Systematic review of shoulder function questionnaires: Comment on the article by Roy et al

Authors

  • Roberto Padua MD,

    1. Don Gnocchi Foundation and GLOBE, Evidence-Based Orthopedics Working Group of Italian Society of Orthopedics and Traumatology, Rome, Italy, Nicola's Foundation, Arezzo, Italy
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  • Alex Castagna MD,

    1. GLOBE, Evidence-Based Orthopedics Working Group of Italian Society of Orthopedics and Traumatology, Rome, Italy, Instituto Clinico Humanitas, Milan, Italy
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  • Federica Alviti MD,

    1. GLOBE, Evidence-Based Orthopedics Working Group of Italian Society of Orthopedics and Traumatology and Sapienza University of Rome, Rome, Italy
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  • Luca Padua MD

    1. Don Gnocchi Foundation and Neurology Institute, Catholic University, Rome, Italy
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Systematic Review of Shoulder Function Questionnaires: Comment on the Article by Roy et al

To the Editors:

We read with great interest the systematic review of four shoulder function questionnaires by Roy et al, recently published in Arthritis Care & Research (1). We appreciated the effective study design and the simple and clear exposure. We would like to comment on the use of questionnaires in clinical research. The “ideal” questionnaire, as described by Roy et al, must be validated by an extensive process, which includes tests for reliability, sensitivity, and responsiveness (2, 3). However, there are 2 other characteristics that are fundamental for using questionnaires in clinical research. First, the questionnaire must be submitted to a cross-cultural validation process in order to have a version that fits the language and culture of the studied population. To use a questionnaire from different language groups and in different cultural settings, the questionnaire must not only be translated into the new language, but also be adapted to the local culture. The cross-cultural adaptation guidelines described by Guillemin et al are widely accepted and used for the translation and adaptation of questionnaires (2, 4–6). We used these guidelines for the cross-cultural adaptation and validation of the Italian version of some questionnaires (6–9). In their study, Roy et al report that the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire has been translated into 16 different languages. This characteristic must be emphasized so clinicians can choose the correct questionnaire for their own clinical research.

Second, the questionnaire should be widely used in the literature. If, in scientific literature, the researchers use only 1 questionnaire, the data extraction for secondary publication may be possible. This fact, in our opinion, is very important for providing potentially useful information for therapeutic recommendations.

Roberto Padua MD*, Alex Castagna MD†, Federica Alviti MD‡, Luca Padua MD§, * Don Gnocchi Foundation and GLOBE, Evidence-Based Orthopedics Working Group of Italian Society of Orthopedics and Traumatology, Rome, Italy, Nicola's Foundation, Arezzo, Italy, † GLOBE, Evidence-Based Orthopedics Working Group of Italian Society of Orthopedics and Traumatology, Rome, Italy, Instituto Clinico Humanitas, Milan, Italy, ‡ GLOBE, Evidence-Based Orthopedics Working Group of Italian Society of Orthopedics and Traumatology and Sapienza University of Rome, Rome, Italy, § Don Gnocchi Foundation and Neurology Institute, Catholic University, Rome, Italy.

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