Arabic Patients Research Articles

Metacognitive Training for Depression (D-MCT) for Arabic Speaking Patients with Refugee Experience: Cultural Adaptation and Piloting

Despite high demand, culturally adapted therapies for Arabic speaking refugee patients with depression are rare. Aim of the study was to culturally adapt and evaluate the group treatment Metacognitive Training for Depression (D-MCT) for them. The cultural adaptation of the D-MCT included translation and surface adaptation as well as an expert discussion. The comprehensibility, acceptance and feasibility of the outpatient culturally adapted D-MCT (CA-D-MCT) were then tested in an uncontrolled pilot study with n=11 refugee patients. The experts rated 83% of the translations and 78% of the illustrations as unproblematic in terms of equivalence. The acceptability and feasibility of the eight modules were predominantly positive. From the patients' perspective, the adapted training shows a high acceptance and comprehensibility for culturally sensitive, interpreter-supported implementation.

Assessment of the Validity and Reliability of an Arabic Version of Autism Behavior Checklist: One Center Study

Abstract Background Autism behavior checklist (ABC) is a list of questions concerning a child's behaviors as a part of a broader tool, the Autism screening instrument for educational planning (ASIEP). To date, this checklist has not been translated into Arabic, and therefore, it cannot be used with Arabic speaking patients. Objective To translate the Autism Behavior Checklist from English to Arabic and to assess the psychometric properties of the Arabic version. Patients and Methods A total of 400 Arabic fluent mothers or caregivers of autistic and typically developed children aging 2-14 years recruited from Developmental and behavioral clinic and outpatient clinic-pediatrics hospital, Faculty of Medicine, Ain Shams University participated in the study. The Arabic version of Autism behavior checklist was checked for its structural validity and reliability. Results Of 400 children included in the study, the autism group consisted of 114 boys (76%) and 36 girls (24%), mean age was 7 years ± 1.8 years, and the typical development group consisted of 145 boys (58%) and 105 girls (42%),mean age was 7.4 years ±1.6 years. The Autism behavior checklist was translated following the international guidelines. Autism behavior checklist yielded a five factors model by exploratory factor analysis (EFA). Kaiser-Meyer-Olkin (KMO) statistic was (0.671), Bartlett's Test of Sphericity was statistically significant (P-value< 0.05) with chi square test value of (χ2 = 22231.064, df = 1596). Overall, the 75 items revealed good internal consistency, Cronbach's alpha was (0.972), the intra- class correlation coefficients (ICC) of the five subscales ranged from 0.423 to 0.677 (P < 0.01). At two weeks interval the ICC of the five subscales ranged from 0.335 to 0.856 and the total score was 0.869 (P < 0.01). Conclusion The Arabic version of Autism Behavior Checklist (AV-ABC) is a valid and reliable tool to screen and assess cases with autism spectrum disorder.

The Manchester Scoring System for predicting BRCA1/2 mutations underperforms in Arabic Omani breast cancer patients.

Risk assessment models that are applied to assess the lifetime risk of cancer and pathogenic variant risk are more commonly used in Western populations. Using these models, without validation, for non-Western populations has been questioned. This study aimed to evaluate the use and consistency of the Manchester Scoring System as a risk assessment model for the Omani population. A retrospective, file-based analysis was performed on breast cancer patients seen in a genomics department over a two-year period. Personal cancer history and family history were used to analyze the Manchester scores of 409 breast and/or cancer patients. The results show that, overall, the Manchester scores were low. If this risk assessment model had been used to determine eligibility for a priori service and genetic testing decisions, 12 BRCA pathogenic cases would have been missed. At this time, the Manchester Scoring System does not seem to be the best risk assessment model for use in the Omani population, unless the eligibility threshold of ≥6 is used, which could provide a better sensitivity for the Omani population. We propose using concepts of the Manchester Scoring model to create a scoring system that is more suitable for the Omani and Arabic population.

Cross-Cultural Adaptation, Translation, and Validation of the Victorian Institute of Sport Assessment-Achilles Questionnaire (VISA-A) for Use With Arabic-Speaking Patients With Achilles Tendinopathy.

The Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire is a validated instrument for assessing symptoms of Achilles tendinopathy (AT). However, there is a need to validate the Arabic version of the VISA-A (VISA-A-AR) in Arabic-speaking patients with AT. To validate the VISA-A-AR in Arabic patients with AT and evaluate its reliability and validity. Cohort study (diagnosis); Level of evidence, 3. The translation and cultural adaptation of the VISA-A questionnaire into Arabic followed international guidelines. A total of 81 participants were recruited, including 45 patients diagnosed with AT and 36 healthy individuals. The AT group comprised male and female native Arabic speakers aged ≥18 years who were diagnosed with and had symptoms of AT. The inclusion criteria for the healthy group were the same, except that they must not have had AT at the time of the study or previously. The exclusion criteria were individuals with a partial or complete Achilles tendon rupture or prior Achilles tendon surgery. The internal consistency of the VISA-A-AR was assessed using the Cronbach α coefficient. Test-retest reliability was evaluated using the intraclass correlation coefficient (ICC[3,1]). Construct validity was assessed through correlation analysis between VISA-A-AR scores and the Arabic versions of the Short Form-36 Health Survey (SF-36-AR) and the Numeric Pain Rating Scale (ANPRS). Differences in VISA-A-AR scores between patients with AT and healthy controls were analyzed using appropriate statistical tests. The VISA-A-AR demonstrated a high level of internal consistency (Cronbach α = 0.935) and excellent test-retest reliability (ICC[3,1] = 0.985). Significant positive correlations were observed between VISA-A-AR scores and SF-36-AR (r(43) = 0.838, P < .001), indicating good construct validity. In addition, VISA-A-AR scores showed a significant negative correlation with ANPRS (rS(43) = -0.835, P < .001). Furthermore, VISA-A-AR scores exhibited a significant difference between patients with AT (mean, 45.82 ± 16.65) and healthy controls (mean, 99.94 ± 0.33) (P < .001). The findings of this study validate the VISA-A-AR as a reliable and valid tool for assessing symptoms of AT in Arabic-speaking patients.

Validation of the arabic version of the EuroQol-5-dimension 5-level (EQ-5D-5 L) in patients with spinal degenerative diseases

ObjectiveThis study aims to test the reliability and validity of the translated Arabic version of EQ-5D-5 L.MethodsThe study was conducted on 100 patients operated upon for degenerative spine diseases coming for follow up in the outpatient clinic of a Tertiary care hospital. Test-retest reliability was assessed by completing the self-administered tool in two follow up visits, one week apart, by 50 patients. Internal consistency was evaluated by Cronbach’s alpha. Intra-class correlation coefficients and kappa statistics were performed to test for the agreement between the two ratings. Criterion validity was assessed by comparing the responses of 100 patients to the EQ-5D-5 L with scores of two validated questionnaires; the Arabic version of the Oswestry disability index and the Arabic version of short-form health survey-36. The construct validity was assessed using known-groups comparison to test for hypothesized differences concerning demographic and clinical variables.ResultsThe Arabic version of EQ-5D-5 L questionnaire had a high reliability with high observed internal consistency (Cronbach’s alpha = 0.816, CI: 0.719–0.886). It showed strong temporal stability, with ICCs of the EQ-5D-5 L score, index and EQ-visual analog scale (EQ-VAS) of 0.852, 0.801, and 0.839 respectively. Agreement by kappa was moderate; above 0.4, for all domains, except for the “Usual activities” domain. EQ-5D-5 L domains, VAS and index had moderate to strong significant correlations with SF-36 and ODI subscales and total scores in the correct direction indicating a good criterion validity of the instrument.ConclusionThe Arabic version of EQ-5D-5 L is reliable and valid for assessment of HRQoL of Arabic speaking patients.

Identifying Factors Associated With Disparities in Access to Integrative Oncology Program

Context and ObjectivesCancer centers are increasingly providing complementary medicine as part of an emerging discipline termed ‘integrative oncology’ (IO). The present study explored factors associated with disparities in referral and adherence to a freely-provided IO program. MethodsThe databases of three oncology centers in northern Israel were searched retrospectively for chemotherapy-treated oncology patients eligible for referral by their oncology healthcare professionals to an integrative physician (IP) consultation. Demographic and cancer-related variables associated with the referral, and attendance by patients at the consultation were identified, as was adherence to the 6-week IO treatment program (high adherence, attending ≥4 IO treatment sessions; low adherence, 0–3 sessions). ResultsOf 4988 eligible patients, 1694 (34%) were referred to the IP consultation, with 1331 (78.6%) attending the consultation of which 766 (57.6%) were adherent to IO treatments. Multivariate analysis revealed lower referral rates among patients speaking primarily Arabic and Russian vs. Hebrew (OR = 3.0, 95% CI = 2.0–4.6, P < 0.0001); males vs. females (OR = 1.94, CI = 1.3–2.9, P = 0.001); those not reporting emotional distress (OR = 1.5, CI = 1.02–2.16, P = 0.037); and older age (OR = 1.04, CI = 1.03–1.06, P < 0.0001). Arabic and Russian-speaking patients were less likely to adhere to IO treatments (OR = 0.52, 95% CI = 0.32–0.83, P = 0.006). ConclusionPatients’ ethno-national origin and immigration status (primary language, Arabic and Russian), male gender and older age were associated with lower rates of referral to and attendance of the IP consultation, with reduced adherence to weekly IO treatments. These findings require further study to identify barriers toward diversity, equity and inclusion in IO care, increasing awareness among healthcare professionals regarding the benefits of these services for improving patient wellbeing.

Interpreters as facilitators of emotional expressions in multilingual medical interactions: Observations from Italian healthcare practices

This article discusses insights from a research on the management of emotions in medical interactions involving Italian healthcare providers, Arabic speaking interpreters and Arabic speaking patients. The findings suggest that the possibility for patient’s emotions to become relevant in the medical encounter is affected by the activity of interpreters as mediators of the inter-linguistic interaction. While this contribution also considers examples of interpreters’ choices excluding the emotions of the patients from the interaction, the discussion focuses on affective formulations of patient’s expression of emotions, as an interactional resource to make doctors aware of patients’ emotional expressions emerged from dyadic monolingual interactions. This article concludes by suggesting that interpreters as linguistic mediators may effectively promote emotional literacy in healthcare interactions, promoting a patient-centred model of multilingual healthcare.

Arabic version of the SF‐Qualiveen: cross-cultural adaptation, translation, and validation of urinary disorder‐specific instruments in patients with spinal cord injury

BackgroundThe Short-Form Qualiveen (SF-Qualiveen) questionnaire assesses the effect of bladder and urinary symptoms on patients' quality of life (QoL) with urological impairment caused by neurological diseases. There is no validated SF-Qualiveen questionnaire in Arabic, so this study aims to provide a translated and validated version of the SF-Qualiveen questionnaire among Arabic patients experiencing spinal cord injury (SCI).MethodsPsychometric features such as content and construct validity, test–retest reliability, and internal consistency were analyzed. Construct validity was evaluated by contrasting the SF-Qualiveen with the Neurogenic Bladder Symptom Score Short-Form (NBSS-SF) questionnaire. Internal consistency was measured using Cronbach's alpha, whereas the intraclass correlation coefficient (ICC) was employed to assess the test–retest reliability. Factorial validity was established by principal component analysis (PCA).ResultsThe internal consistency of the total SF-Qualiveen and the domains “Bother with limitations,” “Fear,” “Feeling,” and “Frequency of limitations” showed good internal consistency (Cronbach's alpha of > 0.7). ICC was 0.90 for the total score, 0.83 for the bother with limitations, 0.80 for fears, 0.84 for feeling, and 0.81 for frequency of limitations. The correlation analysis revealed a positive association between the total scores on the NBSS-SF and the domains of the SF-Qualiveen, comprising bother with limitations (r = 0.53, p = 0.02), fears (r = 0.44, p = 0.03), feelings (r = 0.49, p = 0.04), and frequency of limitations (r = 0.46, p = 0.02). The best-fit four-factor model for confirming overall item communalities ranged from 0.552 to 0.814, which indicates moderate to high communalities, and confirms the homogeneity of the SF-Qualiveen using PCA.ConclusionsThe findings of this validation study revealed that the SF-Qualiveen is a reliable and valid instrument appropriate for Arabic-speaking patients with SCI in both research and clinical practices.

Psychometric properties of an Arabic translation of the chronic pain acceptance questionnaire (CPAQ) in a sample of patients with chronic pain

Purpose Chronic pain (CP) acceptance is a major factor in determining the well-being of patients with chronic pain. The chronic pain acceptance questionnaire (CPAQ) was translated and validated into Arabic (CPAQ-Ar). Methods 244 patients with CP completed the CPAQ-Ar, the Beck Depression Inventory-II (BDI-II), the short form health survey (SF-36), the Pain Catastrophizing Scale (PCS), the Pittsburgh Sleep Quality Index (PSQI), the Modified Fatigue Impact Scale (MFIS), and the Depression Anxiety Stress Scale 21 (DASS-21). 110 patients completed the CPAQ-Ar twice separated by two weeks to investigate test-retest reliability. Results Cronbach’s α was 0.902 while the intraclass correlation coefficient (ICC) was 0.917. The standard error measurement (SEM) was seven points while the minimal detectable change with 95% confidence interval (MDC95) was seventeen points. The CPAQ-Ar showed moderate to high correlations with the PCS, the BDI-II, the SF-36, the MFIS, the PSQI, and the DASS-21 indicating a good concurrent validity. Exploratory factor analysis confirmed that the CPAQ-Ar consists of two subscales. Better pain acceptance associated with male gender, older people, employed participants, low pain intensity, and single pain site. Conclusions The CPAQ-Ar is a valid and reliable tool for the measurement of pain acceptance in Arabic speaking patients with CP.

Quality and safety issue: language barriers in healthcare, a qualitative study of non-Arab healthcare practitioners caring for Arabic patients in the UAE

ObjectivesTo identify language-related communication barriers that expatriate (non-Arabic) healthcare practitioners in the UAE encounter in their daily practice.DesignQualitative study utilising semi-structured in-depth interviews. The interviews were conducted in English language.SettingDifferent...

Reliability and validity of an adapted Arabic version of Scoliosis Japanese Questionnaire-27 in Saudi Arabia

BackgroundThe Scoliosis Research Society SRS-22 questionnaire is a standard tool to assess the Health-Related Quality of Life (HRQoL) in scoliosis patients but, because of cultural differences limited use among Arabic patients. The aim is to perform a cross-cultural adaptation and validation of Arabic version of Scoliosis Japanese Questionnaire-27 and test it on Saudi patients with adolescent idiopathic scoliosis (AIS). MethodsThis a cross sectional study run between July 2021 and December 2022 recruited 194 patients. The cross-cultural adaptation process was performed using the American Association of Orthopedic Surgeons (AAOS) Outcomes Committee method. All patients had completed the Arabic version of Scoliosis Japanese Questionnaire-27 and SF-12 preoperatively and 3-month postoperatively. The validity and internal consistency were tested using the Intraclass correlation coefficient (ICC), Cronbach alpha, Pearson correlation coefficient, and confidence interval (CI). ResultsWe analyzed the result of 194 female adolescent patients. The average age is 14 ± 2.4 years (range from 10 to 21 years). The majority of patients have a Lenke type 1 curve (54 %). The overall Cronbach alpha (CA) of all domains of Scoliosis Japanese Questionnaire-27 is 0.92. However, the Cronbach alpha for the mental health (Q17,18,20,21,23,24) and, self-image (Q12-14,22,25,26) are 0.93 and 0.84 respectively. ConclusionThe Arabic version of Scoliosis Japanese Questionnaire-27 is a reliable and valid instrument and can be applied to evaluate the quality of life in patients with AIS.

Construct validity, test–retest reliability, and responsiveness of the Arabic version of the upper limb functional index

BackgroundThe upper limb functional index (ULFI) is a widely used self-report outcome measure questionnaire with robust psychometric properties to assess the upper limb musculoskeletal disorders (UL-MSDs). This study aimed to investigate the psychometric properties of the Arabic version of ULFI (ULFI-Ar).MethodsIn this observational study, 139 patients (87 male, 52 females with mean age of 38.67 ± 13.04 year) with various UL-MSD’s, completed the ULFI-Ar, Disability of Arm, Shoulder, and Hand questionnaire (DASH-Arabic), and numeric pain rating scale (NPRS-Arabic). All participants determined the factor structure, and the construct validity. A subgroup of the participants determined test–retest reliability (n = 46) and responsiveness (n = 27).ResultsThe ULFI-Ar construct validity obtained by the expletory factor analysis as one-factor structure, demonstrated an excellent test–retest reliability [intraclass correlation coefficient (ICC2:1) = 0.95], measurement error [standard error of measurement (SEM) = 4.43%; minimal detectable change at 90% confidence interval (MDC90) = 10.34%], medium internal responsiveness [Cohen’s d = 0.62 and standard response of mean (SRM) = 0.67], strong external responsiveness DASH-Arabic (r =—0.90; p < 0.001), and negative strong correlation with NPRS-Arabic (r =—0.75, p < 0.001).ConclusionsThe ULFI-Ar is a valid, reliable, and responsive self-report questionnaire to assess UL-MSDs in Arabic speaking patients.

Reliability and Validity of Kansas City Cardiomyopathy Questionnaire in Arabic Patients with Chronic Heart Failure.

Background: The Kansas City Cardiomyopathy Questionnaire (KCCQ) is the most specific and widely used questionnaire for assessing health-related quality of life (HRQoL) in chronic heart failure (CHF). This study aimed to examine reliability and validity of the KCCQ in Arabic patients with CHF. Material and Methods: Patients with CHF filled out the Arabic versions of the Minnesota Living with Heart Failure (MLHF) and KCCQ questionnaire, and performed a six-minute walk test (6MWT) on their first visit. On the return, the patients filled out the KCCQ along with the global rating of change (GRC) scale. Internal consistency, test-retest reliability, and construct validity were examined. Results: A total of 101 Arabic patients with CHF, with a mean (SD) age of 55 (11) years old, completed the study. The Cronbach's alpha was 0.97, and the ICC2,1 = 0.95 (95%CI: 0.92 to 0.97, p < 0.001). The Arabic version of KCCQ was correlated with the MLHF (r = -0.57, p = 0.01) and with the 6MWT (r = 0.70, p < 0.001). Conclusions: The Arabic version of KCCQ is a reliable and valid measure of HRQoL, which could be utilized in routine clinical practice for Arabic-speaking patients with CHF.

Translation, cultural adaptation and psychometric validation of the Arabic short version of the coronary artery disease education questionnaire (CADE-Q SV) in Saudi Arabia

ObjectiveTo translate, culturally adapt, and psychometrically validate the Arabic Coronary Artery Disease Education Questionnaire Short Version (CADE-Q SV). MethodsThe CADE-Q SV was translated to Arabic by two independent translators, followed by back-translation. Then, an expert panel of 10 healthcare providers and 10 patients reviewed the survey and provided input for content validity (CV) and clarity of items. For the psychometric analysis, 202 cardiac patients from Saudi Arabia completed the questionnaire, of which factor structure, internal consistency, construct, and criterion validity were assessed. ResultsItems were translated, and CV was confirmed. Items were rated based on relevance and understandability. The scale was finalized after changes in 5 items. Confirmatory factor analysis revealed 5 factors, all internally consistent: medical condition, risk factors, exercise, nutrition, and psychosocial health. Overall alpha was 0.84. Construct validity was established by significant associations between scores and occupation, educational level, family income, having a diagnosis of acute coronary syndrome or valve disorders and with a history of valve repair or replacement a coronary artery bypass graft procedure. Scores were significantly higher for those that participated in cardiac rehabilitation, confirming criterion validity. ConclusionsResults from this study confirm the validity and reliability of the CADE-Q SV in Arabic-speaking patients. InnovationThe CADE-Q SV can be used as a knowledge measurement to support clinical work and development of education intervention for Arabic patients.

Cultural adaptation and validation of the scleroderma health assessment questionnaire into Arabic language

BackgroundSystemic sclerosis is an autoimmune multisystem disorder which affects the patients’ physical and psychological functioning. Scleroderma health assessment questionnaire used to measure physical disability in systemic sclerosis patients. It consists of Health Assessment Questionnaire Disability Index plus five visual analogue scores related to systemic sclerosis symptoms. There is no Arabic questionnaire specifically measuring physical disability in Arabic systemic sclerosis patients; therefore, this study aimed to translate the scleroderma health assessment questionnaire, culturally adapt it, and test its reliability and validity.MethodThe scleroderma health assessment questionnaire was translated into Arabic according to translation and cross-cultural adaptation guidelines. Convergent validity is measured by correlation of scleroderma health assessment questionnaire scores for 56 patients with short-form health survey scores, while discriminate validity is tested by stratifying clinical manifestations of patients and disease subtypes. Reliability measured by the intraclass correlation coefficient by interviewing patients twice 14 days apart.ResultsThere was a strong correlation between the short-form health survey scores: physical component score and Health Assessment Questionnaire Disability Index and scleroderma health assessment questionnaire global scores (r = − 0.659**, − 0.727**), while a moderate correlation between the short-form health survey scores physical component score, and scleroderma health assessment questionnaire, visual analogue scores, and all scleroderma health assessment questionnaire visual analogue score subtypes except for Raynaud’s and digital ulcer, was found (r = − 0.495**, − 0.458*, − 0.495**, − 0.403*). The mental component score of the short-form health survey scores was moderately correlated with Health Assessment Questionnaire Disability Index and scleroderma health assessment questionnaire global scores (r = − 0.507**, − 0.51**), while it was mildly correlated with scleroderma health assessment questionnaire visual analogue score and only its subtype overall severity score (r = − 0.398*, − 0.375*). Also, statistically significant association is between diffuse disease type and digestive visual analogue score (p = 0.001). The Arabic edition of scleroderma health assessment questionnaire has a Cronbach’s alpha of 0.845.ConclusionThe translated Arabic version is a valid and reliable questionnaire to assess Egyptian systemic sclerosis patients’ functional disability.

Long-Term Survival Analysis and Prognostic Factors of Arabic Patients with Differentiated Thyroid Carcinoma: A 20-Year Observational Study at the King Hussein Cancer Center (KHCC) Involving 528 Patients.

DTC accounts for the majority of endocrine tumors. While the incidence of thyroid cancer has been increasing globally over the past few decades, papillary thyroid carcinoma (PTC) generally shows an excellent prognosis, except in cases with aggressive clinicopathological features. This study aimed to assess the 5- and 10-year overall survival (OS) and progression-free survival (PFS) of 528 Arabic patients diagnosed with primary DTC from 1998 to 2021. Additionally, the study aimed to analyze the impact of various factors on both OS and PFS. An univariable survival analysis was conducted using Kaplan-Meier curves. The 5- and 10-year OS for patients with DTC have exceeded 95%. Additionally, PFS showed very good rates (ranging between 96.5 and 85% at 5 and 10 years, respectively). Age, male gender, risk of recurrence, and distant metastasis were identified as the main negative prognostic factors for both OS and PFS, while RAI treatment was found to be a significant factor in improving OS. Moreover, adherence to the King Hussein Cancer Center's (KHCC) CPG demonstrated significant improvement in PFS. These findings highlight common prognostic factors and favorable outcomes in Arabic patients with DTC treated at a tertiary cancer center using standard of care approaches.

ChatGPT’s ability to comprehend and answer cirrhosis related questions in Arabic

Background and study aimsCirrhosis is a chronic progressive disease which requires complex care. Its incidence is rising in the Arab countries making it the 7th leading cause of death in the Arab League in 2010. ChatGPT is a large language model with a growing body of literature demonstrating its ability to answer clinical questions. We examined ChatGPT’s accuracy in responding to cirrhosis related questions in Arabic and compared its performance to English. Materials and methodsChatGPTs responses to 91 questions in Arabic and English were graded by a transplant hepatologist fluent in both languages. Accuracy of responses was assessed using the scale: 1. Comprehensive, 2. Correct but inadequate, 3. Mixed with correct and incorrect/outdated data, and 4. Completely incorrect.Accuracy of Arabic compared to English responses was assessed using the scale: 1. Arabic response is more accurate, 2. Similar accuracy, 3. Arabic response is less accurate. ResultsThe model provided 22 (24.2%) comprehensive, 44 (48.4%) correct but inadequate, 13 (14.3%) mixed with correct and incorrect/outdated data and 12 (13.2%) completely incorrect Arabic responses. When comparing the accuracy of Arabic and English responses, 9 (9.9%) of the Arabic responses were graded as more accurate, 52 (57.1%) similar in accuracy and 30 (33.0%) as less accurate compared to English. ConclusionChatGPT has the potential to serve as an adjunct source of information for Arabic speaking patients with cirrhosis. The model provided correct responses in Arabic to 72.5% of questions, although its performance in Arabic was less accurate than in English. The model produced completely incorrect responses to 13.2% of questions, reinforcing its potential role as an adjunct and not replacement of care by licensed healthcare professionals. Future studies to refine this technology are needed to help Arabic speaking patients with cirrhosis across the globe understand their disease and improve their outcomes.

Translation and Validation of the Arabic Version of the Reflux Symptom Score, Short Version 12 (RSS-12)

The Reflux Symptom Score (RSS) is a patient-related outcomes measure (PROM) that was developed to diagnose Laryngopharyngeal reflux (LPR), by assessing the severity and frequency of specific symptoms and their respective impact on quality of life (QoL). To develop the Arabic version of RSS-12 (Ar-RSS-12), and to assess its validity and reliability. The RSS-12 was translated from French into Arabic using the forward-backward translation method, and the translated version underwent transcultural validation. A case-control study was conducted at the otolaryngology clinics of a referral hospital, during the period November to December 2022. It included 61 patients with LPR-related symptoms and a Reflux Symptom Index (RSI) score >13, and 61 control without LPR-related symptoms and negative RSI scores ≤13. The internal consistency, internal and external validity, and Test-Retest reliability of Ar-RSS-12 were analyzed. Patients had significantly higher scores than controls in all 12 items and total Ar-RSS and QoL impact scores, with high Z score values. Item scores showed variable correlation levels with total Ar-RSS score, with ear-nose-throat items showing the strongest correlation (Spearman's rho 0.592-0.866). The QoL scores were more strongly correlated to the symptoms' severity than frequency. The internal consistency was high, with Cronbach's alpha=0.878. Regarding external validity, correlations with RSI score showed high Spearman's rho values for total Ar-RSS (0.905) and QoL total score (0.903). No statistically significant difference was observed between Test and Retest results in any of the 12 items' score or the total score and QoL, indicating the reproducibility of the test. The Ar-RSS is a valid and reproducible tool for the screening, assessment, and monitoring of LPR in Arabic speaking patients. The inclusion of symptoms severity and frequency, as well as their individual effects on patient's QoL, support the superior clinical applications of RSS compared to other existing PROMs.

Arabic translation, cultural adaptation, and validation of the Bristol Impact of Hypermobility questionnaire

BackgroundThe Bristol Impact of Hypermobility questionnaire (BIoH) is the first condition-specific patient reported outcome measure for people with hypermobility-related conditions. The BIoH original version is in English, which limits its use for patients who speak other languages. The study aimed to translate and culturally adapt the BIoH into Arabic and determine its concurrent validity, reliability, internal consistency and smallest detectable change.MethodsForward-backward translation and cross-sectional designs were used. The Ethics Committee of Kuwait Ministry of Health approved the study. Spearman correlation coefficient, intraclass correlation coefficient (ICC), and Cronbach’s α were used for statistical analysis. Patients with hypermobility spectrum disorders (HSD) were included, diagnosed using the 2017 classification framework.Results55 HSD patients were included, aged 26.0 (18.0) years old; median (IQR), and 85.5% were women. The BIoH showed very good concurrent validity when correlated with the SF-12 total and physical component scores; r = -0.743 and − 0.740, respectively (p < 0.05). Good correlation was identified between the BIoH and the SF-12 mental component score; r = -0.496 (p < 0.05). The BIoH demonstrated excellent test-retest reliability; ICC = 0.934 (0.749–0.983 95% CI) (p < 0.05), and high internal consistency (Cronbach’s α = 0.933). The smallest detectable change was 30.90 points, representing 19.8% of the mean baseline score.ConclusionsThe study successfully translated the BIoH into Arabic and demonstrated high psychometric properties. The translated score can help Arabic patients with HSD in their clinical evaluation process. Future research needs to determine the responsiveness of the Arabic version and translate the BIoH to other languages.

Impaired morphological processing: insights from multiple sclerosis

ABSTRACT Multiple Sclerosis (MS) is a neurological disease characterised by damage affecting large bundles of white matter fibres. Morphological segmentation of complex words (e.g. walked) into stems (walk) and suffixes (∼ed) is thought to depend on intact white matter. We tested the hypothesis that Arabic speaking patients with MS may lose the ability to segment morphologically complex words in a primed lexical decision task using word pairs that shared either a root and a semantic relationship (+R + S, e.g. “AnzAl”–“nuzwl” lowering-landing), a root without semantics (+R–S, e.g. “rtAbp”–“trtyb” monotony-tidying up),a semantic relationship (–R + S, e.g. “xyr”–“nEmp” good-grace), or a phonological relationship (–R + Phon, e.g. “mEdn”–“mEAnd” mineral-stubborn). While healthy controls showed priming by root regardless of semantics and inhibition by phonology, the patients showed facilitation by semantics (+R + S and –R + S), and inhibition by phonology (–R + Phon). These findings are used to adjudicate three contending models of lexical processing.