (KOOS-PS), at baseline and 3-month follow-up, transition item of change at 3 months.ResultsThe OKS summary scale and its pain and functional component subscales demonstrated good test-retest reliability (intraclass correlation coefficient 0.93, 0.91 and 0.92, respectively) and measurement precision which, allows its use with groups of patients with knee OA (research/audit) and with individuals (clinical practice). The results in this study were consistent with a priori set hypotheses about the relationship of OKS with other validated measures (KOOS-PS, ICOAP and short form 12 (SF-12)), which provided evidence of its construct validity and responsiveness. Confirmatory factor analysis confirmed the structural validity of OKS. However, there was a lack of satisfactory evidence of structural validity for ICOAP and KOOS. The minimum detectable change (MDC90) was ±6 for OKS (±16 for the Pain Component Score (OKS-PCS) and ±15 for the Functional Component Score (OKS-FCS)). Minimal important changes were ≈7 for OKS (≈17 for OKS-PCS and ≈11 for OKS-FCS) and minimal important differences were ≈6 for OKS (≈14 for OKS-PCS and ≈10 for OKS-FCS). These values were also calculated for ICOAP and KOOS-PS.ConclusionsThe OKS summary scale, together with its pain and functional component subscales, has excellent measurement properties when used with patients with knee OA undergoing non-operative treatment and is superior to ICOAP and KOOS-PS for this purpose. This evidence provides support for the validity of the use of OKS when used across the spectrum of knee OA disease severity, both in research and clinical practice.
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Project description:ObjectivesThe Knee Injury and Osteoarthritis Outcome Score (KOOS) has been utilized to evaluate short- and long-term outcomes in individuals following knee injuries, such as those with anterior cruciate ligament reconstruction and knee osteoarthritis, but has not yet been applied to individuals undergoing total knee arthroplasty (TKA) in China. The aim of this study was to assess the psychometric properties of the Simplified Chinese version of the KOOS in Chinese individuals undergoing TKA.MethodsThis study distributed 170 questionnaires, and assessed the KOOS of the participants, along with requiring them to complete the Short Form 36 (SF-36) survey. There were 35 participants completed a test-retest reliability survey with a 24-h interval, 129 participants completed a pre - surgery survey, and 119 individuals completed a post - surgery survey 6 weeks after the surgery. The following tests were conducted: Cronbach's alpha (α) to assess internal consistency, intraclass correlation coefficient (ICC) to evaluate test-retest reliability, Spearman's correlation coefficient (ρ) to examine construct validity, effect size (ES) to detect measure responsiveness, minimal detectable change (MDC) to assess measurement errors. Floor and ceiling effects (<15%) were also asses evaluated.ResultsThe simplified Chinese version of the KOOS showed good test-retest reliability in participants after TKA, with an ICC of 0.82-0.97 (95% CI). The internal consistency of the five subscales of the KOOS was good (Cronbach's α = 0.70-0.96). No floor or ceiling effects were found. Regarding construct validity, a strong positive correlation was found between each of the three KOOS subscales (activities of daily living, knee-related Quality of Life, and sport and recreation subscales) and the general health and bodily pain subscales of the SF-36 (0.53 < ρ < 0.61). The subscales of the simplified Chinese version of the KOOS showed responsiveness (ES: 0.68 to 0.86) before and after 6 weeks of physical treatment. The MDC ranged from 10.28 to 23.24.ConclusionsThe Chinese version of the KOOS showed good psychometric properties and was found to be valid, reliable, and simple as an assessment tool for symptoms, pain, activity of daily living, sports and recreational activity and quality of life for the Chinese population suffering from TKA.
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Project description:BackgroundEQ5D is a generic measure of health. It provides a single index value for health status that can be used in the clinical and economic evaluation of healthcare. Oxford Knee Score (OKS) is a joint-specific outcome measure tool designed to assess symptoms and function in osteoarthritis patients after joint replacement surgery. Though widely used, it has the disadvantage of lacking health index value. To fill the gap between functional and generic questionnaires with economic value, we linked generic EQ-5D-5L to the specific OKS to give a single index value for health status in KOA patients.Questions/purposesDeveloping and evaluating an algorithm to estimate EuroQoL generic health utility scores (EQ-5D-5L) from the disease-specific OKS using data from patients with knee osteoarthritis (KO).Patients and methodsThis is a cross-sectional study of 571 patients with KO. We used four distinct mapping algorithms: Cumulative Probability for Ordinal Data, Penalized Ordinal Regression, CART (Classification and Regression Trees), and Ordinal random forest. We compared the resultant models' degrees of accuracy.ResultsMobility was best predicted by penalized regression with pre-processed predictors, usual activities by random forest, pain/discomfort by cumulative probability with pre-processed predictors, self-care by random forest with RFE (recursive feature elimination) predictors, and anxiety/depression by CART with RFE predictors. Model accuracy was lowest with anxiety/depression and highest with mobility and usual activities. Using available country value sets, the average MAE was 0.098 ± 0.022, ranging from 0.063 to 0.142; and the average MSE was 0.020 ± 0.008 ranging from 0.008 to 0.042.ConclusionsThe current study derived accurate mapping techniques from OKS to the domains of EQ-5D-5L, allowing for the computation of QALYs in economic evaluations. A machine learning-based strategy offers a viable mapping alternative that merits further exploration.
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Project description:BackgroundThe Oxford Elbow Score (OES) is an English-language questionnaire specifically designed to evaluate surgical elbow outcomes. This scoring system has been translated into other languages. Given the lack of an Italian version of the OES, the present study was designed to establish, culturally adapt, and validate the Italian version.MethodsThe OES questionnaire was culturally adapted to Italian patients in accordance with the literature guidelines with a pilot phase including seven patients with elbow problems and seven healthy subjects. The study includes 110 participants from three hospitals, who underwent elbow surgery for acute (70%) or chronic diseases. At least one month after elbow surgery, at the "index visit", the physician completed the Mayo Elbow Performance Index and patients completed the following questionnaires: the Italian OES, the shortened version of the Disability of Arm, Shoulder and Hand Questionnaire (QuickDASH) and the Short-Form 36 Health Survey. Internal consistency was evaluated using Cronbach's alpha. Reproducibility was assessed using the intraclass correlation coefficient in ten patients who completed the OES again two-three days after the index visit. Construct validity was assessed using Spearman correlation coefficients. Responsiveness was evaluated in 68 patients who answered the questionnaires four months after the index visit, using the Wilcoxon signed-rank test, the effect size and the standardized response mean calculation.ResultsCronbach's alpha was excellent: 0.86 (0.82-0.90) for OES pain, 0.92 (0.90-0.94) for OES function, and 0.90 (0.87-0.93) for OES social/psychological. The intraclass correlation coefficient was 0.94 (0.78-0.98) for OES pain, 0.91 (0.71-0.97) for OES function, 0.95 (0.83-0.98) for OES social-psychological and 0.93 (0.76-0.98) for OES total. The Spearman ρ was >0.7 for OES pain and QuickDASH, for OES function and both QuickDASH and Mayo Elbow Performance Index, and for OES social-psychological and QuickDASH. Regarding responsiveness, the mean of the changes between the two visits ranged from 33.9 for OES pain, to 44 points for OES function and OES social/psychological. The effect size and the standardized response mean were >0.8 for all OES domains.ConclusionThis study demonstrates that the Italian version of the OES, translated in accordance with the international standardized guidelines, is reliable, valid, and responsive in patients who have undergone elbow surgery.
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Project description:BackgroundA patient-reported outcome (PRO) tool which reflects the outcomes of patients underwent total knee arthroplasty (TKA) are important to be "ceiling effect free" which commonly used PRO tools face. Forgotten joint score-12 (FJS-12) has been proved to reduce or even free from ceiling effect. FJS-12 has been translated to different languages. The objectives of this study are to validate FJS-12 in Traditional Chinese-Hong Kong language and look for the goodness of FJS-12 still exist in this language adapted FJS-12 version.MethodsFJS-12 was administered to 75 patients whose majority was obese underwent TKA between September 2019 and March 2020. Patients completed 3 sets of questionnaires (FJS-12, Oxford Knee Score (OKS), and Numeric Rating Scale (NRS)) twice, 2 weeks apart. Reliability, internal consistency, responsiveness, test-retest agreement and discriminant validity were evaluated.ResultsReliability of FJS-12 showed moderate to excellent internal consistency (Cronbach's α = 0.870). Test-retest reliability of FJS-12 was good (ICC = 0.769). Bland-Altman plot showed good test-retest agreement. Construct validity in terms of correlations between FJS-12 and OKS, and FJS-12 and NRS were moderate at baseline (Pearson's coefficient r = 0.598) and good at follow-up (r = 0.879). Smallest detectable change (Responsiveness) was higher than MIC. Floor effect was none observed, and ceiling effect was low. Discriminant validity was found to have no significance. BMI (obesity) did not affect FJS-12 outcomes.ConclusionsThe Traditional Chinese-Hong Kong version of FJS-12 showed good test-retest reliability, validity, responsiveness, BMI non-specific, with no floor and low ceiling effects for patients who underwent TKA. Sub-culture differences in individual PRO tools should be considered in certain ethnicities and languages.
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Project description:BackgroundThe Knee injury and Osteoarthritis Outcome Score for patellofemoral pain and osteoarthritis (KOOS-PF) is a condition-specific patient-reported outcome measure that is used to evaluate patients with patellofemoral pain.PurposeTo translate the KOOS-PF into the Thai language, to make necessary adaptations to a Thai cultural context, and to assess the measurement properties of the Thai version of the KOOS-PF (TH-KOOS-PF) using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist.Study designCohort study (diagnosis); Level of evidence, 3.MethodsThis study was conducted between December 2021 and May 2023. Language translation of the KOOS-PF was performed according to guidelines for the cross-cultural adaptation of self-report measures. Eligible participants aged 18 to 50 years were asked to complete various patient-reported outcome measures including the TH-KOOS-PF at 3 time points: baseline, 2 weeks after baseline for test-retest reliability analysis, and 2 months after baseline for responsiveness assessment.ResultsThe KOOS-PF was successfully translated and culturally adapted to create the TH-KOOS-PF. A total of 86 participants (mean age, 37.0 ± 8.1 years; 59.3% female) with patellofemoral pain participated in the validation process. Construct validity of the TH-KOOS-PF was demonstrated by confirmation of all a priori hypotheses. The standardized Cronbach alpha coefficient was 0.88 (95% CI, 0.83-0.91), which indicated good internal consistency. Test-retest reliability was high, with an intraclass correlation coefficient of 0.87 (95% CI, 0.77-0.92). The TH-KOOS-PF demonstrated good responsiveness, as evidenced by all predefined hypotheses' being confirmed, and there were no floor or ceiling effects. Using an anchor-based approach, the minimal clinically important difference was 11.6 points.ConclusionThe results of this study revealed the TH-KOOS-PF to be a valid, reliable, and responsive tool for assessing Thai patients with patellofemoral pain. The TH-KOOS-PF will be useful in both clinical and research settings.
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Project description:BackgroundThe Hospital for Special Surgery Hip Replacement Expectations Survey (HSS-THRES) and Knee Replacement Expectations Survey (HSS-TKRES) are widely used tools developed to assess patients' preoperative expectations for total hip and knee arthroplasty. This study aimed to translate and adapt the HSS-THRES and HSS-TKRES into Chinese versions (SC-THRES/TKRES) and evaluate their psychometric properties in patients with osteoarthritis (OA) and ankylosing spondylitis (AS).MethodsPatients scheduled for total hip (104 hip OA and 51 AS) or knee replacements (101 knee OA) were recruited in this study. Confirmatory Factor Analysis (CFA) was used to evaluate structural validity. The internal consistency was assessed by the Cronbach's α coefficient. The intraclass correlation coefficient (ICC) was used to assess test-retest reliability. The construct validity was analyzed by evaluating the correlations between SC-THRES/TKRES and the Expectation WOMAC. The correlations with the Expectation WOMAC were tested against our hypotheses. We additionally compared preoperative expectations of AS patients to those of hip OA patients.ResultsThe results of CFA for the SC-THRES and SC-TKRES demonstrated good fit. The results for the SC-THRES/TKRES revealed good test-retest reliability and good internal consistency (AS: ICC = 0.893, Cronbach's α = 0.815; hip OA: ICC = 0.878, Cronbach's α = 0.814; knee OA: ICC = 0.806, Cronbach's α = 0.808). The correlations between the SC-THRES/TKRES and the Expectation WOMAC were moderate (0.541 for AS, 0.490 for hip OA and 0.465 for knee OA), which were consistent with the hypotheses.ConclusionThe SC-THRES/TKRES are reliable, valid for the evaluation of Chinese patients with OA and AS undergoing total hip and knee arthroplasty. The surveys can be used as part of preoperative assessments. Meanwhile, additional research is needed to replicate these findings and to assess the content validity in a larger sample.
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Project description:PurposeThe primary aim of this study was to translate a self-reported questionnaire (KOOS) from English to Urdu and then to see its internal consistency, agreement, test-retest reliability, and validity among primary OA knee patients.MethodologyFirst, KOOS questionnaire was translated from English language to Urdu through standardized cross-cultural protocol. This translated version of KOOS was administered to 111 radiographically diagnosed primary OA knee patients at two times with 48-hour interval in-between. Cronbach's alpha, floor and ceiling effect, intraclass correlation coefficient (ICC), absolute agreement %, and Spearman correlation were used to fulfill our objectives.ResultsAverage time to administer this questionnaire was 20 minutes. There was good internal consistency with Cronbach's alpha ranging from 0.7246 to 0.9139. The absolute agreement of each item between two tests ranged from 81.08% to 98.20%. Test-retest reliability was excellent ("r" ranged from 0.9673 to 0.9782). There was no ceiling effect; however less than 4% floor effect was seen in two subscales. There was significant difference that existed between different X-ray grades in all subscales meaning good content validity for disease prognosis.ConclusionThe present results show that KOOS Urdu version is a reliable and valid measure for primary OA knee patients.
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