Abstract
To evaluate the validity, reliability, and responsiveness to change of the 12-item Knee injury and Osteoarthritis Outcome Score (KOOS) Spanish version questionnaire. This study was based on a questionnaire validation design. A cross-sectional survey of 199 patients with knee osteoarthritis (KOA) and ten healthy controls was studied to evaluate the validity and reliability of KOOS-12. One hundred and sixteen patients were assessed for test-retest reliability, and 38 patients were included for a responsiveness assessment. Structural validity was assessed by the confirmatory factor analysis (CFA). Item response theory-based methods were used to determine the performance of the items. Internal consistency reliability was appropriate for all scales (Cronbach’s alpha = 0.85–0.94). The intra-class correlation coefficient of KOOS-12 scales ranged from 0.60 to 0.71. The CFA and generalized partial credit model showed that KOOS-12 scales presented a good overall model fit. No differential item functioning was found. Convergent validity was demonstrated by strong correlations (Spearman’s rho ≥ 0.70) with KOOS, International Knee Documentation Committee subjective knee evaluation form (IKDC), and Knee Intermittent and Constant Osteoarthritis Pain (ICOAP). Known-groups validity showed that KOOS-12 well discriminated subgroups of patients (radiographic severity and nutritional status). Standardized response means for KOOS-12 scales were ≥ 0.75. Changes in KOOS-12 scales had a moderate to strong correlation (Pearson’s r ≥ 0.40) with the changes in the KOOS, ICOAP, and IKDC scales. The KOOS-12 Spanish version is a valid, reliable, and responsiveness to change questionnaire to measure patients’ opinions about their knee and associated problems in Mexican subjects with KOA.
Key Points • KOOS-12 is a short self-reported measure that assesses patient’s opinions about the difficulties they experience due to problems with their knee and also covers aspects of pain, functional limitations, and knee-related quality of life. • The Spanish version of KOOS-12 questionnaire is a valid instrument for measuring the patients’ opinions about their knee and associated problems, and is both reliable and responsiveness to change. |
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The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
References
Goncalves RS, Cabri J, Pinheiro JP, Ferreira PL, Gil J (2010) Reliability, validity and responsiveness of the Portuguese version of the Knee injury and Osteoarthritis Outcome Score--physical function short-form (KOOS-PS). Osteoarthr Cartil 18(3):372–376
Gandek B, Roos EM, Franklin PD, Ware JE Jr (2019) Item selection for 12-item short forms of the Knee injury and Osteoarthritis Outcome Score (KOOS-12) and Hip disability and Osteoarthritis Outcome Score (HOOS-12). Osteoarthr Cartil 27(5):746–753
Tolk JJ, Janssen RPA, Prinsen CAC, Latijnhouwers D, van der Steen MC, Bierma-Zeinstra SMA et al (2019) The OARSI core set of performance-based measures for knee osteoarthritis is reliable but not valid and responsive. Knee Surg Sports Traumatol Arthrosc 27(9):2898–2909
Collins NJ, Misra D, Felson DT, Crossley KM, Roos EM (2011) Measures of knee function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee injury and Osteoarthritis Outcome Score (KOOS), Knee injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), Lysholm Knee Scoring Scale, Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS). Arthritis Care Res (Hoboken) 63(Suppl 11):S208–S228
Martin-Fernandez J, Garcia-Maroto R, Sanchez-Jimenez FJ, Bau-Gonzalez A, Valencia-Garcia H, Gutierrez-Teira B et al (2017) Validation of the Spanish version of the Oxford knee score and assessment of its utility to characterize quality of life of patients suffering from knee osteoarthritis: a multicentric study. Health Qual Life Outcomes 15(1):186
Roos EM, Toksvig-Larsen S (2003) Knee injury and Osteoarthritis Outcome Score (KOOS) - validation and comparison to the WOMAC in total knee replacement. Health Qual Life Outcomes 1:17
Eckhard L, Munir S, Wood D, Talbot S, Brighton R, Walter B, Baré J (2020) The KOOS-12 shortform shows no ceiling effect, good responsiveness and construct validity compared to standard outcome measures after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc
Gandek B, Roos EM, Franklin PD, Ware JE Jr (2019) A 12-item short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-12): tests of reliability, validity and responsiveness. Osteoarthr Cartil 27(5):762–770
Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M, Howell D, Kaplan D, Koopman W, Longley S, Mankin H, McShane DJ, Medsger T, Meenan R, Mikkelsen W, Moskowitz R, Murphy W, Rothschild B, Segal M, Sokoloff L, Wolfe F (1986) Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 29(8):1039–1049
Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16(4):494–502
Mokkink LB, Prinsen CAC, Patrick DL, Alonso J, Bouter LM, de Vet HC, et al. COSMIN study design checklist for Patient.reported outcome measurement instruments 2019 [Available from: https://www.cosmin.nl/wp-content/uploads/COSMIN-study-designing-checklist_final.pdf
Reeve BR, Fayers P (2005) Applying item response theory modelling for evaluating questionnaire itemscale properties. In: Fayers P, Hays H (eds) Assessing quality of life in clinical trials: methods and practice, 2nd edn. Oxford University Press, New York, pp 55–73
Nguyen TH, Han HR, Kim MT, Chan KS (2014) An introduction to item response theory for patient-reported outcome measurement. Patient. 7(1):23–35
Edelen MO, Reeve BB (2007) Applying item response theory (IRT) modeling to questionnaire development, evaluation, and refinement. Qual Life Res 16(Suppl 1):5–18
Vaquero J, Longo UG, Forriol F, Martinelli N, Vethencourt R, Denaro V (2014) Reliability, validity and responsiveness of the Spanish version of the Knee Injury and Osteoarthritis Outcome Score (KOOS) in patients with chondral lesion of the knee. Knee Surg Sports Traumatol Arthrosc 22(1):104–108
Bond M, Davis A, Lohmander S, Hawker G (2012) Responsiveness of the OARSI-OMERACT osteoarthritis pain and function measures. Osteoarthr Cartil 20(6):541–547
Vazquez-Barquero JL, Vazquez Bourgon E, Herrera Castanedo S, Saiz J, Uriarte M, Morales F et al (2000) Version en lengua espanola de un nuevo cuestionario de evaluacion de discapacidades de la OMS (WHO-DAS-II): fase inicial de desarrollo y estudio piloto. Grupo Cantabria en Discapacidades. Actas Esp Psiquiatr 28(2):77–87
Dobson F, Hinman RS, Roos EM, Abbott JH, Stratford P, Davis AM, Buchbinder R, Snyder-Mackler L, Henrotin Y, Thumboo J, Hansen P, Bennell KL (2013) OARSI recommended performance-based tests to assess physical function in people diagnosed with hip or knee osteoarthritis. Osteoarthr Cartil 21(8):1042–1052
Dunn TJ, Baguley T, Brunsden V (2014) From alpha to omega: a practical solution to the pervasive problem of internal consistency estimation. Br J Psychol 105(3):399–412
Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J et al (2007) Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 60(1):34–42
Nolte S, Coon C, Hudgens S, Verdam MGE (2019) Psychometric evaluation of the PROMIS(R) Depression Item Bank: an illustration of classical test theory methods. J Patient Rep Outcomes. 3(1):46
Reeve BB, Hays RD, Bjorner JB, Cook KF, Crane PK, Teresi JA, Thissen D, Revicki DA, Weiss DJ, Hambleton RK, Liu H, Gershon R, Reise SP, Lai JS, Cella D (2007) Psychometric evaluation and calibration of health-related quality of life item banks: plans for the Patient-Reported Outcomes Measurement Information System (PROMIS). Med Care 45(5 Suppl 1):S22–S31
Hu L, Bentler PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model Multidiscip J 6(1):1–55
Browne MW, Cudeck R (1993) Alternative ways of assessing model fit. In: Bollen KA, J.S L, editors. Testing structural equation models. Newbury Park, CA: Sage. p. 136–62
Alageel M, Al Turki A, Alhandi A, Alohali R, Alsalem R, Aleissa S (2020) Cross-cultural adaptation and validation of the Arabic version of the Intermittent and Constant Osteoarthritis Pain Questionnaire. Sports Med Int Open 4(1):E8–E12
Panah SH, Baharlouie H, Rezaeian ZS, Hawker G (2016) Cross-cultural adaptation and validation of the Persian version of the Intermittent and Constant Osteoarthritis Pain Measure for the knee. Iran J Nurs Midwifery Res 21(4):417–423
Baidya O, Prabhakar R, Wadhwa M, Baidya P (2018) Cross-cultural translation and validation of the Hindi version of the intermittent and constant osteoarthritis pain scale in knee osteoarthritis patients. Ortho & Rheum Open Access 10:1–5
Chen W-H, Thissen D (1997) Local dependence indexes for item pairs using item response theory. J Educ Behav Stat 22(3):265–289
Reise SP, Rodriguez A (2016) Item response theory and the measurement of psychiatric constructs: some empirical and conceptual issues and challenges. Psychol Med 46(10):2025–2039
Stover AM, McLeod LD, Langer MM, Chen WH, Reeve BB (2019) State of the psychometric methods: patient-reported outcome measure development and refinement using item response theory. J Patient Rep Outcomes 3(1):50
Depaoli S, Tiemensma J, Felt JM (2018) Assessment of health surveys: fitting a multidimensional graded response model. Psychol Health Med 23(sup1):13–31
Paek I, Cole K (2020) Using R for item response theory model applications. Routledge, New York, USA
Felt JM, Castaneda R, Tiemensma J, Depaoli S (2017) Using person fit statistics to detect outliers in survey research. Front Psychol 8:863
Husted JA, Cook RJ, Farewell VT, Gladman DD (2000) Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol 53(5):459–468
Fritz CO, Morris PE, Richler JJ (2012) Effect size estimates: current use, calculations, and interpretation. J Exp Psychol Gen 141(1):2–18
Dinno A (2015) Nonparametric pairwise multiple comparisons in independent groups using Dunn’s test. Stata J 15(1):292–300
Dobson F, Hinman RS, Hall M, Terwee CB, Roos EM, Bennell KL (2012) Measurement properties of performance-based measures to assess physical function in hip and knee osteoarthritis: a systematic review. Osteoarthr Cartil 20(12):1548–1562
Marconcin P, Espanha M, Yázigi F, Teles J (2015) Predictor of timed “Up-and-Go” test in elderly with knee osteoarthritis. In: Cabri J, Pezarat-Correia P, editors. Proceedings of the 3rd International Congress on Sport Sciences Research and Technology Support. 1. Lisbon, Portugal: Science and Technology Publications, Lda
de Rezende MU, de Farias FES, da Silva CAC, Cernigoy CHA, de Camargo OP (2016) Objective functional results in patients with knee osteoarthritis submitted to a 2-day educational programme: a prospective randomised clinical trial. BMJ Open Sport Exerc Med 2(1):e000200
Gandhi R, Tsvetkov D, Davey JR, Syed KA, Mahomed NN (2009) Relationship between self-reported and performance-based tests in a hip and knee joint replacement population. Clin Rheumatol 28(3):253–257
Wolf EJ, Harrington KM, Clark SL, Miller MW (2013) Sample size requirements for structural equation models: an evaluation of power, bias, and solution propriety. Educ Psychol Meas 76(6):913–934
Moshagen M, Musch J (2014) Sample size requirements of the robust weighted least squares estimator. Methodology. 10(2):60–70
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Conceptualization and design: Gabriel Horta-Baas; Rodrigo Vargas-Mena; Erik Alejandre; Ingris Peláez-Ballestas; María del Socorro Romero-Figueroa; and Gloria Queipo.
Provision of study materials or patients: Gabriel Horta-Baas; Rodrigo Vargas-Mena; and Erik Alejandre.
Analysis: Gabriel Horta-Baas; Ingris Peláez-Ballestas; María del Socorro Romero-Figueroa; and Gloria Queipo.
Data interpretation: Gabriel Horta-Baas; Rodrigo Vargas-Mena; Erik Alejandre; Ingris Peláez-Ballestas; María del Socorro Romero-Figueroa; and Gloria Queipo.
Manuscript writing: Gabriel Horta-Baas.
Manuscript review final approval: Gabriel Horta-Baas; Rodrigo Vargas-Mena; Erik Alejandre; Ingris Peláez-Ballestas; María del Socorro Romero-Figueroa; and Gloria Queipo.
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The research ethics committee of the Instituto Mexicano del Seguro Social approved this study. Informed consent was obtained from all individual participants included in the study.
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Horta-Baas, G., Vargas-Mena, R., Alejandre, E. et al. Psychometric properties of the 12-item Knee injury and Osteoarthritis Outcome Score (KOOS-12) Spanish version for people with knee osteoarthritis. Clin Rheumatol 40, 1547–1558 (2021). https://doi.org/10.1007/s10067-020-05403-x
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DOI: https://doi.org/10.1007/s10067-020-05403-x