CROSS-CULTURAL ADAPTATION AND VALIDATION OF THE ARABIC VERSION OF MUSCULOSKELETAL HEALTH QUESTIONNAIRE

F. Algarni¹, A. Alotaibi², H. Al-Sobayel¹

Background: Several Arabic outcome measures (OMs) are available but differ across several musculoskeletal disorders (MSDs) and different health care settings, thereby decreasing the level of care consistency. Furthermore, the OM typically fails to address the long-term nature of MSDs. The Musculoskeletal Health Questionnaire (MSK-HQ) is a new and novel OM that will enhance the consistency of care provided to patients with MSDs throughout the health care pathway. To date, no validated Arabic version of the MSK-HQ is available.

Purpose: The purpose of this study was to cross-culturally translate and adapt the MSK-HQ into Arabic and to test its psychometric properties in order to validate its use for assessing health status in Arabic-speaking patients with MSDs.

Methods: The study was conducted in two phases. The first phase was the adaptation of the English version to Arabic, which was done according to the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines. The second phase was the testing of the psychometric properties of the Arabic version of the Musculoskeletal Health Questionnaire (MSK-HQ-Ar) in a sample of 149 consecutive participants, 119 of them showed stable symptoms were included in the evaluation of test-retest reliability. The participants completed the MSK-HQ-Ar again up to two weeks later for retesting purposes. In addition, the measurement properties of reliability, internal consistency and construct validity were measured. The participants completed the Arabic version of the MSK-HQ, with the European quality of life five-dimension, five-level scale (EQ-5D-5L) as its baseline to evaluate the construct validity.

Results: The translation and adaptation process of the MSK-HQ was successfully performed. The MSK-HQ was adapted and translated from the English language version into an Arabic language version in a simple and clear dialect. No major difficulties were encountered during the translation and adaptation of the MSK-HQ into Arabic. Out of the total 149 participants, 84 (56.4 %) were male and 65 (43.6 %) were female. The internal consistency of the Arabic version of the MSK-HQ’s total score for Cronbach’s alpha was 0.88. The test-retest reliability (interclass correlation coefficient) was excellent at 0.94 at (95% confidence interval from 0.92 to 0.95). A strong correlation (rho= 0.72, P ˂ 0.001) was found between the MSK-HQ-Ar total score and EQ-5D-5L index value.

Conclusion(s): The Arabic version of the MSK-HQ has adequate measurement properties and may be used in identifying the health care outcome domains that describe the disease’s impact on patients with arthritis, inflammatory conditions and musculoskeletal pain.

Implications: The MSK-HQ represents a balanced version of the previously available generic and condition-specific tools intended to capture the holistic impact of MSK conditions on patients’ health. Further, it can be used regardless of the site of the symptoms or the location in which the patient is receiving care across the clinical pathway.
Hence, the Arabic version of the MSK-HQ will facilitate shared decision making across health care settings, enable the benchmarking of health services and be applicable for a wide range of MSK conditions throughout the clinical pathway.

Funding, acknowledgements: The authors extend their appreciation to the Deanship of Scientific Research at King Saud University, Riyadh for funding this research.

Keywords: musculoskeletal Health Questionnaire, Musculoskeletal disorders, cross-cultural adaptation

Topic: Musculoskeletal

Did this work require ethics approval? Yes

Institution: King Saud University

Committee: Ethics committee at College of Applied Medical Sciences

Ethics number: CAMS-139a-3839