Comparison of the responsiveness of the WOMAC and the 12-item WHODAS 2.0 in patients with Kashin–Beck disease

Abstract

Background: 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. 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). Methods: A 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. Results: Overall, 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 12item 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. Conclusions: These 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.

Evaluation of health-related quality of life in patients with Kashin-Beck disease using a new questionnaire：A cross-sectional study

“…Comparing KBDQOL with SF-36, some aspects are unique to KBDQOL (for example, social support, economics, etc.). Among the 12 physical function and activity limitation items of KBDQOL, only 66% and 50% respectively are part of the WOMAC and Lequesne indexes, respectively [18]. During the personal interview, more than 40% of the patients put forward two new contents as follow: Q2.2, in the past 30 days, "How many days do you need to take painkillers?"…”

“…KBDQOL is a low-educated KBD population survey that can be easily used in rural areas, and most of the questions are direct statements from KBD patients [9]. Some studies [16][17][18] reported the symptoms and signs of KBD, but none of the studies linked the clinical manifestations of KBD to patients' disability, restriction of daily activities, the impact of disease on income, and the impact of disease on mood. We found that KBD patients do often have restricted activities, nancial di culties, and negative emotions.…”

Nurses’ Working Experiences of Their Provision of Cross-Cultural Services to Tibetan Patients With Kashin–Beck Disease: A Qualitative Study

“…KBD remains endemic in 379 counties of 13 provinces or autonomous regions, and an estimated 37.2 million people are at high risk of developing KBD. Of these, there are 54 KBD counties in Tibet, accounting for 15.47% (National Health Commission of the People’ Republic of China, 2018; L. Yang et al, 2020).…”

“…KBD remains endemic in 379 counties of 13 provinces or autonomous regions, and an estimated 37.2 million people are at high risk of developing KBD. Of these, there are 54 KBD counties in Tibet, accounting for 15.47% (National Health Commission of the People' Republic of China, 2018; L. Yang et al, 2020). The clinical features of the disease include tuberosity of the fingers and brachydactylia, deformed and enlarged joints, and limited motion of the joints (Guo et al, 2017;.…”