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Development of a Valid Simplified Chinese Version of the Oxford Hip Score in Patients With Hip Osteoarthritis

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Although the Oxford Hip Score has been translated and validated in several languages, there is currently no Chinese version of the outcomes measurement. Our study aims to crossculturally adapt and validate the Oxford Hip Score into a simplified Chinese version.

Questions/purposes

We tested the (1) reliability; (2) validity; and (3) responsiveness of the Chinese version of the Oxford Hip Score.

Methods

First we translated the Oxford Hip Score into simplified Chinese, then back into English, then held a consensus meeting to achieve the final simplified Chinese version. Then we evaluated the psychometric properties of Chinese version of the Oxford Hip Score in patients undergoing total hip arthroplasty (THA). All patients undergoing THA between July and December 2012 were invited to participate in this study; a total of 108 (79% of 136 invited) did so. To assess the test-retest validity, all participants completed the Chinese version of the Oxford Hip Score again with a 2-week interval. Pearson correlation coefficient was used to evaluate the construct validity between the Chinese version of the Oxford Hip Score and visual analog scale (VAS), Harris hip score, and eight individual domains of the SF-36. Responsiveness was demonstrated by comparing the pre- and postoperative scores of the Chinese version of the Oxford Hip Score.

Results

The test-retest reliability with intraclass correlation coefficient (0.937) and internal consistency with Cronbach’s alpha (0.91) were excellent. The Chinese version of the Oxford Hip Score correlated with the Harris hip score (0.89, p < 0.01), VAS (−0.79, p < 0.01), and Physical Functioning (0.79, p < 0.01) and Bodily Pain (0.70, p < 0.01) domains of SF-36, which suggested construct validity. No floor or ceiling effects were found. The effect size and standardized response mean values were 3.52 and 3.31, respectively, indicating good responsiveness.

Conclusions

The Chinese version of the Oxford Hip Score showed good reliability, validity, and responsiveness in evaluating standard Chinese-speaking patients with hip osteoarthritis undergoing THA. It can be used by clinical surgeons as a complement to the traditional outcome measures.

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References

  1. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine Phila Pa 1976. 2000;25:3186–3191.

    Google Scholar 

  2. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–310.

    Article  PubMed  CAS  Google Scholar 

  3. Bland JM, Altman DG. Measuring agreement in method comparison studies. Stat Methods Med Res. 1999;8:135–160.

    Article  PubMed  CAS  Google Scholar 

  4. Davies GM, Watson DJ, Bellamy N. Comparison of the responsiveness and relative effect size of the Western Ontario and McMaster Universities Osteoarthritis Index and the Short-Form Medical Outcomes Study Survey in a randomized, clinical trial of osteoarthritis patients. Arthritis Care Res. 1999;12:172–179.

    Article  PubMed  CAS  Google Scholar 

  5. Dawson J, Fitzpatrick R, Carr A, Murray D. Questionnaire on the perceptions of patients about total hip replacement. J Bone Joint Surg Br. 1996;78:185–190.

    PubMed  CAS  Google Scholar 

  6. Dawson J, Fitzpatrick R, Murray D, Carr A. Comparison of measures to assess outcomes in total hip replacement surgery. Quality in Health Care. 1996;5:81–88.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  7. Delaunay C, Epinette JA, Dawson J, Murray D, Jolles BM. Cross-cultural adaptations of the Oxford-12 HIP score to the French speaking population. Orthop Traumatol Surg Res. 2009;95:89–99.

    Article  PubMed  CAS  Google Scholar 

  8. de Nies F, Fidler MW. Visual analog scale for the assessment of total hip arthroplasty. J Arthroplasty. 1997;12:416–419.

    Article  PubMed  Google Scholar 

  9. Fleiss JL, Shrout PE. The effects of measurement errors on some multivariate procedures. Am J Public Health. 1977;67:1188–1191.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  10. Gosens T, Hoefnagels NH, de Vet RC, Dhert WJ, van Langelaan EJ, Bulstra SK, Geesink RG. The ‘Oxford Hip Score’: the translation and validation of a questionnaire into Dutch to evaluate the results of total hip arthroplasty. Acta Orthop. 2005;76:204–211.

    Article  PubMed  Google Scholar 

  11. 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.

    Article  PubMed  CAS  Google Scholar 

  12. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51:737–755.

    PubMed  CAS  Google Scholar 

  13. Husted JA, Cook RJ, Farewell VT, Gladman DD. Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol. 2000;53:459–468.

    Article  PubMed  CAS  Google Scholar 

  14. Kalairajah Y, Azurza K, Hulme C, Molloy S, Drabu KJ. Health outcome measures in the evaluation of total hip arthroplasties: a comparison between the Harris hip score and the Oxford hip score. J Arthroplasty. 2005;20:1037–1041.

    Article  PubMed  Google Scholar 

  15. 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.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  16. Loureiro A, Mills PM, Barrett RS. Muscle weakness in hip osteoarthritis: a systematic review. Arthritis Care Res (Hoboken). 2013;65:340–352.

    Article  PubMed  Google Scholar 

  17. Martinelli N, Longo UG, Marinozzi A, Franceschetti E, Costa V, Denaro V. Cross-cultural adaptation and validation with reliability, validity, and responsiveness of the Italian version of the Oxford Hip Score in patients with hip osteoarthritis. Qual Life Res. 2011;20:923–929.

    Article  PubMed  Google Scholar 

  18. McHorney CA, Tarlov AR. Individual-patient monitoring in clinical practice: are available health status surveys adequate? Qual Life Res. 1995;4:293–307.

    Article  PubMed  CAS  Google Scholar 

  19. Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC. The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res. 2010;19:539–549.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Naal FD, Sieverding M, Impellizzeri FM, von Knoch F, Mannion AF, Leunig M. Reliability and validity of the cross-culturally adapted German Oxford Hip Score. Clin Orthop Relat Res. 2009;467:952–957.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Ostendorf M, van Stel HF, Buskens E, Schrijvers AJ, Marting LN, Verbout AJ, Dhert WJ. Patient-reported outcome in total hip replacement. A comparison of five instruments of health status. J Bone Joint Surg Br. 2004;86:801–808.

    Article  PubMed  CAS  Google Scholar 

  22. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60:34–42.

    Article  PubMed  Google Scholar 

  23. Thorborg K, Roos EM, Bartels EM, Petersen J, Hölmich P. Validity, reliability and responsiveness of patient-reported outcome questionnaires when assessing hip and groin disability: a systematic review. Br J Sports Med. 2010;44:1186–1196.

    Article  PubMed  CAS  Google Scholar 

  24. Uesugi Y, Makimoto K, Fujita K, Nishii T, Sakai T, Sugano N. Validity and responsiveness of the Oxford Hip Score in a prospective study with Japanese total hip arthroplasty patients. J Orthop Sci. 2009;14:35–39.

    Article  PubMed  Google Scholar 

  25. Wang W, Lopez V, Ying CS, Thompson DR. The psychometric properties of the Chinese version of the SF-36 health survey in patients with myocardial infarction in mainland China. Qual Life Res. 2006;15:1525–1531.

    Article  PubMed  Google Scholar 

  26. Wei X, Wang Z, Yang C, Wu B, Liu X, Yi H, Chen Z, Wang F, Bai Y, Li J, Zhu X, Li M. Development of a simplified Chinese version of the Hip Disability and Osteoarthritis Outcome Score (HOOS): cross-cultural adaptation and psychometric evaluation. Osteoarthritis Cartilage. 2012;20:1563–1567.

    Article  PubMed  CAS  Google Scholar 

  27. Zhou Z, Yang L, Chen Z, Chen X, Guo Y, Wang X, Dong X, Wang T, Zhang L, Qiu Z, Yang R. Health-related quality of life measured by the Short Form 36 in immune thrombocytopenic purpura: a cross-sectional survey in China. Eur J Haematol. 2007;78:518–523.

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank the staff from our outpatient clinics and the patients participating in the study. We also thank Yang Jiao, Francis Aaron, and Gregory Dole for help with the translation process.

Author information

Authors and Affiliations

  1. Department of Orthopedics, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai, 200433, China

    Wei Zheng MD, Jia Li MD, Jinzhu Zhao MD, Denghui Liu MD & Weidong Xu MD

Authors
  1. Wei Zheng MD
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  2. Jia Li MD
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  3. Jinzhu Zhao MD
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  4. Denghui Liu MD
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  5. Weidong Xu MD
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Corresponding author

Correspondence to Weidong Xu MD.

Additional information

Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

Wei Zheng and Jia Li contributed equally to this work as cofirst authors.

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Zheng, W., Li, J., Zhao, J. et al. Development of a Valid Simplified Chinese Version of the Oxford Hip Score in Patients With Hip Osteoarthritis. Clin Orthop Relat Res 472, 1545–1551 (2014). https://doi.org/10.1007/s11999-013-3403-y

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  • DOI: https://doi.org/10.1007/s11999-013-3403-y

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