Reliability and validity study on the Hungarian versions of the Oswestry Disability Index and the Quebec Back Pain Disability Scale

Abstract

Purpose Patient-reported outcome measurements (PROMs) are widely used in spine care. The development of reliable and valid National versions of spine-related disability questionnaires is strongly recommended from both the clinical and scientific points-of-view. The aims of this study were to adapt and validate the Oswestry Disability Index (ODI) and the Quebec Back Pain Disability Scale (QDS) for use with the Hungarian language. Methods After translating and culturally adapting the ODI and QDS, 133 patients with lumbar degenerative spinal disorder filled in the questionnaire booklet twice within 2 weeks. Subjects completed the Hungarian versions of the two PROMs as well as the WHOQoL-BREF validated as a general life quality questionnaire and Visual Analogue Scale of pain. Internal consistency, reliability and construct validity of the questionnaires were determined, as were the standard error of measurement (SEM) and minimal detectable change (MDC) scores. Results The Hungarian ODI consisted of one factor that showed good internal consistency (Cronbach-a 0.890). The QDS showed a four-factor structure with Cronbach-a values between 0.788 and 0.917. No significant floor or ceiling effects were observed. The test-retest analysis showed excellent reliability of the Hungarian ODI and QDS. The intraclass correlation coefficients (ICC) were 0.927 and 0.923, respectively. SEM values of 4.8 and 5.2 resulted in a MDC of 13 and 14 points in the Hungarian ODI and QDS, respectively. The correlation coefficient (r) between pain and ODI was 0.680 (p \ 0.001) and the correlation between the ODI and the physical subscale of WHOQoL was also very good (r = -0.705, p \ 0.001). The QDS total score and its four subscales correlated significantly with pain and with the physical subscale of WHOQoL (r [ 0.4, p \ 0.001). The level of disability measured by the Hungarian ODI and QDS was significantly higher in the surgical subgroup than in non-surgically treated patients (p \ 0.001). Conclusions Translation and cultural adaptation of the ODI and QDS were successful. Hungarian versions of the ODI and QDS proved to be reliable, valid PROMs confirming that they can be used in future clinical and scientific work with Hungarian-speaking spine patients.

Cross-cultural adaptation and psychometric testing of the Arabic version of the Modified Low Back Pain Disability Questionnaire

“…For instance, the MDC 95% value of 7.67 calculated for 14 days indicates that, for a specific patient, a change of more than 8 points is most likely due to true change in the functional disability status of that patient rather than measurement error. This threshold is relativity less than the values reported in most of the previous validation studies of the ODQ (ranging from 9 to 13) [13,21,22,27,32,50,51], and the MODQ (8.8) [36]. The SEM and MDC 95% of the Arabic-MODQ reported in this study suggest the absolute reliability of the questionnaire.…”

“…Cronbach's α = 0.70-0.95 [40] Test-retest ICC > 0.70 [40] SEM � 2.15-6.5 [12,[20][21][22]27,32,34,50] MDC 95% � 6-13.67 [12,13,[20][21][22]27 The MIC was determined by locating the point on the curve nearest to the left-hand corner of the graph. This point is associated with the maximum sensitivity and specificity of the questionnaire and represents a cutoff value to separate patients who have experienced improvements in their condition from those who have not [66].…”

Cross-cultural adaptation and psychometric evaluation of the Yoruba version of Oswestry disability index

“…The MDC 95% found in our study was like that reported in the Croatian version of the ODI (6.0) [37]. The MDC of the ODI-Y was lower than that of the Polish (MDC=10) [41]; German (9.0) [15]; Hungarian (MDC=11) [42] and Chinese (12.8) [43] translations of the ODI. An MDC of 5.5 found in our study implies that below 5.5, the measurement error of the ODI-Y is indistinguishable.…”

Validation of the Hungarian version of the Roland–Morris disability questionnaire

“…Based on the results above, positive rating for the reliability of the Hungarian RMQ can be given. Authors of the present paper published previously the validation study of the Hungarian ODI [19]. The RMQ and the ODI are the two most widespread and most frequently cited spine related disability questionnaires.…”

“…Besides the RMQ to be validated, the patients completed the previously validated Hungarian version of the Oswestry Disability Index [18,19] (ODI) as well as the valid Hungarian version of the the WHO Quality of Life-BREF assessment (WHOQoL) [20]. To assess the patients' pain, the 100-mm long Visual Analogue Scale (VAS) was applied [21].…”