Systematic review of shoulder function questionnaires: Comment on the article by Roy et al
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.
- 1 Measuring shoulder function: a systematic review of four questionnaires. Arthritis Rheum 2009; 61: 623–32., , .
- 2 Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol 1993; 46: 1417–32., , .
- 3 Choosing an outcome measure. J Bone Joint Surg Br 2001; 83: 792–4..
- 4 The Disabilities of Arm, Shoulder, and Hand outcome questionnaire: reliability and validity of the Swedish version evaluated in 176 patients. Acta Orthop Scand 2000; 71: 613–8., , , , .
- 5 The DASH (Disability of Arm-Shoulder-Hand) questionnaire: a new instrument for evaluating upper extremity treatment outcome. Handchir Mikrochir Plast Chir 1999; 31: 149–52. In German., , .
- 6 Health-related quality of life in patients with myasthenia gravis and the relationship between patient-oriented assessment and conventional measurements. Neurol Sci 2001; 22: 363–9., , , , , , et al.
- 7 The Italian version of the Oxford 12-item Knee Questionnaire: cross-cultural adaptation and validation. Int Orthop 2003; 27: 214–6., , , , , .
- 8 Italian version of the Disability of the Arm, Shoulder and Hand (DASH) questionnaire: cross-cultural adaptation and validation. J Hand Surg Br 2003; 28: 179–86., , , , , , et al.
- 9 Italian version of the Roland Disability Questionnaire, specific for low back pain: cross-cultural adaptation and validation. Eur Spine J 2002; 11: 126–9., , , , , , et al.
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.