Padovani Sara, Capuzzo Maurizia, Massari Leo, Caruso Gaetano, Arrigoni Paolo, Zaolino Carlo, Cucchi Davide, Valpiani Giorgia, Colozza Alessandra
Department of Orthopedics and Traumatology, Ospedale degli Infermi di Faenza, Faenza (RA), Italy.
Orthopedics and Traumatology Unit, Sant Anna University Hospital of Ferrara, Ferrara, Italy.
JSES Int. 2021 Feb 6;5(2):328-333. doi: 10.1016/j.jseint.2020.10.025. eCollection 2021 Mar.
The Oxford Elbow Score (OES) is an English-language questionnaire specifically designed to evaluate surgical elbow outcomes. This scoring system has been translated into other languages. Given the lack of an Italian version of the OES, the present study was designed to establish, culturally adapt, and validate the Italian version.
The OES questionnaire was culturally adapted to Italian patients in accordance with the literature guidelines with a pilot phase including seven patients with elbow problems and seven healthy subjects. The study includes 110 participants from three hospitals, who underwent elbow surgery for acute (70%) or chronic diseases. At least one month after elbow surgery, at the "index visit", the physician completed the Mayo Elbow Performance Index and patients completed the following questionnaires: the Italian OES, the shortened version of the Disability of Arm, Shoulder and Hand Questionnaire (DASH) and the Short-Form 36 Health Survey. Internal consistency was evaluated using Cronbach's alpha. Reproducibility was assessed using the intraclass correlation coefficient in ten patients who completed the OES again two-three days after the index visit. Construct validity was assessed using Spearman correlation coefficients. Responsiveness was evaluated in 68 patients who answered the questionnaires four months after the index visit, using the Wilcoxon signed-rank test, the effect size and the standardized response mean calculation.
Cronbach's alpha was excellent: 0.86 (0.82-0.90) for OES pain, 0.92 (0.90-0.94) for OES function, and 0.90 (0.87-0.93) for OES social/psychological. The intraclass correlation coefficient was 0.94 (0.78-0.98) for OES pain, 0.91 (0.71-0.97) for OES function, 0.95 (0.83-0.98) for OES social-psychological and 0.93 (0.76-0.98) for OES total. The Spearman ρ was >0.7 for OES pain and DASH, for OES function and both DASH and Mayo Elbow Performance Index, and for OES social-psychological and DASH. Regarding responsiveness, the mean of the changes between the two visits ranged from 33.9 for OES pain, to 44 points for OES function and OES social/psychological. The effect size and the standardized response mean were >0.8 for all OES domains.
This study demonstrates that the Italian version of the OES, translated in accordance with the international standardized guidelines, is reliable, valid, and responsive in patients who have undergone elbow surgery.
牛津肘关节评分（OES）是一份专门设计用于评估肘关节手术效果的英文问卷。该评分系统已被翻译成其他语言。鉴于缺乏意大利语版的OES，本研究旨在建立、进行文化适应性调整并验证意大利语版。
根据文献指南对OES问卷进行文化适应性调整，以适用于意大利患者，试点阶段包括7名有肘部问题的患者和7名健康受试者。该研究纳入了来自三家医院的110名参与者，他们因急性（70%）或慢性疾病接受了肘关节手术。在肘关节手术后至少一个月的“首次就诊”时，医生完成梅奥肘关节功能指数，患者完成以下问卷：意大利语版OES、手臂、肩部和手部功能障碍问卷（DASH）简版以及健康调查简表36。使用克朗巴哈系数评估内部一致性。在首次就诊后两到三天再次完成OES的10名患者中，使用组内相关系数评估再现性。使用斯皮尔曼相关系数评估结构效度。在首次就诊四个月后回答问卷的68名患者中，使用威尔科克森符号秩检验、效应量和标准化反应均值计算来评估反应度。
克朗巴哈系数非常好：OES疼痛维度为0.86（0.82 - 0.90），OES功能维度为0.92（0.90 - 0.94），OES社会/心理维度为0.90（0.87 - 0.93）。OES疼痛维度的组内相关系数为0.94（0.78 - 0.98），OES功能维度为0.91（0.71 - 0.97），OES社会 - 心理维度为0.95（0.83 - 0.98），OES总分维度为0.93（0.76 - 0.98）。OES疼痛与DASH、OES功能与DASH及梅奥肘关节功能指数、OES社会 - 心理与DASH之间的斯皮尔曼ρ>0.7。关于反应度，两次就诊之间变化的均值范围从OES疼痛的33.9到OES功能及OES社会/心理的44分。所有OES领域的效应量和标准化反应均值均>0.8。
本研究表明，按照国际标准化指南翻译的意大利语版OES在接受肘关节手术的患者中具有可靠性、有效性和反应度。
