Validation of the French version of the Bournemouth Questionnaire. Measuring Function of the Shoulder. A Cross-Sectional Comparison of Five Questionnaires* Cervical Spine Outcomes Questionnaire: Its Development and Psychometric Properties Subjective Health Measure Used on Chinese Patients With Neck Pain in Hong Kong The Core Outcomes for Neck Pain: Validation of a New Outcome Measure The ability to change of three questionnaires for neck pain. Sensitivity and Specificity of Outcome Measures in Patients with Neck Pain: Detecting Clinically Significant Improvement Comparison of the Neck Disability Index and the Neck Bournemouth Questionnaire in a sample of patients with chronic uncomplicated neck pain. Quality of life in head and neck cancer patients: validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35. The Bournemouth Questionnaire: a short-form comprehensive outcome measure. II. Psychometric properties in neck pain patients. Validity of five common manual neck pain provoking tests. Questionnaire on the perceptions of patients about shoulder surgery. Accurately measuring the quality and effectiveness of cervical spine surgery in registry efforts: determining the most valid and responsive instruments. Development and validation of a bilingual questionnaire for measuring udder health related management practices on dairy farms. Prospective, Longitudinal Quality-of-Life Study of Patients With Head and Neck Cancer: A Feasibility Study Including the EORTC QLQ-C30 Agreement, reliability and validity in 3 shoulder questionnaires in patients with rotator cuff disease A Self-Administered Questionnaire for Assessment of Symptoms and Function of the Shoulder*
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 Measures of both generic and disease-specific health status are being developed and used with increasing frequency for the appraisal of musculoskeletal conditions . The purpose of this study was to compare prospect ively the validity of five question naires in the assessment of function of the shoulder . Ninety subjects who had various problems related to the shoulder agreed to enter the study . All of the subjects completed a question naire package that included the  Shoulder Pain and Disability Index , the Simple Shoulder Test , the Subjective Shoulder Rating Scale , the Modified American Shoulder and Elbow Surgeons Shoulder Patient Self-Evaluation Form , and the Shoulder Severity Index as well as a measure of generic health status ( the acute version of the Short Form 36 [ SF-36 ] ) and two questions that asked the patient to rate the severity of the problem and his or her over-all health . Frequency distributions were created and compared among question naires . Spearman rank correlations were calculated to compare the question naires with each other and with other assessment s. One-way analysis of variance was used to determine the ability of the question naires to discriminate between self-rated severity of the problem and over-all health . The frequency distributions were similar among the five shoulder question naires , but those of the five shoulder question naires differed from that of the SF-36 . The correlations were good ( 0.73 ⩽ r ⩽ 0.80 ) among all of the five shoulder question naires except the Subjective Shoulder Rating Scale ; they were lower with the Subjective Shoulder Rating Scale and the physical function dimension of the SF-36 ( 0.12 ⩽ r ⩽ 0.60 ) . The shoulder question naires discriminated between levels of severity ( p < 0.0001 ) but not between levels of over-all health ( 0.10 ⩽ p ⩽ 0.86 ) . In this concurrent comparison of measures of shoulder-specific outcome in the same subjects , the shoulder question naires performed similarly , both in describing function of the shoulder and in discriminating between levels of severity . The shoulder question naires performed differently than the SF-36 , which confirms the need to use both disease-specific and generic health-status measures to evaluate patients who have a problem related to the shoulder Study Design . A cross-sectional study was conducted to analyze a convenience sample of patients seeking treatment for cervical spine conditions . Objective . To develop and evaluate the psychometric properties of a comprehensive , disease-specific question naire for characterizing complaints of neck pain and evaluating the outcomes of treatments for these complaints . Summary of Background Data . There currently are a number of generic and disease-specific instruments for assessing complaints of neck pain . None comprehensively cover the wide range of factors considered essential in evaluating treatment outcomes . Methods . The authors developed a comprehensive , disease-specific question naire for characterizing complaints of neck pain and evaluating the outcomes of treatments for these complaints . In this study , 216 patients who underwent surgery for cervical spine disorders completed the Cervical Spine Outcomes Question naire before treatment , then at 3 and 6 months after treatment . The data were used to evaluate the reliability , validity , and responsiveness of the question naire . Results . The authors have shown that the Cervical Spine Outcomes Question naire has high test – retest reliability , good construct validity , and responsiveness to change after treatment . Conclusions . The Cervical Spine Outcomes Question naire is a comprehensive , disease-specific instrument for assessing complaints of neck pain and evaluating the outcomes of treatments for these complaints . It provides information on demographics , pain severity , functional disability , psychological distress , physical symptoms , health care utilization , and satisfaction . It appears to be acceptable to patients , easy to administer , highly reliable , valid , and responsive . It should be considered for use in monitoring patients with cervical spine conditions and in studies of cervical spine disorders and their treatments Study Design . A prospect i ve observational study was conducted on the use of the Chinese version of the Northwick Park Neck Pain Question naire . Objective . To examine the reliability , validity , and responsiveness of the Chinese version of the Northwick Park Neck Pain Question naire in Chinese patients with neck pain in Hong Kong . Summary of Background Data . There is increasing recognition that patient perspectives are essential both in making medical decisions and in judging the treatment outcomes . A valid Chinese version of a neck disability index question naire is urgently needed for effective and reliable evaluation of the treatment outcomes for patients with neck pain . Methods . Two sample s with 532 consecutive adult patients with neck pain from seven physiotherapy outpatient departments in Hong Kong who completed the Northwick Park Neck Pain Question naire  were observed and measured at different intervals : at the beginning of physiotherapy , at 7 days , at 3 weeks , and 6 weeks after physiotherapy . Results . The question naire had good content validity , very good test – retest reliability , and internal consistency ( intraclass correlation coefficient , 0.95 ; Cronbach ’s alpha , 0.87 ) . It also had good validity ( Spearman correlation coefficient of 0.59 when the score was correlated with that of a generic 42-item Chinese health question naire ) and good responsiveness ( effect size of 1.11 at week 6 after treatment began ) . Conclusions . The Chinese version of the Northwick Park Neck Pain Question naire has been shown to demonstrate very good content validity , a high degree of test – retest reliability , and internal consistency . It also exhibited good construct validity and high sensitivity to changes in severity over time Study Design . Patients enrolled in a r and omized controlled trial were asked to complete various question naires , which were then compared to establish validity for a new neck pain question naire . Objectives . To vali date a new and brief outcome measure for use with patients with mechanical neck pain . Summary of Background Data . Neck pain is a very common problem and one that clinicians will be required to treat with some regularity . In today ’s climate of evidence -based practice and the need to quantify and justify clinical intervention , a quick and easy method to evaluate progress is required . Such a measure has already been produced for those experiencing back pain , but as yet , there is no such measure for neck pain and this needs to be addressed . Methods . The  back pain measure  was adapted to enable its use with patients with neck pain .  Repeatability was assessed by using a 1-week test/retest on 104 patients who were enrolled in a neck pain trial .  Validity was assessed by comparing the new question naire against other already well vali date d measures ( i.e. , the Neck Disability Index and a Visual Analogue Scale for pain ) with 133 patients . Results . The test/retest showed excellent repeatability with high intraclass correlations and P < 0.001 for each question tested . The Core Neck Pain Question naire also showed good validity , giving close agreement to the other comparison measures . Conclusion . The short Core Neck Pain Question naire has been demonstrated to be repeatable and valid as a brief outcome measure for use with patients with mechanical neck pain 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 Study Design . Prospect i ve , single-cohort study . Objective . To determine the relative sensitivity of a range of outcome measures used in evaluating treatment interventions in patients with neck pain and the magnitude of change scores on the neck Bournemouth Question naire and the cutoff score on the Patients ’ Global Impression of Change scale associated with clinical ly significant improvement . Summary of Background Data . Traditionally , evaluation of treatment interventions using subjective outcome measures has been based on the statistical significance of the difference between group mean values . To be clinical ly meaningful , however , information is required from sensitive outcome measures on the proportion of patients undergoing a clinical ly important improvement and from this , the number needed to treat for a single patient to benefit . Methods . Patients with nonspecific neck pain from a number of treatment centers completed a battery of self-report question naires , including the Bournemouth Question naire , before and after chiropractic treatment . After treatment , patients also completed a retrospective analysis of their overall improvement since the start of treatment ( Patients ’ Global Impression of Change ) . The a priori definition of clinical ly significant improvement was defined as a Reliable Change Index on the Bournemouth Question naire of > 1.96 . Results . The best cutoffs with a balance between the highest sensitivity and highest specificity in detecting clinical improvement were a score of 2 or less on the Patients ’ Global Impression of Change ( 11-point Numerical Rating Scale : 0 = much better , 5 = no change , and 10 = much worse ) and a raw change score of three or more points on each of the seven 11-point Numerical Rating Scale subscales of the Bournemouth Question naire . For the total score of the Bournemouth Question naire , raw change scores of 13 or more points , percentage change scores of 36 % or more , and individual effect sizes of 1.0 or more were all associated with clinical ly significant improvement . The sensitivity of the Bournemouth Question naire in terms of its effect size was comparable with that of pain intensity scales and the Neck Disability Index . Conclusions . The present findings will assist in the choice of outcome measures in trials on neck pain . The study also illustrates a method ologic framework for interpreting change scores in terms of clinical improvement , facilitating the process of making sense of research data in the clinical setting OBJECTIVE This study compares the sensitivity to change of the Neck Disability Index ( NDI ) and the Neck Bournemouth Question naire ( NBQ ) in patients with chronic uncomplicated neck pain . METHODS This prospect i ve longitudinal study was completed in an outpatient physical therapy clinic . Subjects , with uncomplicated neck pain ( no concurrent shoulder pain or nerve root symptoms ) for more than a 3-month duration , participated in a 4-week course of therapy that included moist heat , neck exercises , and either mobilization or massage . Outcome measures included st and ardized response means ( sensitivity to change ) , Cronbach alpha ( internal consistency ) , and 2-way Spearman correlations between the 2 question naires and between a pain Visual Analog Scale and each question naire ( convergent validity ) . RESULTS Mean ( SD ) score change of the NDI was 6.22 ( 5.12 ) , and of the NBQ , 14.00 ( 11.99 ) . St and ardized response means were 1.21 and 1.17 , respectively . Both question naires were more sensitive to change than the pain Visual Analog Scale ( 0.68 ) . There was moderate correlation between the change scores of all 3 outcome tools ( Spearman 0.46 - 0.57 ) . The NBQ had higher internal consistency than the NDI . CONCLUSIONS The NDI and the NBQ performed comparably in this group of patients with chronic uncomplicated neck pain . Both are sensitive to change and would be efficient outcome tools in studies of chronic neck pain . Both had acceptable internal consistency and are appropriate for use as single- outcome scales PURPOSE The aim of this study was to define the scales and test the validity , reliability , and sensitivity of the European Organization for Research and Treatment of Cancer Quality of Life Question naire ( EORTC QLQ)-H&N35 , a question naire design ed to assess the quality of life of head and neck ( H&N ) cancer patients in conjunction with the general cancer-specific EORTC QLQ-C30 . PATIENTS AND METHODS Question naires were given to 500 H&N cancer patients from Norway , Sweden , and the Netherl and s as part of two prospect i ve studies . The patients completed the question naires before , during ( Norway and Sweden only ) , and after treatment , yielding a total of 2070 completed question naires . RESULTS The compliance rate was high , and the question naires were well accepted by the patients . Seven scales were constructed ( pain , swallowing , senses , speech , social eating , social contact , sexuality ) . Scales and single items were sensitive to differences between patient subgroups with relation to site , stage , or performance status . Most scales and single items were sensitive to changes , with differences of various magnitudes according to the site in question . The internal consistency , as assessed by Cronbach 's alpha coefficient , varied according to assessment point and within sub sample s of patients . A low overall alpha value was found for the speech and the senses scales , but values were higher in assessment s of patients with laryngeal cancer and in patients with nose , sinus , and salivary gl and tumors . Scales and single items in the QLQ-H&N35 seem to be more sensitive to differences between groups and changes over time than do the scales and single items in the core question naire . CONCLUSION The QLQ-H&N35 , in conjunction with the QLQ-C30 , provides a valuable tool for the assessment of health-related quality of life in clinical studies of H&N cancer patients before , during , and after treatment with radiotherapy , surgery , or chemotherapy OBJECTIVE To modify an existing outcome measure ( Bournemouth Question naire [ BQ ] ) for use in patients with nonspecific neck pain and test its psychometric properties . DESIGN Prospect i ve longitudinal study in which the question naire was administered on 3 occasions ( pretreatment , retest , and posttreatment ) . SETTING Anglo-European College of Chiropractic outpatient clinic and 8 field chiropractic practice s. METHOD Seven core items relating to the biopsychosocial model of pain were included in the original question naire ( back BQ ) . The wording of one of these items ( disability in activities of daily living ) was modified to include activities likely to be affected by neck pain . Testing of the neck BQ was carried out in 102 patients with nonspecific neck pain . RESULTS The instrument demonstrated high internal consistency on 3 administrations ( Cronbach 's alpha = 0.87 , 0.91 , 0.92 ) . All 7 items were retained on the basis that they each significantly contributed to the total score ( item-corrected total score correlations > 0.43 ) and to the instrument 's responsiveness to clinical change ( item change-corrected total change score correlations > 0.42 ) . The instrument was reliable in test-retest administrations in stable subjects ( ICC = 0.65 ) . The instrument demonstrated acceptable construct validity and longitudinal construct validity with established external measures . The treatment effect size of the instrument was found to be high ( 1.67 ) . CONCLUSION The neck BQ covers the salient dimensions of the biopsychosocial model of pain , is quick and easy to complete , and has been shown to be reliable , valid , and responsive to clinical ly significant change in patients with nonspecific neck pain . Its use as an outcome measure in clinical trials and outcomes research is recommended The purpose of the present study was to assess five manual tests for pain provocation of the neck to determine their suitability for epidemiological investigations . To 75 r and omly selected men , five manual pain-provoking tests were applied in a single-blind design . Prevalence of reported neck dysfunction , sensitivity , specificity , and positive and negative predicted value for each test were calculated . 22 of the 75 reported present neck pain , while the remainder reported freedom from neck pain for at least one year . Palpation over the facet joints in the cervical spine was found to be the most appropriate screening test to corroborate the replies in self-reported question naires on dysfunctions of the neck . The outcome of this test was quite consistent with the reported neck pain . The test of the formina intervertebralia and the upper limb tension test caused pain in almost all subjects with reported neck dysfunctions , though not causing referred pain in the arm as an indication of neurogenous tissue origin , as it was aim ed to . Neither the neck rotation test nor the active flexion/extension test was sufficiently provocative to confirm the reported neck pain in these subjects , as both were insufficiently sensitive We developed a 12-item question naire for completion by patients having shoulder operations other than stabilisation . A prospect i ve study of 111 patients was undertaken before operation and at follow-up six months later . Each patient completed the new question naire and the SF36 form . Some filled in the Stanford Health Assessment Question naire ( HAQ ) . An orthopaedic surgeon assessed the Constant shoulder score . The single score derived from the question naire had a high internal consistency . Reproducibility , examined by test-retest reliability , was found to be satisfactory . The validity of the question naire was established by obtaining significant correlations in the expected direction with the Constant score and the relevant scales of the SF36 and the HAQ . Sensitivity to change was assessed by analysing the differences between the preoperative scores and those at follow-up . Changes in scores were compared with the patients ' responses to postoperative questions about their condition . The st and ardised effect size for the new question naire compared favourably with that for the SF36 and the HAQ . The new question naire was the most efficient in distinguishing patients who said that their shoulder was much better from all other patients . The shoulder question naire provides a measure of outcome for shoulder operations which is short , practical , reliable , valid and sensitive to clinical ly important changes BACKGROUND CONTEXT There is a growing dem and to measure the real-world effectiveness and value of care across all specialties and disease states . Prospect i ve registries have emerged as a feasible way to capture real-world care across large patient population s. However , the proven validity of more robust and cumbersome patient-reported outcome instruments ( PROi ) must be balanced with what is feasible to apply in large-scale registry efforts . Hence , commercial registry efforts that measure quality and effectiveness of care in an attempt to guide quality improvement , pay for performance , or value-based purchasing should incorporate measures that most accurately represent patient-centered improvement . PURPOSE We set out to establish the relative validity and responsiveness of common PROi in accurately determining effectiveness of cervical surgery for neck and arm pain in registry efforts . STUDY DESIGN Prospect i ve cohort study . PATIENT SAMPLE Eighty-eight patients undergoing primary anterior cervical discectomy and fusion ( ACDF ) for neck and arm pain . OUTCOME MEASURES Patient-reported outcome measures for pain ( numeric rating scale for neck pain [ NRS-NP ] and arm pain [ NRS-AP ] ) , disability ( neck disability index [ NDI ] ) , general health ( short-form 12-item survey physical component summary [ SF-12 PCS ] and mental component summary [ SF-12 MCS ] ) , and quality of life ( Euro-Qol-5D [ EQ-5D ] ) were assessed . METHODS Eighty-eight patients undergoing primary ACDF for neck and arm pain were entered into a Web-based prospect i ve registry . Baseline and 12-month patient-reported outcomes ( NRS-NP , NRS-AP , NDI , SF-12 PCS , SF-12 MCS , and EQ-5D ) were assessed . Patients were also asked whether they experienced a level of improvement after ACDF that met their expectation ( meaningful improvement ) . To assess the validity of NRS-NP , NRS-AP , and NDI ( measures of pain and disability ) to discriminate between meaningful and nonmeaningful improvement and the validity of SF-12 PCS , SF-12 MCS , and EQ-5D ( measures of general health and quality of life ) to discriminate between meaningful and nonmeaningful improvement , receiver-operating characteristic curves were generated for each outcome instrument . The greater the area under the curve ( AUC ) , the more valid the discriminator . The difference between st and ardized response means ( SRMs ) in patients reporting meaningful improvement versus not was calculated to determine the relative responsiveness of each outcome instrument to changes in  pain and QOL after surgery . RESULTS For pain and disability , both NDI ( AUC=0.75 ) and NRS-AP ( AUC=0.74 ) were valid discriminators of meaningful improvement . Numeric rating scale for neck pain ( AUC=0.69 ) was a poor discriminator . Neck disability index was also most responsive to postoperative improvement ( SRM difference 0.78 ) , followed by NRS-AP ( SRM difference 0.59 ) and NRS-NP ( SRM difference 0.46 ) . For general health and quality of life , SF-12 PCS ( AUC=0.79 ) was the only valid discriminator of meaningful improvement . Euro-Qol-5D ( AUC=0.68 ) and SF-12 MCS ( AUC=0.44 ) were poor discriminators . Short-form 12 physical component summary ( SRM difference 1.08 ) was also most responsive compared with EQ-5D ( SRM difference 0.89 ) and SF-12 MCS ( SRM difference 0.01 ) . CONCLUSIONS For pain and disability , NDI is the most valid and responsive measure of improvement after surgery for neck and arm pain . Numeric rating scale for neck pain and NRS-AP are poor substitutes for NDI when measuring effectiveness of care in registry efforts . For health-related quality of life , only SF-12 PCS could accurately discriminate meaningful improvement after cervical surgery and was found to be most valid and responsive . Large-scale registry efforts aim ed at measuring effectiveness of cervical spine surgery should use NDI and SF-12 to accurately assess improvements in pain , disability , and quality of life Question naires are frequently used instruments to collect data in epidemiological studies . In countries where more than one language is spoken , the development of a question naire in more than one language is needed . The objective of this study was to develop and test the repeatability and validity of English and French versions of a personal interview-format question naire design ed to capture udder health related management practice s used on dairy farms . A st and ardized protocol was used to develop and translate the research instrument . Equivalence of the English and French question naires was assessed using a cross-over study design with 24 bilingual dairy producers completing both versions on three different occasions in a r and omly assigned sequence . Repeatability of the question naire was evaluated using the test-retest method with the same questions being asked on two different occasions to 88 dairy producers participating in the National Cohort of Dairy Farms of the Canadian Bovine Mastitis Research Network .  Validity of the questions related to milking procedures and general housing was assessed using on-farm observations as a gold st and ard . Measures of agreement were calculated using kappa , quadratic-weighted Kappa and concordance correlation coefficients for categorical , ordinal and continuous variables , respectively . Sensitivity and specificity estimates were computed for the validity analysis . The overall equivalence of the English and French versions of the question naire was adequate ; agreement measures when administered twice in the same language were not significantly higher than when administered in each language . Similarly , question naire overall repeatability was good . When accounting for prevalence bias , Kappa and CCC estimates ranged from 0.40 to 0.92 for 27 of the 29 items evaluated in the question naire , with 18 items yielding agreement estimates greater than 0.60 . Finally , milking procedures and general housing questions validity was excellent with mean sensitivity and specificity of 86 % and 92 % , respectively . Although the overall evaluation of the instrument was satisfactory , specific doubtful items were identified . This illustrates the need to address question naire reliability as even rigorously design ed and pre-tested questions can have poor repeatability or validity . Our results indicate that the developed English and French question naires can be used simultaneously to accurately measure the udder health related management practice s used on Canadian dairy farms . This question naire is adaptable for use in other developed dairy industry population s. The question naire is freely available online at www.mastitisnetwork.org under the " Publications/others " section Despite modern advances in the treatment of head and neck cancer , the survival rate fails to improve . Considering the different treatment modalities involved , quality of life has been thought of as an additional end point criterion for use in clinical trials . A Nordic protocol to measure the quality of life of head and neck cancer patients before , during , and after treatment was established . Before the study , a pilot study was done with this protocol . The main purpose of this pilot study was to find out whether this cancer population would answer  quality -pf-life question naires repeatedly ( six times ) over a 1-year period and whether the chosen question naires — a core question naire ( European Organisation for Research and Treatment of Cancer Core Quality of Life Question naire ( EORTC QLQ-C30 ) ) , a tumor-specific question naire , and a psychological distress measure ( Hospital Anxiety and Depression scale (HAD))—were sensitive for changes to functions and symptoms during the study year . The results presented in this article all refer to the pilot study . Forty-eight consecutive patients agreed to participate in the study . The most common tumor locations were the oral cavity ( 17 ) and the larynx ( 12 ) . Almost all patients received combined treatment : 45 of 48 radiation therapy , 18 of 48 chemotherapy , and 17 of 48 surgery . After the primary treatment , 40 patients had complete tumor remission . Four of the 48 patients did not answer any question naires and were therefore excluded from the study . Of the remaining 44 patients , 3 died during the study year , and another 6 withdrew for various reasons . Thirty-five ( 85 % ) of the 41 patients alive at the 1-year follow-up answered all six question naires and thus completed the study . Mailed question naires were used throughout the study . All question naires were well accepted and found to be sensitive to changes during the study year . The greatest variability was found for symptoms and functions related specifically to head and neck cancer . The symptoms were swallowing difficulties , hoarse voice , sore mouth , dry mouth , and problems with taste . They all showed the same pattern , with an increase of symptoms during and just after finishing the treatment . The HAD scale revealed a high level of psychological distress , with 21 % probable cases of psychiatric morbidity at diagnosis . In conclusion , it was shown that the study design and question naires were feasible for the forthcoming prospect i ve quality -of-life assessment of Swedish and Norwegian head and neck cancer patients 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 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
The Neck Disability Index is the most frequently evaluated question naire and shows positive results for internal consistency , content validity , structural validity , hypothesis testing , and responsiveness , but a negative result for reliability .
The other question naires show positive results , but the evidence for each measurement property is mostly limited , and at least 50 % of the information on measurement properties per question naire is lacking .
Purpose To critically appraise and compare the measurement properties of the original versions of  neck-specific question naires .