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Turkish Validation of the HOOS-12

17. srpna 2026 aktualizováno: Nazli Cigercioglu, Hacettepe University

Turkish Cross-cultural Adaptation, Validity, Reliability, and Responsiveness of the Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12) in Patients With Hip Osteoarthritis

The Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12) is a short patient-reported outcome measure developed to assess pain, function, and hip-related quality of life in individuals with hip osteoarthritis. Although widely used internationally, a validated Turkish version is currently unavailable. This study aims to translate and culturally adapt the HOOS-12 into Turkish and evaluate its psychometric properties, including internal consistency, test-retest reliability, construct validity, structural validity, responsiveness, and measurement error, in Turkish-speaking patients with hip osteoarthritis.

Přehled studie

Postavení

Zatím nenabíráme

Detailní popis

## Detailed Description

Hip osteoarthritis (HOA) is one of the leading causes of pain, disability, and reduced health-related quality of life among older adults worldwide. Patient-reported outcome measures (PROMs) are essential for evaluating symptoms, functional limitations, treatment effectiveness, and patient-centered outcomes in both clinical practice and research. The Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12) is a concise, multidimensional PROM developed to assess pain, physical function, and hip-related quality of life while substantially reducing respondent burden compared with the original HOOS questionnaire.

Although the HOOS-12 has been validated in several languages and populations, no culturally adapted and psychometrically validated Turkish version is currently available. The absence of a validated Turkish HOOS-12 limits its use in clinical practice, multicenter studies, and international research involving Turkish-speaking patients with hip osteoarthritis. Therefore, a rigorous cross-cultural adaptation and psychometric evaluation is required before the instrument can be recommended for clinical and research applications in Türkiye.

The primary objective of this study is to translate and culturally adapt the HOOS-12 into Turkish and to evaluate its psychometric properties in patients with hip osteoarthritis who are scheduled to undergo primary total hip arthroplasty. The translation and cross-cultural adaptation process will be conducted in accordance with internationally accepted guidelines for patient-reported outcome measures, including forward translation, synthesis, backward translation, expert committee review, and pilot testing to ensure semantic, idiomatic, experiential, and conceptual equivalence between the original and Turkish versions.

Following the adaptation process, the psychometric performance of the Turkish HOOS-12 will be evaluated according to the COSMIN recommendations. Internal consistency will be assessed using Cronbach's alpha, while test-retest reliability will be examined using the intraclass correlation coefficient (ICC) in clinically stable participants who complete the questionnaire twice before surgery without any therapeutic intervention between assessments. Measurement error will be determined by calculating the standard error of measurement (SEM) and the minimal detectable change (MDC). Structural validity will be evaluated using confirmatory factor analysis (CFA). Construct validity will be examined by testing predefined hypotheses regarding the relationships between the Turkish HOOS-12 and the Short Form-12 Health Survey (SF-12). Floor and ceiling effects will also be investigated.

To determine responsiveness, participants will complete the Turkish HOOS-12 and SF-12 before surgery and again three months after primary total hip arthroplasty. Changes in questionnaire scores over time will be analyzed to evaluate the instrument's ability to detect clinically meaningful improvement following surgical treatment.

The results of this study are expected to provide a reliable, valid, and responsive Turkish version of the HOOS-12 for evaluating patient-reported outcomes in individuals with hip osteoarthritis. The availability of this instrument will facilitate standardized outcome assessment in routine clinical practice, clinical trials, and multicenter research involving Turkish-speaking populations.

Typ studie

Pozorovací

Zápis (Odhadovaný)

150

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní kontakt

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

  • Dospělý
  • Starší dospělý

Přijímá zdravé dobrovolníky

N/A

Metoda odběru vzorků

Vzorek nepravděpodobnosti

Studijní populace

The study population will consist of Turkish-speaking adults diagnosed with primary hip osteoarthritis who are scheduled to undergo primary total hip arthroplasty at the Department of Orthopedics and Traumatology. Eligible participants will be recruited consecutively during routine preoperative outpatient visits. Participants will complete the Turkish version of the Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12) and the Short Form-12 Health Survey (SF-12) before surgery. A subgroup of clinically stable participants will complete the HOOS-12 again seven days after the initial assessment to evaluate test-retest reliability. All participants will be reassessed three months after surgery to evaluate the responsiveness of the Turkish HOOS-12.

Popis

Inclusion Criteria:

  • Age 18 years or older.
  • Native Turkish speaker or able to read and understand Turkish fluently.
  • Diagnosed with primary hip osteoarthritis based on clinical and radiographic evaluation.
  • Scheduled to undergo primary total hip arthroplasty.
  • Able to complete the study questionnaires independently or with standardized assistance.
  • Clinically stable during the test-retest period.
  • Willing to participate in the study and provide written informed consent.

Exclusion Criteria:

  • Previous total hip arthroplasty on the affected side.
  • Scheduled for revision hip arthroplasty.
  • Hip arthroplasty indicated for conditions other than primary hip osteoarthritis, including hip fracture, inflammatory arthritis, avascular necrosis, congenital hip disorders, or malignancy.
  • History of major lower-extremity surgery within the previous six months.
  • Neurological or neuromuscular disorders that may substantially affect mobility or lower-extremity function.
  • Severe cognitive impairment, psychiatric disorder, or communication difficulty that prevents reliable questionnaire completion.
  • Severe visual or hearing impairment that prevents completion of the assessment procedures.
  • Presence of another acute musculoskeletal condition that substantially affects pain or physical function.
  • Any therapeutic intervention, significant change in medication, acute clinical deterioration, or surgery occurring between the baseline and test-retest assessments.
  • Incomplete questionnaire data or inability to complete the planned follow-up assessments.

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

Kohorty a intervence

Skupina / kohorta
Intervence / Léčba
Patients with Hip Osteoarthritis
Adults with clinically and/or radiographically diagnosed hip osteoarthritis who are scheduled to undergo primary total hip arthroplasty. Participants will complete the Turkish version of the Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12) and the Short Form-12 Health Survey (SF-12) before surgery. A subset of clinically stable participants will complete the HOOS-12 again after 7 days for test-retest reliability assessment. Participants will also complete the HOOS-12 and SF-12 three months after surgery to evaluate responsiveness.
Participants will complete the Turkish version of the Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12) and the Short Form-12 Health Survey (SF-12) at predefined assessment time points. No therapeutic intervention will be assigned or administered as part of this observational study. Primary total hip arthroplasty will be performed as part of routine clinical care and will not be assigned by the investigators.

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Internal Consistency of the Turkish HOOS-12
Časové okno: Baseline
Internal consistency of the Turkish Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12) will be assessed using Cronbach's alpha coefficient. The HOOS-12 is a 12-item patient-reported outcome measure assessing hip-related pain, physical function, and hip-related quality of life. The HOOS-12 summary score ranges from 0 to 100, where 0 represents the worst possible hip-related health and 100 represents the best possible hip-related health. Higher scores indicate better hip-related health. Internal consistency will be evaluated using baseline data.
Baseline
Test-Retest Reliability
Časové okno: Baseline and Day 7
Test-retest reliability of the Turkish Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12) will be assessed in clinically stable participants who complete the questionnaire at baseline and again on Day 7. The HOOS-12 summary score ranges from 0 to 100, where 0 represents the worst possible hip-related health and 100 represents the best possible hip-related health. Higher scores indicate better hip-related health. Test-retest reliability will be evaluated using the intraclass correlation coefficient (ICC). Participants with a substantial therapeutic intervention or clinically relevant change in their condition between the two assessments will not be included in the test-retest reliability analysis.
Baseline and Day 7
Construct Validity With SF-12 Physical Component Summary
Časové okno: Baseline
Construct validity of the Turkish Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12) will be evaluated by examining the correlation between the HOOS-12 summary score and the Physical Component Summary (PCS) score of the 12-Item Short Form Health Survey (SF-12), according to a predefined hypothesis. Higher scores on both measures indicate better health status.
Baseline
Construct Validity With SF-12 Mental Component Summary
Časové okno: Baseline
Construct validity of the Turkish Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12) will be evaluated by examining the correlation between the HOOS-12 summary score and the Mental Component Summary (MCS) score of the 12-Item Short Form Health Survey (SF-12), according to a predefined hypothesis. Higher scores on both measures indicate better health status.
Baseline
Structural Validity
Časové okno: Baseline
Structural validity of the Turkish Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12) will be evaluated using confirmatory factor analysis (CFA). The HOOS-12 consists of 12 items assessing hip-related pain, physical function, and quality of life. The HOOS-12 summary score ranges from 0 to 100, where 0 represents the worst possible hip-related health and 100 represents the best possible hip-related health. Higher scores indicate better hip-related health. Model fit will be evaluated using the Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), Root Mean Square Error of Approximation (RMSEA), and Standardized Root Mean Square Residual (SRMR). CFI, TLI, RMSEA, and SRMR will be interpreted jointly as complementary model-fit indices to evaluate the overall fit of the prespecified measurement model rather than as separate outcome measures.
Baseline
Responsiveness
Časové okno: From baseline until primary total hip arthroplasty, assessed up to 12 months; responsiveness assessed 3 months after surgery.
Responsiveness will be evaluated in participants who undergo primary total hip arthroplasty within 12 months after baseline assessment. The Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12) will be administered before surgery and again 3 months after surgery. The HOOS-12 summary score ranges from 0 to 100, with higher scores indicating better hip-related health. Changes in scores will be used to evaluate the ability of the Turkish HOOS-12 to detect clinically meaningful change.
From baseline until primary total hip arthroplasty, assessed up to 12 months; responsiveness assessed 3 months after surgery.

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Standard Error of Measurement of the Turkish HOOS-12
Časové okno: Baseline and Day 7
Measurement error of the Turkish Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12) will be quantified using the Standard Error of Measurement (SEM), based on scores obtained from clinically stable participants at baseline and Day 7.
Baseline and Day 7
Minimal Detectable Change of the Turkish HOOS-12
Časové okno: Baseline and Day 7
The Minimal Detectable Change at the 95% confidence level (MDC95) of the Turkish Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12) will be calculated using scores obtained from clinically stable participants at baseline and Day 7.
Baseline and Day 7
Floor Effect of the Turkish HOOS-12
Časové okno: Baseline
The floor effect will be determined as the percentage of participants achieving the minimum possible HOOS-12 summary score of 0 at baseline.
Baseline
Ceiling Effect of the Turkish HOOS-12
Časové okno: Baseline
The ceiling effect will be determined as the percentage of participants achieving the maximum possible HOOS-12 summary score of 100 at baseline.
Baseline
Physical Health-Related Quality of Life
Časové okno: Baseline and Month 3
Physical health-related quality of life will be assessed using the Physical Component Summary (PCS) score of the 12-Item Short Form Health Survey (SF-12). Higher PCS scores indicate better physical health-related quality of life.
Baseline and Month 3
Mental Health-Related Quality of Life
Časové okno: Baseline and Month 3
Mental health-related quality of life will be assessed using the Mental Component Summary (MCS) score of the 12-Item Short Form Health Survey (SF-12). Higher MCS scores indicate better mental health-related quality of life.
Baseline and Month 3

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Odhadovaný)

1. září 2026

Primární dokončení (Odhadovaný)

1. září 2027

Dokončení studie (Odhadovaný)

1. prosince 2027

Termíny zápisu do studia

První předloženo

31. července 2026

První předloženo, které splnilo kritéria kontroly kvality

17. srpna 2026

První zveřejněno (Aktuální)

18. srpna 2026

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

18. srpna 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

17. srpna 2026

Naposledy ověřeno

1. srpna 2026

Více informací

Termíny související s touto studií

Další identifikační čísla studie

  • HOOS-12 Turkish
  • Selcuk University (Identifikátor registru: Selcuk University)

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

NE

Popis plánu IPD

Individual Participant Data (IPD) will not be shared.

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ne

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

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