Radboud University Nijmegen Medical Centre, Department of Neurosurgery, 6500 HB Nijmegen, The Netherlands.
Neurosurgery. 2010 May;66(5):1013-6. doi: 10.1227/01.NEU.0000368391.79314.6F.
Although the Japanese Orthopaedic Association (JOA) originally developed in Japan, the modified English version (mJOA) has become widely used and is arguably now the accepted standard.
In order to apply the mJOA successfully at an international level, we have translated it with a validated approach into Dutch to pave the way for other translated versions.
After a thorough forward and backward translation procedure, a final Dutch version of the mJOA was developed. This translated version was used to assess the interobserver reliability among 2 independent examiners by using a cohort of patients with neurological impairment due to spinal pathology.
The mJOA grading scale was used by 2 independent examiners in 25 patients with a variety of spinal diseases. Initially, the interobserver reliability expressed as kappa was 0.56 +/- 0.11. Then, instructions were given to the instructors to refrain from providing patients with an interpretation of the symptoms. Patients were asked to restrict themselves to the questionnaire and select the most appropriate score without bias from the examiner. Kappa increased to 0.78 +/- 0.05. This difference reached statistical significance (P < .001).
We present a streamlined approach to translate the mJOA into a language other than English. The approach resulted in a Dutch version of the mJOA that had a high degree of interobserver reliability.
日本矫形外科学会（JOA）最初在日本发展起来，但改良后的英文版（mJOA）已被广泛使用，可以说是现在被接受的标准。
为了在国际上成功应用 mJOA，我们采用经过验证的方法将其翻译成荷兰语，为其他翻译版本铺平道路。
经过彻底的前后翻译程序，开发出了 mJOA 的最终荷兰语版本。使用该翻译版本，通过对因脊柱病变导致神经功能障碍的患者队列进行评估，评估了 2 名独立评估员之间的观察者间可靠性。
2 名独立评估员在 25 名患有各种脊柱疾病的患者中使用了 mJOA 分级量表。最初，观察者间可靠性表示为kappa，为 0.56 +/- 0.11。然后，指导评估员不要为患者提供症状解释。患者被要求仅根据问卷并在没有评估员偏见的情况下选择最合适的分数。kappa 增加到 0.78 +/- 0.05。这一差异具有统计学意义（P <.001）。
我们提出了一种简化的方法将 mJOA 翻译成英语以外的语言。该方法产生了具有高度观察者间可靠性的 mJOA 荷兰语版本。
