The Dutch version of the Spinal Appearance Questionnaire for adolescents with idiopathic scoliosis: patient-based cross-cultural adaptation and measurement properties evaluation

Abstract

Purpose Adolescent idiopathic scoliosis (AIS) affects the appearance of spine and trunk. The Spinal Appearance Questionnaire (SAQ) assesses the perception of appearance in AIS patients. The aim of this study is to translate and culturally adapt the recommended short version of the SAQ into Dutch and to test its measurement properties. Methods A Dutch SAQ (14-item; appearance and expectations domains) was developed following guidelines for translation and cross-cultural adaptation. The COSMIN Study Design checklist was used for measurement properties evaluation. In this multicenter study, the Dutch SAQ, SRS-22R and NPRS (back pain) were administered to 113 AIS patients (aged 15.4 years [SD 2.2], 21.2% male). Floor and ceiling effects were evaluated for content analysis. For reliability, internal consistency (Cronbach’s alpha) and test–retest reliability (ICC; n = 34) were evaluated. Predefined hypotheses of relationships with other questionnaires and between subgroups based on scoliosis severity (radiological and clinical) were tested for construct validity. Exploratory factor analysis (EFA) was performed to investigate the validity of the underlying structure of this 14-item questionnaire. Results No floor and ceiling effects were found for domains and total scores. Cronbach’s alpha ranged from 0.84 to 0.89. ICCs varied from 0.76 to 0.77. For construct validity, 89% (8/9) of the predefined hypotheses were confirmed. Significant higher scores for the appearance domain were found for subgroups based on radiological (Cobb angle; > 25.0°) and clinical outcomes. (Angle of Trunk Rotation; > 9.0°). A two-factor structure was found (EV 5.13; 36.63% explained variance). Conclusion The Dutch SAQ is an adequate, valid and reliable instrument to evaluate patients’ perception of appearance in AIS. Level of evidence Level I—diagnostic studies.

The effectiveness of a protocol without routine radiographs for follow-up of adolescent idiopathic scoliosis patients (CURVE): a study protocol

“…√ √ √ √ √ √ A 5-item questionnaire, consisting of 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) QALYs will be estimated using the Dutch tariff [25] Condition-specific quality of life (PROM): SRS-22r -Dutch version [26] √ √ √ √ √ √ A 22-item questionnaire, consisting of 5 domains (pain [5 items], self-image [5 items], function ([5 items], mental health [5 items], and satisfaction with management [2 items]) and a total score, with scores ranging 1 to 5 for each item Pain (PROM) Numerical Rating Scale (NRS) √ √ √ √ √ √ Ranging from 0 (no pain) to 10 (worst imaginable pain) for mean pain since last visit Spinal appearance questionnaire (PROM): Short SAQ √ √ √ √ √ √ A 14-item questionnaire [27,28], consisting of a total score and 2 domain scales, "appearance" (10 items) and "expectations" (4 items), with scores ranging from 1 to 5 Global Perceived Effect (PROM): GPE √ √ √ √ √ √ 2 items ranging in score from 1 to 7 regarding satisfaction with the treatment effect [29] Education status (PROM) Patient-reported √ √ √ √ √ √ Absence from school, absence from physical education (PE) classes, frequency of missing school exams, necessity to repeat a class, support and alternatives provided by the school Health-related and societal costs (PROM): Questionnaires √ √ √ √ √ √ Costs will be collected with cost questionnaires (modified iPCQc , iMCQ, and iViCQ). Resource use will be valued in accordance with the Dutch Manual for Costing Studies in Health Care [30] Angle of trunk rotation (ATR, °; patient-reported) Scolioscope (only PE-FU) √ √ √ √ √ √ The asymmetry of the spine results in an ATR and a rib hump, which will be measured by the parent/caregiver Curve progression (ATR, °; clinician-reported) The Bunnell scoliometer [11] √ √ √ √ √ √ Patient-reported questions after surgery (post-surgery group only): Return to school, return to sport √ √ -√ -√ Radiographic assessment (full spineradiograph; clinician-reported) √ √ √ √ √ √ Progression of deformity in the primary and compensatory Cobb angels (°).…”