Abstract
BackgroundSeveral questionnaires have been used to assess the health status of patients with Kashin-Beck disease (KBD) in clinical trials, but the evidence regarding the responsiveness of these instruments in KBD patients is limited. Therefore, the aim of this study was to evaluate and compare the responsiveness of the Chinese version of the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) and 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in KBD patients undergoing intra-articular injection of hyaluronic acid (HA).MethodsA sample of 232 KBD patients treated with intra-articular injection of HA completed the WOMAC, 12-item WHODAS 2.0 and joint dysfunction index (JDI) both pre- and post-treatment. Responsiveness was assessed using correlation and receiver operating characteristic (ROC) curve analyses following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist.ResultsOverall, there were significant improvements in the mean scores on the WOMAC and on the 12-item WHODAS 2.0, except for in the cognition domain. Correlation analysis showed that changes in the WOMAC and 12-item WHODAS 2.0 scores had moderate or weak positive associations with the changes in the JDI. However, acceptable areas under the ROC curve (value > 0.7) were found for all domains and for the total score on the WOMAC, but only for the mobility domain and the total score on the 12-item WHODAS 2.0.ConclusionsThese results demonstrated that the WOMAC was more responsive than the 12-item WHODAS 2.0 in KBD patients treated with intra-articular injection of HA. Our findings support the continued use of the WOMAC as an outcome measure in assessing disability in KBD patients.
Highlights
Several questionnaires have been used to assess the health status of patients with Kashin-Beck disease (KBD) in clinical trials, but the evidence regarding the responsiveness of these instruments in KBD patients is limited
The results demonstrated that the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) had a greater degree of responsiveness than did the 12-item World Health Organization Disability Assessment Schedule (WHODAS) 2.0 in KBD patients treated with intra-articular injections of hyaluronic acid (HA)
By conducting a correlation analysis, we found that the change scores for the WOMAC and the 12-item WHODAS 2.0, except for the getting alone domain, were all significantly correlated with the change scores for the joint dysfunction index (JDI); the WOMAC had larger correlation coefficients than the 12-item WHODAS 2.0
Summary
Several questionnaires have been used to assess the health status of patients with Kashin-Beck disease (KBD) in clinical trials, but the evidence regarding the responsiveness of these instruments in KBD patients is limited. The aim of this study was to evaluate and compare the responsiveness of the Chinese version of the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) and 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in KBD patients undergoing intra-articular injection of hyaluronic acid (HA). Kashin-Beck disease (KBD) is a chronic, progressive and degenerative osteoarticular disorder with an unknown etiology [1]. It is primarily found in individuals in an endemic agricultural region in southeastern Siberia, North Korea and a belt-shaped region from northeastern to southwestern China [2, 3]. It has been shown to be a safe and effective treatment for KBD patients with knee joint involvement [9]
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