Department of Rheumatology and Immunology, Singapore General Hospital, Academia Building, Level 4, 20 College Road, Singapore, 169856, Singapore.
Health Services Research Unit, Singapore General Hospital, Singapore, Singapore.
Clin Rheumatol. 2019 Sep;38(9):2383-2397. doi: 10.1007/s10067-019-04567-5. Epub 2019 Apr 29.
To cross-culturally adapt the Connective Tissue Disease (CTD) Screening Questionnaire (CSQ) in a multi-ethnic Asian population in Singapore.
An expert panel of accredited rheumatologists evaluated the content validity of the original CSQ. Consenting participants newly referred from primary care to a rheumatology specialist outpatient clinic for evaluation of possible CTDs were studied. Cognitive debriefing interviews (CDIs) using the original CSQ were conducted with English-speaking participants, with modifications made based on their inputs and in discussion with a second expert panel (rheumatologists and the CSQ developers). Forward and back translations of the adapted English version were reviewed by the second expert panel. The common translation produced was tested in CDIs with Chinese-speaking participants. Adapted English and Chinese versions were pilot tested in a separate group of newly referred patients.
Content validity of the original CSQ was confirmed by the expert panel. A total of 30 and 15 participants were recruited for English and Chinese CDIs, respectively. Alternative terms and explanatory notes were added to difficult medical terms in the adapted English CSQ. A further explanatory note was added to one difficult item, and English medical terms were retained in the Chinese version. Pilot testing of the adapted CSQ was performed on 116 participants, which exhibited an overall sensitivity and specificity of 71% and 58%, respectively, in identifying CTDs.
The adapted CSQ demonstrated satisfactory sensitivity in the pilot testing and appears to be a promising tool for facilitating early identification of CTDs in the multi-ethnic Asian population.
• Early identification and management of patients with CTDs is crucial given their high disease burden and short "windows of opportunity." • High reliability and validity of original CSQ and its cross-culturally adapted versions have been reported; however, the CSQ has not been validated in Southeast Asia where CTDs are associated with higher morbidity and mortality compared to other countries. • Our cross-culturally adapted CSQ demonstrated satisfactory sensitivity in identifying CTDs in the multi-ethnic Asian population.
在新加坡的多民族亚洲人群中，跨文化适应结缔组织疾病（CTD）筛查问卷（CSQ）。
一个由认可的风湿病专家组成的专家小组评估了原始 CSQ 的内容效度。研究了新从初级保健转诊到风湿病专家门诊进行可能的 CTD 评估的参与者。对讲英语的参与者进行了使用原始 CSQ 的认知剖析访谈（CDI），并根据他们的意见进行了修改，并与第二个专家小组（风湿病专家和 CSQ 开发人员）进行了讨论。对改编后的英文版的正向和反向翻译由第二个专家小组进行了审查。共同产生的通用翻译在讲中文的参与者的 CDI 中进行了测试。改编后的英文和中文版本在新转诊患者的单独一组中进行了试点测试。
原始 CSQ 的内容效度得到了专家小组的确认。总共招募了 30 名和 15 名参与者分别进行英语和中文 CDI。改编后的英语 CSQ 中添加了困难医学术语的替代术语和说明性注释。对一个困难项目添加了进一步的说明性注释，而中文版本保留了英文医学术语。对 116 名参与者进行了改编 CSQ 的试点测试，其在识别 CTD 方面的总体敏感性和特异性分别为 71%和 58%。
改编后的 CSQ 在试点测试中表现出令人满意的敏感性，似乎是一种很有前途的工具，可以促进在多民族亚洲人群中早期识别 CTD。
• 鉴于 CTD 患者的疾病负担高且“机会窗口”较短，因此早期识别和管理 CTD 患者至关重要。
• 原始 CSQ 及其跨文化适应版本具有较高的可靠性和有效性，但 CSQ 尚未在东南亚得到验证，在东南亚，与其他国家相比，CTD 与更高的发病率和死亡率相关。
• 我们跨文化适应的 CSQ 在识别多民族亚洲人群中的 CTD 方面表现出令人满意的敏感性。
