Cross-cultural adaptation and validity of the Chinese version of the Oxford elbow score

• Main Authors: James Reeves Mbori Ngwayi, Jie Tan, Ning Liang, Emmanuel Gildas Eric Sita, Daniel Edward Porter
• Format: Article
• Language: English
• Published: BMC 2020-11-01
• Series: Journal of Orthopaedic Surgery and Research
• Subjects: Oxford elbow score; QuickDASH; SF-36; Elbow disorder; Reliability; Validity
• Online Access: http://link.springer.com/article/10.1186/s13018-020-02100-y

Abstract Background The Oxford Elbow score (OES) is a patient-reported outcome measure designed to evaluate patients before and after elbow surgery. Although various translated versions of the score are available, there is no Chinese mandarin version. The aim of this study was to develop a Chinese language version of the OES and evaluate its psychometric properties for clinical use. Methods The English version of the OES was forward translated into Chinese, followed by a backward translation into English. Then a final Chinese version was produced following expert committee discussions and pilot study of 11 patients. A smart device compatible electronic version of the OES was designed and completed by 70 patients with elbow pathology alongside the Quick-Dash and the SF-36. Reliability was assessed by measuring intraclass correlation coefficient (ICC) for test-retest reliability and Cronbach’s alpha for internal consistency. Spearman’s correlation coefficient was used to test the construct validity. Confirmatory factor analysis (CFA) was performed to evaluate the 3-factor structure of the OES. Results The overall Cronbach’s α coefficient was 0.906 and for the 3 different domains Function, Pain, and Social-psychological was 0.806, 0.796, and 0.776 respectively. The overall intraclass correlation coefficient was 0.764 and for the three different domains Function, Pain, and Social-psychological was 0.764, 0.624, and 0.590 respectively. The Spearman’s coefficient for correlation, between the QuickDASH and OES domains Function, Pain, and Social-psychological, was − 0.824, − 0.734, and − 0.622 respectively, showing strong correlation (r > 0.5; p < 0.01). There were moderate correlations between OES domains and the physical functioning, role physical, and strong correlations with bodily pain subscales of the PCS domain of the SF-36; results were insignificant for all other subscales. Conclusion Our translated Chinese mandarin OES version (mainland) was reliable and valid, suitable for evaluating elbow disorders in the Chinese population. Reliability was measured using both the Cronbach’s α for internal consistency and the intraclass correlation. Results were classified as “excellent” and were similar to results from the original OES. Electronic PROMs were used instead of the traditional paper-based PROMs for collection of data which was well tolerated by patients.