Orthopedic Department of Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China.
Spine (Phila Pa 1976). 2012 Aug 1;37(17):1497-504. doi: 10.1097/BRS.0b013e3182407e25.
Cross-cultural adaptation and psychometric testing of the Spinal Appearance Questionnaire (SAQ).
To evaluate the reliability and validity of simplified Chinese version of the SAQ (SC-SAQ).
The SAQ is widely used to assess the perception of spinal appearance in patients with adolescent idiopathic scoliosis (AIS). However, there is no culturally adapted, reliable, and validated SAQ for mainland China.
The cross-cultural adaptation of the original SAQ was performed following international guidelines. The SC-SAQ was administered concurrently with the simplified Chinese version of the Scoliosis Research Society-22 (SC-SRS-22) questionnaire to 223 patients with AIS. A total of 92 patients were randomly selected to complete the questionnaires again 4 to 7 days after the first completion. Psychometric testing included reliability by internal consistency and test-test reliability, convergent validity by comparing the SC-SAQ with the SC-SRS-22 appearance domain, and discriminant validity by analyzing the relationship between SC-SAQ scores and patients' characteristics.
Internal consistency for the SC-SAQ was satisfactory, with intradomain correlations ranging from r = 0.526 to r = 0.808 (P, 0.0001). The test-retest reliability for the SC-SAQ was excellent with intraclass correlation coefficient of 0.933 (95% confidence interval = 0.903-0.956) and good Bland-Altman agreement. (No systematic bias was found in the Bland-Altman plot.) Convergent validity test demonstrated a moderate correlation between the overall SC-SAQ and SC-SRS-22 appearance domain, with ρ = -0.401 (P, 0.0001). Correlation between the overall SC-SAQ and the major curve magnitude was significant, with r = 0.827 (P, 0.0001). Discriminant validity was confirmed by significant differences of overall SC-SAQ and individual domain scores among the 6 subgroups categorized by the major curve magnitude (P, 0.0001) and among patients requiring exercise, bracing, or surgery (P, 0.0001).
The SC-SAQ showed satisfactory reliability and validity in the evaluation of spinal deformity appearance for patients with AIS in mainland China.
脊柱外观问卷（SAQ）的跨文化适应性和心理计量学测试。
评估简化中文版 SAQ（SC-SAQ）的可靠性和有效性。
SAQ 广泛用于评估青少年特发性脊柱侧凸（AIS）患者对脊柱外观的感知。然而，对于中国大陆地区，尚无经过文化适应性调整、可靠且经过验证的 SAQ。
根据国际指南对原始 SAQ 进行跨文化适应性改编。同时向 223 名 AIS 患者施测简化中文版 SAQ（SC-SAQ）和简化中文版脊柱侧凸研究协会-22 问卷（SC-SRS-22）。随机选择 92 名患者在首次完成后 4 至 7 天内再次完成问卷。心理计量学测试包括内部一致性的可靠性（通过内在一致性和测试-测试可靠性进行评估）、与 SC-SRS-22 外观领域的收敛有效性（通过比较 SC-SAQ 与 SC-SRS-22 评估的相关性进行评估），以及判别有效性（通过分析 SC-SAQ 评分与患者特征之间的关系进行评估）。
SC-SAQ 的内部一致性令人满意，各领域的内在相关性范围为 r = 0.526 至 r = 0.808（P，0.0001）。SC-SAQ 的重测信度极佳，组内相关系数为 0.933（95%置信区间=0.903-0.956），且 Bland-Altman 一致性良好（ Bland-Altman 图中未发现系统偏差）。收敛有效性测试表明，SC-SAQ 总分与 SC-SRS-22 外观领域之间存在中度相关性，ρ=-0.401（P，0.0001）。SC-SAQ 总分与主曲线幅度之间存在显著相关性，r=0.827（P，0.0001）。根据主曲线幅度分为 6 组的情况下，SC-SAQ 总分和各领域得分在 6 个分组之间（P，0.0001）以及需要运动、支具或手术治疗的患者之间（P，0.0001）存在显著差异，证实了判别有效性。
在中国内地，SC-SAQ 用于评估 AIS 患者脊柱畸形外观时具有良好的可靠性和有效性。
