Roorda L D, Jones C A, Waltz M, Lankhorst G J, Bouter L M, van der Eijken J W, Willems W J, Heyligers I C, Voaklander D C, Kelly K D, Suarez-Almazor M E
Department of Rehabilitation Medicine, VU University Medical Centre, Amsterdam, The Netherlands.
Ann Rheum Dis. 2004 Jan;63(1):36-42. doi: 10.1136/ard.2002.001784.
Cross cultural validity is of vital importance for international comparisons.
To investigate the validity of international Dutch-English comparisons when using the Dutch translation of the Western Ontario and McMaster Universities osteoarthritis index (WOMAC).
The dimensionality, reliability, construct validity, and cross cultural equivalence of the Dutch WOMAC in Dutch and Canadian patients waiting for primary total hip arthroplasty was investigated. Unidimensionality and cross cultural equivalence was quantified by principal component and Rasch analysis. Intratest reliability was quantified with Cronbach's alpha, and test-retest reliability with the intraclass correlation coefficient. Construct validity was quantified by correlating sum scores of the Dutch WOMAC, Arthritis Impact Measurement Scales (Dutch AIMS2), Health Assessment Questionnaire (Dutch HAQ), and Harris Hip Score (Dutch HHS).
The WOMAC was completed by 180 Dutch and 244 English speaking Canadian patients. Unidimensionality of the Dutch WOMAC was confirmed by principal component and Rasch analysis (good fit for 20/22 items). The intratest reliability of the Dutch WOMAC for pain and physical functioning was 0.88 and 0.96, whereas the test-retest reliability was 0.77 and 0.92, respectively. Dutch WOMAC pain sum score correlated 0.69 with Dutch HAQ pain, and 0.39 with Dutch HHS pain. Dutch WOMAC physical functioning sum score correlated 0.46 with Dutch AIMS2 mobility, 0.62 with Dutch AIMS2 walking and bending, 0.67 with Dutch HAQ disability, and 0.49 with Dutch HHS function. Differential item functioning (DIF) was shown for 6/22 Dutch items.
The Dutch WOMAC permits valid international Dutch-English comparisons after correction for DIF.
跨文化效度对于国际比较至关重要。
探讨使用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）荷兰语翻译版本进行荷兰语与英语国际比较时的效度。
对等待初次全髋关节置换术的荷兰和加拿大患者中荷兰语版WOMAC的维度、信度、结构效度和跨文化等效性进行研究。通过主成分分析和拉施分析对单维度性和跨文化等效性进行量化。用克朗巴赫α系数量化内部信度，用组内相关系数量化重测信度。通过对荷兰语版WOMAC、关节炎影响测量量表（荷兰语版AIMS2）、健康评估问卷（荷兰语版HAQ）和哈里斯髋关节评分（荷兰语版HHS）的总分进行相关分析来量化结构效度。
180名荷兰患者和244名说英语的加拿大患者完成了WOMAC测评。主成分分析和拉施分析证实了荷兰语版WOMAC的单维度性（22个条目中20个拟合良好）。荷兰语版WOMAC疼痛和身体功能方面的内部信度分别为0.88和0.96，而重测信度分别为0.77和0.92。荷兰语版WOMAC疼痛总分与荷兰语版HAQ疼痛的相关性为0.69，与荷兰语版HHS疼痛的相关性为0.39。荷兰语版WOMAC身体功能总分与荷兰语版AIMS2活动度的相关性为0.46，与荷兰语版AIMS2行走和弯腰的相关性为0.62，与荷兰语版HAQ残疾的相关性为0.67，与荷兰语版HHS功能的相关性为0.49。22个荷兰语条目中有6个显示存在项目功能差异（DIF）。
校正DIF后，荷兰语版WOMAC可用于有效的荷兰语与英语国际比较。
