Translation, Cross-Cultural Adaptation and Validation of the Chinese Version of the High Activity Arthroplasty Score

Overview

Journal Patient Relat Outcome Meas

Specialty Health Services

Date 2024 May 6

PMID 38706693

Authors

Dongping Wan

ShiHang Cao

Xinrui Li

Qiang Zan

Shuxin Yao

Jianbing Ma

Lei Shang

Chao Xu

Affiliations

Soon will be listed here.

Abstract

Background: The High Activity Arthroplasty Score (HAAS) is a validated score that assesses functional outcomes after lower limb arthroplasty, with fewer ceiling effects than other scores. The aim is to translate and cross-culturally adapt the HAAS into a Chinese version (HAAS-C) and to evaluate the psychometric properties of HAAS-C in patients after primary total knee arthroplasty (TKA).

Methods: A total of 104 patients diagnosed with knee osteoarthritis who had undergone TKA at least 12 months prior were recruited. A forward and backward translation procedure was performed for developing a culturally acceptable HAAS-C. Internal consistency was assessed using Cronbach's α, and test-retest reliability was measured using the intraclass correlation coefficient (ICC) within a 10-day interval. Construct validity was assessed by examining the correlations between HAAS-C and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EuroQoL Group's five-dimension questionnaire (EQ-5D-5L), and Oxford knee score (OKS).

Results: HAAS-C demonstrated adequate Internal consistency reliability, as indicated by Cronbach's α coefficient of 0.75. Test-retest reliability yielded excellent results, with an ICC value of 0.98. Content validity indices were high, with a scale-level validity index of 0.9 and item-level validity indices greater than or equal to 0.8. HAAS-C showed a strong correlation with WOMAC ( = 0.69), a moderate correlation with EQ-5D-5L ( = 0.43), and OKS ( = 0.53) while exhibiting no floor or ceiling effects.

Conclusion: The validated HAAS-C questionnaire is a valid instrument for assessing patients undergoing TKA in mainland China.

Citing Articles

A multi-phase approach for developing a conceptual model and preliminary content for patient-reported outcome measurement in TKA patients: from a Chinese perspective.

Xu C, Wei J, Li L, Yao S, Chang X, Ma J Qual Life Res. 2024; .

PMID: 39625626 DOI: 10.1007/s11136-024-03850-6.

References

Luo N, Li M, Liu G, Lloyd A, de Charro F, Herdman M . Developing the Chinese version of the new 5-level EQ-5D descriptive system: the response scaling approach. Qual Life Res. 2012; 22(4):885-90. PMC: 3636433. DOI: 10.1007/s11136-012-0200-0. View

Kurtz S, Lau E, Ong K, Zhao K, Kelly M, Bozic K . Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030. Clin Orthop Relat Res. 2009; 467(10):2606-12. PMC: 2745453. DOI: 10.1007/s11999-009-0834-6. View

Madry H . Surgical therapy in osteoarthritis. Osteoarthritis Cartilage. 2022; 30(8):1019-1034. DOI: 10.1016/j.joca.2022.01.012. View

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(12):1417-32. DOI: 10.1016/0895-4356(93)90142-n. View

Mokkink L, Prinsen C, Bouter L, de Vet H, Terwee C . The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and how to select an outcome measurement instrument. Braz J Phys Ther. 2016; 20(2):105-13. PMC: 4900032. DOI: 10.1590/bjpt-rbf.2014.0143. View

Cao S, Liu N, Li L, Lv H, Chen Y, Qian Q . Simplified Chinese Version of University of California at Los Angeles Activity Score for Arthroplasty and Arthroscopy: Cross-Cultural Adaptation and Validation. J Arthroplasty. 2017; 32(9):2706-2711. DOI: 10.1016/j.arth.2017.03.057. View

Chen H, Wu J, Wang Z, Wu Y, Wu T, Wu Y . Trends and Patterns of Knee Osteoarthritis in China: A Longitudinal Study of 17.7 Million Adults from 2008 to 2017. Int J Environ Res Public Health. 2021; 18(16). PMC: 8395063. DOI: 10.3390/ijerph18168864. View

Williams J . The Declaration of Helsinki and public health. Bull World Health Organ. 2008; 86(8):650-2. PMC: 2649471. DOI: 10.2471/blt.08.050955. View

Hamilton D, Giesinger J, Giesinger K . It is merely subjective opinion that patient-reported outcome measures are not objective tools. Bone Joint Res. 2017; 6(12):665-666. PMC: 5935812. DOI: 10.1302/2046-3758.612.BJR-2017-0347. View

10.

Kan H, Chan P, Chiu K, Yan C, Yeung S, Ng Y . Non-surgical treatment of knee osteoarthritis. Hong Kong Med J. 2019; 25(2):127-133. DOI: 10.12809/hkmj187600. View

11.

Oliveira N, Cardinot T, Caputo D, Soares J, Mathias L, Batista L . The Brazilian version of the High-Activity Arthroplasty Score: cross-cultural adaptation. Sao Paulo Med J. 2023; 142(3):e2023121. PMC: 10708892. DOI: 10.1590/1516-3180.2023.0121.26072023. View

12.

Symonds T, Hughes B, Liao S, Ang Q, Bellamy N . Validation of the Chinese Western Ontario and McMaster Universities Osteoarthritis Index in Patients From Mainland China With Osteoarthritis of the Knee. Arthritis Care Res (Hoboken). 2015; 67(11):1553-60. DOI: 10.1002/acr.22631. View

13.

Ghomrawi H, Lee L, Nwachukwu B, Jain D, Wright T, Padgett D . Preoperative Expectations Associated With Postoperative Dissatisfaction After Total Knee Arthroplasty: A Cohort Study. J Am Acad Orthop Surg. 2019; 28(4):e145-e150. PMC: 8362614. DOI: 10.5435/JAAOS-D-18-00785. View

14.

Koo T, Li M . A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med. 2016; 15(2):155-63. PMC: 4913118. DOI: 10.1016/j.jcm.2016.02.012. View

15.

Bellamy N, BUCHANAN W, Goldsmith C, Campbell J, Stitt L . Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988; 15(12):1833-40. View

16.

Diesinger Y, Jenny J . Validation of the French version of two on high-activity knee questionnaires. Orthop Traumatol Surg Res. 2014; 100(5):535-8. DOI: 10.1016/j.otsr.2014.02.013. View

17.

Xie F, Li S, Goeree R, Tarride J, OReilly D, Lo N . Validation of Chinese Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in patients scheduled for total knee replacement. Qual Life Res. 2008; 17(4):595-601. DOI: 10.1007/s11136-008-9340-7. View

18.

Safiri S, Kolahi A, Smith E, Hill C, Bettampadi D, Mansournia M . Global, regional and national burden of osteoarthritis 1990-2017: a systematic analysis of the Global Burden of Disease Study 2017. Ann Rheum Dis. 2020; 79(6):819-828. DOI: 10.1136/annrheumdis-2019-216515. View

19.

Dawson J, Fitzpatrick R, Murray D, Carr A . Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br. 1998; 80(1):63-9. DOI: 10.1302/0301-620x.80b1.7859. View

20.

Rabin R, de Charro F . EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001; 33(5):337-43. DOI: 10.3109/07853890109002087. View