Reliability, Validity, and Responsiveness of the Chinese Version of the Knee Injury and Osteoarthritis Outcome Score (KOOS) in Patients with Anterior Cruciate Ligament Reconstruction in Mainland China

Abstract

Objective The aim of this study was to perform a cross-cultural adaption of the KOOS into Chinese and to evaluate its psychometric properties in patients with anterior cruciate ligament reconstruction (ACL reconstruction) in mainland China.

Design A cross-sectional study.

Setting Patients completed the Chinese version of the KOOS and the SF-36 questionnaire three times. We evaluated the reliability, checked the validity, and assessed the responsiveness.

Participants A total of 42 patients who had undergone ACL reconstruction.

Main Outcome Measures The results of the questionnaire survey.

Results The Chinese version of the KOOS was well accepted, with ideal test-retest reliability and internal consistency. The test-retest reliability was significant, with high ICC values ranging from 0.888 to 0.941. Additionally, we found that the internal consistency was adequate, with Cronbachʼs alpha coefficient ranging from 0.740 to 0.975. All a priori hypotheses were supported by a high correlation between the KOOS and SF-36. Furthermore, responsiveness was demonstrated since the ES and SRM between subscales following ACL reconstruction was found in the expected pattern.

Conclusions The Chinese version of the KOOS showed psychometric properties demonstrating acceptable reliability and validity similar to the original version. We conclude that the Chinese version is a reliable and valid instrument for research and clinical assessments of ACL reconstruction patients in mainland China.

Zusammenfassung

Zielsetzung Ziel dieser Studie war die Durchführung einer interkulturellen Adaptation des KOOS ins Chinesische und die Auswertung der psychometrischen Eigenschaften des Fragebogens bei Patienten mit Rekonstruktion des vorderen Kreuzbandes (VKB-Rekonstruktion) in Festlandchina.

Design Querschnittsstudie.

Setting Die Patienten füllten die chinesische Version der Fragebögen KOOS und SF-36 dreimal aus. Wir untersuchten die Reliabilität, überprüften die Validität und beurteilten die Änderungssensitivität.

Teilnehmer Insgesamt 42 Patienten, bei denen eine VKB-Rekonstruktion durchgeführt worden war.

Hauptzielkriterien Die Ergebnisse der Fragebogenerhebung.

Ergebnisse Die chinesische Version des KOOS wurde gut aufgenommen und zeigte eine ideale Test-Retest-Reliabilität sowie interne Konsistenz. Die Test-Retest-Reliabilität war signifikant und es wurden hohe ICC-Werte zwischen 0,888 und 0,941 ermittelt. Des Weiteren wurde eine adäquate interne Konsistenz mit einem Cronbach-Alpha-Koeffizienten zwischen 0,740 und 0,975 festgestellt. Alle A-priori-Hypothesen wurden durch eine hohe Korrelation zwischen KOOS und SF-36 untermauert. Außerdem wurde eine Änderungssensitivität nachgewiesen, da die Kennwerte ES und SRM zwischen den Subskalen nach VKB-Rekonstruktion dem erwarteten Muster folgten.

Schlussfolgerungen Die chinesische Version des KOOS zeigte psychometrische Eigenschaften, die auf eine mit der Originalversion vergleichbare akzeptable Reliabilität und Validität schließen lassen. Daraus folgern wir, dass es sich bei der chinesischen Version um ein zuverlässiges und valides Instrument für Forschungszwecke und zur klinischen Beurteilung von Patienten mit VKB-Rekonstruktion in Festlandchina handelt.

Key words

KOOS - psychometric properties - validation study - ACL reconstruction - mainland China

Schlüsselwörter

KOOS - psychometrische Eigenschaften - Validierungsstudie - VKB-Rekonstruktion - Festlandchina

• References

• 1 Sivachidambaram K, Ateef M, Tahseen S. Correlation of Self-Reported Questionnaire (KOOS) with Some Objective Measures in Primary OA Knee Patients. ISRN Rheumatol 2014; 16: 301485
• 2 Kessler S, Lang S, Puhl W, Stove J. The Knee Injury and Osteoarthritis Outcome Score–a multifunctional questionnaire to measure outcome in knee arthroplasty. Z Orthop Ihre Grenzgeb 2003; 141: 277-282
• 3 Roos EM, Roos HP, Lohmander LS. Knee Injury and Osteoarthritis Outcome Score (KOOS)–development of a self-administered outcome measure. J Orthop Sports Phys Ther 1998; 28: 88-96
• 4 Roos EM, Roos HP, Ekdahl C. Knee injury and Osteoarthritis Outcome Score (KOOS)–validation of a Swedish version. Scand J Med Sci Sports 1998; 8: 439-448
• 5 Salavati M, Mazaheri M, Negahban H. Validation of a Persian-version of Knee injury and Osteoarthritis Outcome Score (KOOS) in Iranians with knee injuries. Osteoarthritis Cartilage 2008; 16: 1178-1182
• 6 Xie F, Li SC, Roos EM. Cross-cultural adaptation and validation of Singapore English and Chinese versions of the Knee injury and Osteoarthritis Outcome Score (KOOS) in Asians with knee osteoarthritis in Singapore. Osteoarthritis Cartilage 2006; 14: 1098-1103
• 7 Goncalves RS, Cabri J, Pinheiro JP. Cross-cultural adaptation and validation of the Portuguese version of the Knee injury and Osteoarthritis Outcome Score (KOOS). Osteoarthritis Cartilage 2009; 17: 1156-1162
• 8 Nakamura N, Takeuchi R, Sawaguchi T. Cross-cultural adaptation and validation of the Japanese Knee Injury and Osteoarthritis Outcome Score (KOOS). J Orthop Sci 2011; 16: 516-523
• 9 Ornetti P, Parratte S, Gossec L. Cross-cultural adaptation and validation of the French version of the Knee injury and Osteoarthritis Outcome Score (KOOS) in knee osteoarthritis patients. Osteoarthritis Cartilage 2008; 16: 423-428
• 10 Almangoush A, Herrington L, Attia I. Cross-cultural adaptation, reliability, internal consistency and validation of the Arabic version of the knee injury and osteoarthritis outcome score (KOOS) for Egyptian people with knee injuries. Osteoarthritis Cartilage 2013; 21: 1855-1864
• 11 Gul ED, Yilmaz O, Bodur H. Reliability and validity of the Turkish version of the knee injury and osteoarthritis outcome score-physical function short-form (KOOS-PS). J Back Musculoskelet Rehabil 2013; 26: 461-466
• 12 Monticone M, Ferrante S, Salvaderi S. Development of the Italian version of the knee injury and osteoarthritis outcome score for patients with knee injuries: cross-cultural adaptation, dimensionality, reliability, and validity. Osteoarthritis Cartilage 2012; 20: 330-335
• 13 Paradowski PT, Witonski D, Keska R. Cross-cultural translation and measurement properties of the Polish version of the Knee injury and Osteoarthritis Outcome Score (KOOS) following anterior cruciate ligament reconstruction. Health Qual Life Outcomes 2013; 11: 1-7
• 14 Guillemin F, Bombardier C, Beaton D. Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol 1993; 46: 1417-1432
• 15 Ware Jr JE, Sherbourne CD. The MOS36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30: 473-483
• 16 McHorney CA, Ware Jr JE, Lu JF. The MOS36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 1994; 32: 40-66
• 17 McHorney CA, Ware Jr JE, Raczek AE. The MOS36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993; 31: 247-263
• 18 Li L, Wang HM, Shen Y. Chinese SF-36 Health Survey: translation, cultural adaptation, validation, and normalisation. J Epidemiol Community Health 2003; 57: 259-263
• 19 Terwee CB, Bot SD, de Boer MR. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 2007; 60: 34-42
• 20 Froberg DG, Kane RL. Methodology for measuring health-state preferences–III: Population and context effects. J Clin Epidemiol 1989; 42: 585-592
• 21 Irrgang JJ, Anderson AF. Development and validation of health-related quality of life measures for the knee. Clin Orthop Relat Res 2002; 402: 95-109
• 22 Deyo RA, Diehr P, Patrick DL. Reproducibility and responsiveness of health status measures statistics and strategies for evaluation. Control Clin Trials 1991; 12: 142S
• 23 Roos EM, Toksvig-Larsen S. Knee injury and Osteoarthritis Outcome Score (KOOS) – validation and comparison to the WOMAC in total knee replacement. Health Qual Life Outcomes 2003; 1: 17