Measurement properties of Portuguese-Brazil Western Ontario and McMaster Universities osteoarthritis index (WOMAC) for the assessment of knee complaints in Brazilian adults: ELSA-Brasil Musculoskeletal cohort
Measurement properties of Portuguese-Brazil Western Ontario and McMaster Universities osteoarthritis index (WOMAC) for the assessment of knee complaints in Brazilian adults: ELSA-Brasil Musculoskeletal cohort
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DOI：
10.1007/s00296-019-04496-1
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发表时间：
2020-02-01
影响因子：
4
通讯作者：
Telles, Rosa W.
中科院分区：
文献类型：
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作者：
Lage, Poliane T. S.;Machado, Luciana A. C.;Telles, Rosa W.
有关西安大略大学和麦克马斯特大学 (WOMAC) 骨关节炎指数翻译版本的测量特性的信息仍然有限。本研究调查了葡萄牙-巴西 WOMAC 在 ELSA-巴西肌肉骨骼队列基线上应用于公务员的内部一致性、重测信度/一致性、结构有效性以及下限和上限效应。每个测量属性都在整个样本、报告膝盖症状的亚组以及不同的社会人口统计学层（析因分析除外）中进行评估。对疼痛、僵硬和功能维度进行单独分析，考虑得分最差的膝盖（如果两膝得分相同，则考虑右膝）。共有 1740 名参与者（319 名完成 WOMAC 2 次），平均年龄 56.0（标准差 = 8.9）岁，46.8% 为男性，42.1% 有膝盖症状。在整个样本中，WOMAC 维度的结果范围为： 内部一致性 = cronbach alpha 0.92-0.98；重测信度=组内相关系数0.85-0.97；测量标准误差（SEM）= 1.38-5.86；最小可检测变化（SDC）= 3.84-16.25；最低可能分数 = 38.8%-61.1%（存在地板效应）；最高可能分数 = 0.2%-0.9%（不存在上限效应）。通过假设检验和因子分析证实了结构的有效性。有症状组的结果相似，但 SEM 和 SDC 较高，并且疼痛和功能维度不存在底板效应。葡萄牙-巴西 WOMAC 在非临床环境中表现出良好的整体质量。在设计未来使用 WOMAC 的研究时，应考虑不同人口阶层测量特性的变异性。
Information on measurement properties of translated versions of the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index is still limited. This study investigated the internal consistency, test-retest reliability/agreement, construct validity, and floor and ceiling effects of Portuguese-Brazil WOMAC applied to civil servants at baseline of ELSA-Brasil Musculoskeletal cohort. Each measurement property was evaluated in the overall sample, in the subgroup reporting knee symptoms, and across different sociodemographic strata (except factorial analyses). Separate analyses were performed for pain, stiffness and function dimensions, considering the knee with the worst score (or right knee if same score in both knees). A total of 1740 participants were included (319 completed WOMAC on 2 occasions), mean age 56.0 (standard deviation = 8.9) years, 46.8% male, 42.1% had knee symptoms. In the overall sample, the range of results for WOMAC's dimensions were: internal consistency = cronbach alpha 0.92-0.98; test-retest reliability = intraclass correlation coefficient 0.85-0.97; standard error of measurement (SEM) = 1.38-5.86; smallest detectable change (SDC) = 3.84-16.25; lowest possible score = 38.8%-61.1% (floor effect present); highest possible score = 0.2%-0.9% (ceiling effect absent). Construct validity was confirmed by hypothesis testing and factorial analysis. Results were similar in the symptomatic group, except for higher SEM and SDC, and the absence of floor effects in pain and function dimensions. Portuguese-Brazil WOMAC showed good overall quality in a nonclinical setting. Variability in measurement properties across different strata of the population should be taken into consideration for the design of future studies using WOMAC.