Reliability, validity, and responsiveness of the modified Kapandji index for assessment of functional mobility of the rheumatoid hand. Revalidation of the original Cedars-Sinai health-related quality of life in rheumatoid arthritis questionnaire. WHICH QUESTIONNAIRE IS BEST? THE RELIABILITY, VALIDITY AND EASE OF USE OF THE PATIENT EVALUATION MEASURE, THE DISABILITIES OF THE ARM, SHOULDER AND HAND AND THE MICHIGAN HAND OUTCOME MEASURE A Self-Administered Questionnaire for Assessment of Symptoms and Function of the Shoulder* The lower-limb tasks questionnaire: an assessment of validity, reliability, responsiveness, and minimal important differences. An empirical evaluation of the SF-12, SF-6D, EQ-5D and Michigan Hand Outcome Questionnaire in patients with rheumatoid arthritis of the hand Validation of the French version of the Bournemouth Questionnaire. The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the M. D. Anderson dysphagia inventory. Establishing the minimal number of items for a responsive, valid, health-related quality of life instrument. Use of Condition-Specific Patient-Reported Outcome Measures in Clinical Trials among Patients with Wrist Osteoarthritis: A Systematic Review The ability to change of three questionnaires for neck pain. Construction and validation of a quality of life questionnaire in Chronic Lower Limb Venous Insufficiency (CIVIQ) The responsiveness of the Shoulder Disability Questionnaire A health-related quality-of-life instrument for symptomatic patients with endometriosis: a validation study. Shoulder disability questionnaire design and responsiveness of a functional status measure. A comparison of health-related quality-of-life measures for rheumatoid arthritis research. The Auranofin Cooperating Group. Agreement, reliability and validity in 3 shoulder questionnaires in patients with rotator cuff disease
OBJECTIVE To determine the reliability , validity , and responsiveness of the modified Kap and ji index ( MKI ) . DESIGN Prospect i ve study . A cohort of patients planned for surgery of the wrist and /or fingers was evaluated within 48 hours before surgery and at least 6 months after surgery . SETTING Patients were in hospitalized or private care in France . PARTICIPANTS Patients with rheumatoid arthritis according to criteria of the American College of Rheumatology . Forty-two patients ( 36 women ; mean age , 57.5y ; range , 22 - 80y ) were included in the reliability study . Fifty patients ( 42 women ; mean age , 54.18y ; range , 19 - 77y ) were included in the validity study . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES Clinical outcome measures included the MKI , the overall mobility score of the wrist and fingers , the finger mobility score , a visual analog scale ( VAS ) of pain in the h and s and wrists , morning stiffness duration , total score of tenderness , total score of swelling , grip and pinch strength , the H and Functional Index ( HFI ) , and the Cochin rheumatoid h and disability scale . Reliability was studied with the intraclass correlation coefficient ( ICC ) and the Bl and and Altman method . Convergent and divergent validity were assessed with the Spearman correlation coefficient . Responsiveness was assessed by the paired t test , the effect size , and the st and ardized response mean ( SRM ) . RESULTS Interobserver reliability was good with an ICC of.90 , and the Bl and and Altman analysis showed homogeneous distribution of the differences , with no systematic trend . The MKI correlated well with the other mobility measures ( HFI , the finger mobility score measured with the finger goniometer ) , indicating a good convergent validity , and the expected divergent validity with the other outcome measures ( grip and pinch strength , total score of swelling , total score of Ritchie Articular Index , Cochin scale , VAS of pain ) was observed . The 50 patients in the validity study were evaluated twice , before and after surgery , at a mean interval + /- st and ard deviation of 7.16+/-2.10 months ( range , 6 - 15mo ) . Thirty-six patients ( 72 % ) were very satisfied or satisfied with the results of surgery , 7 ( 14 % ) were not satisfied or dissatisfied , and 7 ( 14 % ) were dissatisfied or very dissatisfied . The SRM and effect size values of the MKI were -.19 and -.10 , respectively . Individual changes in the score had the best correlation ( r(s)=.51 ) with overall patient satisfaction . CONCLUSIONS The MKI has excellent validity and reliability . Individual changes in the score are clinical ly relevant . This index can be used in clinical practice and in therapeutic trials ; it needs further study concerning its use for h and surgery OBJECTIVE To assess the psychometric characteristics of the original 33-item Cedars-Sinai Health-Related Quality of Life in Rheumatoid Arthritis Question naire ( O-CSHQ-RA ) and 11-item CSHQ-RA Short Form ( SF ) using a representative population of patients with rheumatoid arthritis ( RA ) from 55 sites across the United States . METHODS Data were from a 24-week multicenter , open-label , single-arm study of 312 RA patients receiving anakinra .  Cronbach 's alpha coefficient was used to indicate the internal consistency . Test-retest reliability was assessed by establishing the intraclass correlation coefficient ( ICC ) for screening and baseline visit responses . Convergent validity was tested with the Pearson correlation coefficient . Analysis of variance was performed to determine discriminant validity . A Wilcoxon signed-rank test and analysis of covariance were used to assess the responsiveness . A discriminant function was generated to determine the clinical ly meaningful change . RESULTS Test-retest reliability was demonstrated for both versions of the CSHQ-RA , with ICC ranging from 0.82 to 0.94 . Cronbach 's alpha coefficients were > or = 0.9 , indicating good internal consistency . Pearson correlations between health-related quality of life instruments and CSHQ-RA measures ranged from -0.33 to -0.73 and 0.39 to 0.76 , demonstrating good convergent validity . Scores on both versions of the CSHQ-RA differed significantly ( p < 0.0001 ) for patients with different levels of physical disability as measured by the Stanford Health Assessment Question naire . Both instruments were responsive to differences in patient health as measured by the general health question ( p < 0.0001 ) . Clinical ly meaningful changes were calculated for all 5 domains of the O-CSHQ-RA ( 6.9 - 14.0 ) and the overall O-CSHQ-RA SF ( 12.7 ) . CONCLUSION These results support the validity and reliability of both the original CSHQ-RA and the 11-item CSHQ-RA SF when tested in a representative patient population The  Patient Evaluation Measure ( PEM ) , The  Michigan H and Outcome Question naire ( MHQ )  and the Disabilities of the Arm , Shoulder and H and ( DASH ) score were assessed independent of their originators for reliability , construct and criterion validity and acceptability , using an ease of use question naire . These were administered in r and om order to 100 patients with different h and and wrist disorders and with different impairments of movement , pain , sensation and strength . The internal consistency of all three question naires was very high suggesting redundancy in the questions . All question naires were reproducible and valid for finger and wrist disorders , but less for nerve disorders . All had poor construct validity . The PEM was the easiest to underst and and complete , taking the least time . Correlation between the scales is high and conversion equations were calculated . All three are reliable and reproducible patient completed question naires , but the PEM is the easiest to use . The validity of all is suspected for nerve disorders A self-administered question naire was design ed to assess the severity of symptoms related to and the functional status of the shoulder . It includes domains of global assessment , pain , daily activities , recreational and athletic activities , work , satisfaction , and areas for improvement . Each domain is grade d separately and is weighted to arrive at the total score . The over-all scale and each domain were prospect ively tested for validity , reliability , and responsiveness to clinical change . One hundred patients who were seen for evaluation of the shoulder were enrolled in the study . The validity of the scale was demonstrated by moderate-to-high correlation of the domains and individual questions of the Shoulder Rating Question naire with those of the Arthritis Impact Measurement Scales 2 . Validity was supported further by significant correlation of the scores in each domain with the level of satisfaction in that domain and by significantly lower scores in domains that patients selected as areas important for improvement . The over-all scale and each domain were internally consistent ( Cronbach alpha , 0.71 to 0.90 ) . Reproducibility was evaluated by repeated administration of the question naire after a mean of three days to forty patients whose condition was clinical ly stable . Reproducibility of the over-all question naire and individual domains was excellent ( Spearman-Brown index , 0.94 to 0.98 ) . Individual questions were reproducible , with a weighted kappa value of more than 0.7 for each . Responsiveness was evaluated by comparison of the preoperative and postoperative scores of thirty patients who had a satisfactory result one year after an operation on the shoulder . The over-all Shoulder Rating Question naire and each domain were responsive to clinical change as demonstrated by favorable st and ardized response means ( range , 1.1 to 1.9 ) and indices of responsiveness ( range , 1.1 to 2.0 ) . Similar analysis performed for individual diagnostic groups supported the validity , reliability , and responsiveness of the question naire in each group . The self-administered shoulder question naire was found to be valid , reliable , and responsive to clinical change . These qualities should make it a useful instrument for the prospect i ve assessment of the outcome of treatment of disorders related to the shoulder OBJECTIVES To develop a question naire that focuses only on physical tasks related to lower-limb function and , within that question naire , to explore the psychometric properties of a series of questions that are related specifically to activities of daily living ( ADLs ) and a series of activities more often associated with recreation . DESIGN Inception cohort . SETTING Private practice . PARTICIPANTS Data were primarily from patients who had experienced a lower-limb injury that would typically involve rehabilitation up to 6 weeks . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES Through 5 studies , the following psychometric qualities were evaluated : content and factor validity , construct and concurrent validity , test-retest reliability ( intraclass correlation coefficient [ ICC ] , typical error ) , responsiveness ( effect size , st and ardized response mean , Guyatt 's responsiveness statistic ) , and the minimum important difference ( distribution , anchor-based approaches ) . RESULTS Factor analysis supported the theoretical perspective that ADLs and recreational activities can be treated as different domains within the construct of function . Internal consistency was high ( Cronbach alpha : ADLs , .91 ; recreational activities , .95 ) and the 2 domains explained a moderate level of the response variance ( 61 % ) . In the ADL domain , 7 tasks had greater than 80 % of participants regarding them as having some importance . For recreational activities , 6 tasks had 79 % or more of participants regarding them as having some importance . Both domains were moderately correlated to actual performance of tasks ( r = .62 , r = .72 ) , and to other question naires used for lower-limb injuries ( r range , .51-.86 ) . The floor and ceiling effects of the domains followed an expected pattern that could be related to the loading forces experienced on the injured limb during activities . The reliability of the 2 domains was high ( ICCs > .95 ) , and the Bl and -Altman plots showed that the distribution of error across the range of scores was r and om with low bias scores ( < 1.0 point ) . Typical error scores were 2 points for each domain . All measures of responsiveness were high ( 1.2 - 6.7 ) . Measures of the minimal important difference varied ( 3 - 10 points ) according to the method ologic approach used . CONCLUSIONS The question naire possesses good factor structure and composition , relates well with other measures of function , differentiates patients with regard to certain characteristics or processes known to occur after injury , shows high levels of reliability and responsiveness , and shows evidence of good minimal important difference scores . The findings support the use of the question naire in both clinical scenarios and in research Background The aim of this study was to assess the psychometric properties , namely acceptability , validity , reliability , interpretability and responsiveness of the EuroQol EQ-5D ( EQ-5D visual analogue ( VAS ) and EQ-5D ( utility ) ) , Short Form 12 Dimensions ( SF-12 ) , SF-6D and Michigan H and Outcome Question naire ( MHQ ) in patients with rheumatoid arthritis ( RA ) of the h and . Methods The empirical investigation was based upon data from a r and omised controlled trial of 488 adults with rheumatoid arthritis who had pain and dysfunction of the h and s and /or wrists . Participants completed the EQ-5D , SF-12 and MHQ at baseline and at 4 and 12 months follow up . Acceptability was measured using completion rates over time ; construct validity using the “ known groups ” approach , based on pain troublesomeness ; convergent validity using spearman ’s rho correlation ( ρ ) ; reliability using internal consistency ( Cronbach ’s alpha ) ; interpretability using minimal important differences ( MID ) ; and responsiveness using effect sizes and st and ardised response means ( SRM ) stratified by level of self-rated improvement in h and and wrist function or level of self-rated benefit and satisfaction from trial treatments . Results At baseline , the study population had a mean age of 62.4 years , a mean MHQ score of 52.1 and included 76 % women . The EQ-5D ( utility ) had the highest completion rates across time points . All instruments discriminated between pre-specified groups based on pain troublesomeness . Convergent validity analysis indicated that the MHQ score correlated strongly with the EQ-5D ( ρ = 0.65 ) and SF-6D ( ρ = 0.63 ) utility scores . The MHQ was most responsive at detecting change in indicators of RA pain severity between baseline and 4 months , whilst minimal important differences varied considerably across PROMs . Conclusions The instruments evaluated in this study displayed varying psychometric properties in the context of RA of the h and . The selection of a preferred instrument in evaluative studies should ultimately depend on the relative importance placed on individual psychometric properties and the importance placed on generation of health utilities for economic evaluation purpose Self question naires are an important aspect of the management of neck pain patients . The Bournemouth Question naire ( BQ ) , based on the biopsychosocial model , is design ed to evaluate patients with neck pain . The vali date d English version of this question naire ( BQc-English ) has psychometric properties that range from moderate to excellent . The goal of this study is to translate and vali date a French version of the Bournemouth Question naire for neck pain patients ( BQc-f ) . Its translation and adaptation are performed using the translation back-translation method , generating a consensus among the translators . This validation study was performed on 68 subjects ( mean age 41 years old ) who participated in a r and omized controlled trial regarding the efficiency of manual therapy for neck pain patients . This experimental protocol was design ed to generate data in order to evaluate the construct validity , longitudinal validity , test-retest reliability and responsiveness . The BQc-f psychometric properties of construct validity ( r = 0.67 , 0.61 , 0.42 ) for pre treatment , post treatment and longitudinal validity , respectively ) , test-retest reliability ( r = 0.97 ) and responsiveness ( effect size = 0.56 and mean st and ardized response = 0.61 ) are sufficient to suggest it could be used in the management of patients with neck pain OBJECTIVE To design a reliable and vali date d self-administered question naire whose purpose is to assess dysphagia 's effects on the quality of life ( QOL ) of patients with head and neck cancer . DESIGN Cross-sectional survey study . METHODS Focus groups were convened for question naire development and design . The M. D. And erson Dysphagia Inventory ( MDADI ) included global , emotional , functional , and physical subscales . One hundred consecutive adult patients with a neoplasm of the upper aerodigestive tract who underwent evaluation by our Speech Pathology team completed the MDADI and the Medical Outcomes Study 36-Item  Short Form Health Survey  ( SF-36 ) . Speech pathologists completed the Performance Status Scale for each patient . Validity and reliability properties were calculated . Analysis of variance was used to assess how well the MDADI discriminated between groups of patients . RESULTS The internal consistency reliability of the MDADI was calculated using the Cronbach alpha coefficient . The Cronbach alpha coefficients of the MDADI subscales ranged from 0.85 to 0.93 . Test-retest reliability coefficients of the subscales ranged from 0.69 to 0.88 . Spearman correlation coefficients between the MDADI subscales and the SF-36 subscales demonstrated construct validity . Patients with primary tumors of the oral cavity and oropharynx had significantly greater swallowing disability with an adverse impact on their QOL compared with patients with primary tumors of the larynx and hypopharynx ( P<.001 ) . Patients with a malignant lesion also had significantly greater disability than patients with a benign lesion ( P<.001 ) . CONCLUSIONS The MDADI is the first vali date d and reliable self-administered question naire design ed specifically for evaluating the impact of dysphagia on the QOL of patients with head and neck cancer . St and ardized question naires that measure patients ' QOL offer a means for demonstrating treatment impact and improving medical care . The development and validation of the MDADI and its use in prospect i ve clinical trials allow for better underst and ing of the impact of treatment of head and neck cancer on swallowing and of swallowing difficulty on patients ' QOL Reducing the number of items in a health-related quality of life instrument will enhance efficiency . However , it is important to maintain measurement properties . We determined the effect of reducing items from each domain ( dyspnea , fatigue , emotion and mastery ) of the 20-item Chronic Respiratory Question naire ( CRQ ) .  Three r and omized trials of respiratory rehabilitation provided data . We removed items one at a time from each domain in three orders : by item impact , item responsiveness , and at r and om . Responsiveness , test-retest reliability and construct validity were evaluated at each step . Responsiveness and reliability , evaluated by intraclass correlation coefficients ( ICC ) , were reduced marginally as the number of items was reduced to two items per domain . The deterioration was greatest when reducing from two items to one . To detect a particular effect , sample size would increase by about 10 % when reducing the number of items in a domain to 2 . Construct validity showed a more marked deterioration . Reducing to two items per domain would maintain responsiveness and reliability of the CRQ at an acceptable level , with a trade-off of reduced construct validity and increase in sample size requirements Background . This paper aim ed to identify condition-specific patient-reported outcome measures used in clinical trials among people with wrist osteoarthritis and summarise empirical peer- review ed evidence supporting their reliability , validity , and responsiveness to change . Methods . A systematic review of r and omised controlled trials among people with wrist osteoarthritis was undertaken . Studies reporting reliability , validity , or responsiveness were identified using a systematic reverse citation trail audit procedure . Psychometric properties of the instruments were examined against predefined criteria and summarised . Results . Thirteen clinical trials met inclusion criteria . The most common patient-reported outcome was the disabilities of the arm , shoulder , and h and question naire ( DASH ) . The DASH , the  Michigan H and Outcomes Question naire ( MHQ ) , the  Patient Evaluation Measure ( PEM ) , and the  Patient-Reported Wrist Evaluation ( PRWE ) had evidence supporting their reliability , validity , and responsiveness . A post-hoc review of excluded studies revealed the AUSCAN Osteoarthritis H and Index as another suitable instrument that had favourable reliability , validity , and responsiveness . Conclusions . The DASH , MHQ , and AUSCAN Osteoarthritis H and Index instruments were supported by the most favourable empirical evidence for validity , reliability , and responsiveness . The PEM and PRWE also had favourable empirical evidence reported for these elements . Further psychometric testing of these instruments among people with wrist osteoarthritis is warranted OBJECTIVE To assess the sensitivity to change of three algofunctional scales for neck pain . METHODS Observational , prospect i ve study . Patients with neck disorders were included .  Pain and patients ' perceived h and icap assessed on visual analogue scales ( VAS Pain , VAS H and icap ) , and functional disability measures ( Neck Disability Index , Neck Pain and Disability Scale , Northwick Park Neck Pain Question naire  )  were recorded twice , at baseline and at an 11-month follow-up assessment . Sensitivity to change was assessed using the effect size ( ES ) and the st and ardised response mean ( SRM ) , and the non-parametric Spearman 's rank correlation coefficient ( r ) was used to assess the correlation between quantitative variable changes and patients ' overall opinion . Analysis of variance ( ANOVA ) followed by a Tukey-test was performed to determine if the scales distinguished improved , stable , and deteriorated patients . RESULTS Seventy-one patients ( 43 women , mean age 49 years ) were included and evaluated twice at an interval of 11 + /- 2 months . The three scales showed good sensitivity to change . The ANOVA showed a group effect , and individual changes in the scales scores were statistically different in two-by-two comparisons ( improved , stable or deteriorated patients ) . Changes in NPDS scores had the highest correlation with patient 's overall assessment ( r = 0.592 ) . CONCLUSION The three scales can detect changes in patients with neck disorders . Changes in NPDS score had the best correlation with patients ' overall opinion concerning their neck disorder and this question naire should be given preference in clinical trials Quality of life may be considerably reduced in patients who are suffering from chronic lower limb venous insufficiency , although existing generic quality of life instruments ( NHP , SF-36 or SIP ) can not completely identify their specific complaints . The Chronic Venous Insufficiency Question naire ( CIVIQ ) has been developed by iterative process . First , a pilot group of 20 patients was used to identify a number of important features of quality of life affected by venous insufficiency , other than physical symptoms of discomfort . A second study involving 2,001 subjects was used to reduce the number of items . Subjects were asked to score both the severity of their problems and the importance they attributed to each problem on a 5-point Likert scale . The importance items found in patients with venous insufficiency were subjected to factorial analyses ( PCA , PAF ) . The final version is a 20-item self-administered question naire which explores four dimensions : psychological , physical and social functioning and pain . Internal consistency of the question naire was vali date d for each dimension ( Cronbach 's alpha > 0.820 for three out of four factors ) . Reproducibility was confirmed in a 60 patient test-retest study . Pearson 's correlation coefficients for both the four dimension subscales and for the global score at 2-week intervals were greater than 0.940 . Finally , the question naire was tested in a r and omized clinical trial of 934 patients in order to assess responsiveness and the convergent validity of the instrument , together with the patient 's own quality of life . This study demonstrated that convergence was valid : Pearson 's correlation coefficients between clinical score differences and quality of life score differences were small ( from 0.199–0.564 ) but were statistically different from 0 ( p<0.001 ) . St and ardized response mean ( SRM ) and effect size ( ES ) were calculated to assess sensitivity to change . SRM and ES both demonstrated considerble responsiveness to change ( > 0.80 ) . Reliability , face , content , construct validity and responsiveness were also determined for this specific quality of life question naire relating to venous insufficiency . Results suggest that this question naire may be used with confidence to assess quality of life in clinical trials on chronic venous insufficiency Objective —To evaluate the responsiveness of the Shoulder Disability Question naire ( SDQ ) . Methods —The study was conducted within the framework of an observational study on shoulder disorders in primary care . After first presentation of their complaints to the general practitioner and after one and six months , participants completed the SDQ , a single question on functional status ( FSQ ) , and an ordinal 11 point scale for the severity of pain ( PSS ) . Responsiveness of the SDQ was evaluated compared with that of the FSQ and PSS , by calculating responsiveness ratios and by plotting receiver operating characteristic ( ROC ) curves . Recovery according to the patient was used as an external criterion for clinical ly relevant improvement ( complete recovery or much improved on a six point Likert scale was denoted as clinical ly relevant improvement ) . Results —A total of 349 consecutive patients with shoulder disorders were enrolled in the observational study . Response rates ranged between 96 % and 89 % . Responsiveness ratios were slightly higher for the PSS compared with the SDQ ( 2.53 versus 2.22 at one month , 2.24 versus 1.89 at six months ) . The area under the ROC curve was 0.84 for both the SDQ and the PSS , and 0.72 for the FSQ . Conclusion —The results of this study confirm the responsiveness of the SDQ , making it a useful instrument to assess functional disability in longitudinal studies OBJECTIVE This study was design ed to evaluate the reliability , validity , and responsiveness of a newly developed , health-related quality -of-life measure . STUDY DESIGN A total of 137 women ( 122 from a Phase III clinical trial and 15 from a private practice setting ) with endometriosis completed the question naire several times . RESULTS Reproducibility and internal-consistency reliability were acceptable with intraclass correlation coefficients ranging from 0.94 to 1.00 and Cronbach 's alpha coefficients ranging from 0.84 to 0.97 . Construct validity was demonstrated on the basis of correlations between items and scales . Health-related quality of life varied in a consistent manner according to clinician-rated measures of pelvic pain and dysmenorrhea and patient-reported levels of endometriosis pain , but no relationship emerged according to the revised American Fertility Society classification . In general , the question naire was moderately to highly responsive to change . CONCLUSION This is the first comprehensive health-related quality -of-life question naire available for use with endometriosis patients that has demonstrated reliability , validity , and responsiveness The Shoulder Disability Question naire ( SDQ ) is a measure covering 16 items design ed to evaluate functional status limitation in patients with shoulder disorders . The responsiveness of the SDQ was evaluated for 180 patients with soft tissue shoulder disorders , without underlying systemic disorders . These patients participated in a r and omized placebo-controlled trial , in which ultrasound and electrotherapy appeared to be ineffective as adjuvants to st and ardized exercise therapy . At baseline and at 6-week follow-up , patients completed the  SDQ  and rated severity of shoulder pain and their chief complaint , while a research physiotherapist rated severity of symptoms and restriction of mobility . At the 6-week follow-up , patients also rated overall change since baseline . According to the calibrated responsiveness ratio ( CRR ) and the area under the receiver-operator characteristic curve ( AUC ) the SDQ discriminates accurately between self-rated clinical ly stable and improved subjects . The presented results suggest that the SDQ is as responsive as the compared outcome measures , and therefore is ready for use in clinical trials Twenty-eight instruments measuring pain , clinical , functional , and global characteristics  were administered to 303 patients in a six-month r and omized clinical trial of auranofin and placebo in the treatment of patients with rheumatoid arthritis . The instruments were compared with respect to their responsiveness in detecting a treatment effect , the time involved in administering the instrument , the need for the presence of an interviewer , and ease of administration . The instruments ' ability to detect a treatment effect was the deciding characteristic in the clinical , pain , and global categories in choosing the preferred instrument . The counts of tender and swollen joints were found to be the most responsive clinical measures , the 10-cm pain line was the most responsive and the fastest to administer of the pain instruments , and the categorical self- assessment of arthritis was the most responsive global measure . In the functional ability category , the Health Assessment Question naire ( HAQ ) , the Keitel Functional Assessment , and the Quality of Well-Being ( QWB ) Question naire were equally responsive . The HAQ was the shortest and the only self-administered question naire . The QWB has had the most extensive validation work but was a complex instrument requiring intensive interviewer training . The Keitel was the most time-consuming instrument , but had the advantage of high interobserver agreement . The design of future trials can be guided by the information obtained in this study on their relative efficiencies and ease of use Background Self-report question naires play an important role as outcome measures in shoulder research . Having an estimate of the measurement error of these question naires is of importance when assessing follow-up results after treatment and when planning intervention studies . The aim of this study was to cross-culturally adapt the Norwegian version of the OSS and WORC question naire and examine and compare agreement , reliability and construct validity of the disease-specific shoulder question naire WORC with two commonly used shoulder question naires , SPADI and OSS , in patients with rotator cuff disease . Methods 74 patients with rotator cuff disease were recruited from the outpatient clinic of the Physical Medicine and Rehabilitation Department at Ullevaal University Hospital in Oslo , Norway . A test-retest design was used , and the question naires were filled out by the patients at the clinic , with a one week interval between test administrations . Agreement ( repeatability coefficient ) , reliability ( ICC ) and construct validity were examined and compared for WORC , SPADI and OSS . Results Reliability analysis was restricted to the 55 patients ( 51 ± 10 yrs ) who reported no change between test administrations according to scoring on a global scale . The agreement , reliability and construct validity was moderate for all three question naires with ICC ranging from 0.83 to 0.85 , repeatability coefficient from 16.1 to 19.7 and Spearman rank correlations between total scores from r = 0.57 to 0.69 . There was a lower degree of floor and ceiling effects in SPADI compared to WORC and OSS . Conclusion We conclude that the agreement and reliability of the three shoulder question naires examined , WORC index , SPADI and OSS are acceptable and that differences between scores were small . The Norwegian version of the question naires is acceptable for assessing Norwegian-speaking patients with rotator cuff disease . The moderate agreement and construct validity should be taken into consideration when assessing follow-up results after treatment and in the planning of prospect i ve studies
No difference was found in the strength of correlation between validation against the most similar construct versus validation against the least similar construct .
It is concluded that the Arthritis Impact Measurement Scale ( AIMS ) is the most suitable instrument for the assessment of disabilities in personal care
OBJECTIVES The first aim was to make an inventory of available instruments and question naires for the assessment of  disabilities  in personal care in patients with rheumatic disorders .
The second aim was to investigate which of these instruments have acceptable , method ological quality with regard to reliability , validity and responsiveness .
The third aim was to investigate the assumption that convergent validity results in stronger correlations when vali date d against a more similar construct .