Abstract
BackgroundThe Western Ontario Osteoarthritis of the Shoulder index (WOOS) has been introduced as a disease-specific quality of life measurement in patients with glenohumeral arthritis. The aim of the present study was to perform a cross-cultural adaptation of the English version of the WOOS to Italian and to assess its validity, reliability and responsiveness in patients with glenohumeral joint osteoarthritis treated conservatively.Material and methodsThe adaptation process was carried out following the simplified Guillemin criteria. The English version was translated into Italian by two bilingual orthopaedic surgeons and then translated back into English by two different bilingual orthopaedic surgeons. The original version was compared with the back-translation. The questionnaire was prospectively administered to 30 patients with glenohumeral osteoarthritis at baseline and again after 5 days for retest reliability. After 6 months of conservative treatment, the responsiveness of the questionnaire was assessed in a subsample of 20 patients. The level of statistical significance was set at 0.05.ResultsThe interclass correlation coefficient between test and retest of the WOOS was 0.99 (P < 0.001). Pearson’s correlation coefficient between the WOOS and disability of the arm, shoulder and hand (DASH) preoperatively was 0.73 (P < 0.01) and the correlation between the changes of score for the WOOS and DASH was 0.75 (P < 0.01). There were no floor or ceiling effects. Responsiveness, calculated by standardized response mean, was 1.1 and effect size was 1.3.ConclusionsThe Italian version of the WOOS questionnaire has shown to be equivalent to its English version and demonstrated good validity, reliability and responsiveness to conservative treatment of glenohumeral osteoarthritis.Level of evidenceLevel II.Electronic supplementary materialThe online version of this article (doi:10.1007/s10195-016-0400-4) contains supplementary material, which is available to authorized users.
Highlights
Patient-reported outcomes are used to assess the severity of pathology and evaluate the outcomes of both conservative and surgical treatments
Correlation between Western Ontario Osteoarthritis of the Shoulder index (WOOS) and DASH was assessed with a parametric test (Pearson’s correlation) and the test–retest reliability was assessed with interclass correlation coefficient (ICC) for the total score and for the four domains
Responsiveness was assessed by the standardized response mean (SRM) and the effect size (ES)
Summary
Patient-reported outcomes are used to assess the severity of pathology and evaluate the outcomes of both conservative and surgical treatments. Guillemin was the first to describe this process consisting of translation of the questionnaire and subsequent adaptation to idioms, culture and lifestyle He described a 5-step process including translations and back-translations by qualified people, a committee review of these translations and back-translations, pre-testing for equivalence, and a re-examination of the weighting of scores. At the end of this process, a statistical evaluation including validity, reliability and responsiveness to treatment (conservative or surgical) must be carried out before considering these scoring systems suitable to be used in different countries [3]. The aim of the present study was to perform a cross-cultural adaptation of the English version of the WOOS to Italian and to assess its validity, reliability and responsiveness in patients with glenohumeral joint osteoarthritis treated conservatively.
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