Cross-cultural adaptation and validation of the Italian version of the Hip disability and Osteoarthritis Outcome Score (HOOS)

Abstract

ObjectiveTo create a translated version of the HOOS to fit the Italian population and to test its psychometric properties and validity in hip osteoarthritis (OA) patients undergoing total hip arthroplasty (THA).DesignThe HOOS Italian version was developed according to published international guidelines that include preparation, forward translation and reconciliation, backward translation, review and harmonization, and proof reading. The Italian HOOS was administered to 145 patients (mean age 65.7 ± 11.6 years, 34–89, 58.6% women) undergoing THA. The following psychometric properties were evaluated: internal consistency (Cronbach’s alpha); test-retest reliability (Pearson’s r and intra-class correlation coefficient, ICC); convergent validity (Spearman’s rho between HOOS and SF-36); responsiveness (comparison of pre/post-THA scores, Wilcoxon signed rank test). Interpretability (floor and ceiling effects, skewness and kurtosis indexes) and acceptability (time to compiling, missing answers, and autonomy in compilation) were also evaluated.ResultsTranslation and transcultural adaptation were conducted in accordance with the international recommendation. The translation was deemed understandable and appropriate as to the transcultural adaptation. None of the patients reported to have met any difficulties in reading and understanding the HOOS items. Internal consistency and test-retest reliability were good for each HOOS subscale (Cronbach’s alpha ≥0.7, Pearson’s r and ICC > 0.80). Convergent validity showed the highest correlations (Spearman’s rho > 0.5) between HOOS and SF-36 subscales relating to similar dimensions. As to responsiveness, all HOOS subscales scores improved significantly after THA (p < 0.01). Interpretability was acceptable despite ceiling effect in post-THA assessment. Acceptability was good: HOOS resulted easy and quick to fill out (12 min on average).ConclusionsThe HOOS was successfully cross-culturally adapted into Italian. The Italian HOOS showed good psychometric properties therefore it can be useful to assess outcomes in OA patients after THA. This study provided a basis for its use within the Italian Arthroplasty Registry and for future clinical trials.Electronic supplementary materialThe online version of this article (10.1186/s12955-018-0935-6) contains supplementary material, which is available to authorized users.

Polish adaptation and validation of the hip disability and osteoarthritis outcome score (HOOS) in osteoarthritis patients undergoing total hip replacement

“…A lower value of alpha could be due to a heterogeneous construct of these subscales. Cronbach's alpha was greatest for the ADL subscale both preoperatively and at follow-up (0.95 and 0.97 respectively), which concurs with previous validation studies (0.94 in the French version, and 0.98/0.95 for OA/THR group in the Dutch version [23], 0.96 in the Korean [38], German [37] and Italian [45] versions and 0.97 in the Japanese version [42]. However, since it had been reported [46,47] that subscales showing a high coefficient alpha are not necessarily homogenous or unidimensional, very high Cronbach's alpha (exceeding 0.9) may suggest that some items of both, the 17-item ADL Function subscale, and the 10-item Pain subscale are redundant as they test the same question in a different guise.…”

“…As expected, we found strong correlations between subscales of the HOOS and SF-36 that were intended to measure similar constructs. The correlation values were comparable to those reported by de Groot et al [23], Satoh et al [42] and Torre et al [45] in THR patients with a mean age of 62-66 years and higher than observed by Nilsdotter et al in Swedish patients over 70 years of age [4]. This observation might have been expected since the outcome in THR is not specific to the joint but to overall impact on health, and therefore sensitive to age.…”

Patient-reported outcome measures (PROMs) after elective hip, knee and shoulder arthroplasty: protocol for a prospective cohort study

“…One questionnaire (Euro Quality 5 Dimensions, EQ-5D-3 L) for the general assessment of the patient health status will be administered to all patients enrolled in the study [21]. According to the surgical procedure, patients will be administered with a joint-specific questionnaire: the Hip disability and Osteoarthritis Outcome Score – Physical function Short-form (HOOS-PS) for patients undergoing hip replacement [22]; the Knee injury and Osteoarthritis Outcome Score – Physical function Short-form (KOOS-PS) for patients undergoing knee replacement [23]; the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), for patients undergoing shoulder implants. This last questionnaire will be administered in a modified version that does not include the assessments performed by the orthopedic surgeon [24].…”

“…The 5 items included in the short form measure physical function and are rated on five-point Likert scale (none, mild, moderate, severe, extreme), where 0 indicates no problems and 4 extreme problems. Item score can be transformed to a 0–100 scale with 0 indicating the worst problems and 100 indicating no problems The HOOS was translated and adapted to Italian, according to the international guidelines provided by Torre et al [22].…”

Translation, Cross-Cultural Adaptation, and Psychometric Properties of the Polish Version of the Hip Disability and Osteoarthritis Outcome Score (HOOS)

“…The HOOS was developed in 2003 by the Swedish researchers to extend the WOMAC [20,21,22] and to evaluate the patients’ view about their hip dysfunctions. The HOOS questionnaire has been developed, validated, and translated into several languages (Chinese, Dutch, French, German, Italian, Japanese, Korean, Persian, Spanish, Thai), which makes the opportunity to conduct international, multicenter studies [20,21,23,24,25,26,27,28]. Questionnaires are available to download free of charge from .…”