Psychometric Properties of the Malay Language Version of Knee Injury and Osteoarthritis Outcome Score (KOOS) Questionnaire among Knee Osteoarthritis Patients: A Confirmatory Factor Analysis

M M Zulkifli, A A Kadir, A Elias, K C Bea, A N Sadagatullah, M M Zulkifli, A A Kadir, A Elias, K C Bea, A N Sadagatullah

Abstract

Introduction: This study aimed to cross-culturally adapt a Malay version of Knee Injury and Osteoarthritis Outcome Score (KOOS) and to evaluate its psychometric properties in patients with knee osteoarthritis (OA). Materials and Methods: The English version KOOS was translated into a Malay version using forward and backward translation process, followed by face validity and content validity. Two hundred and twenty-six knee OA patients attending the Outpatient and Orthopaedic Clinics, Universiti Sains Malaysia Hospital, completed the Malay version KOOS. Construct validity using confirmatory factor analysis and internal reliability assessment were performed. Results: The results showed that the original five-factor model with 42 items failed to achieve acceptable values of the goodness of fit indices, indicating poor model fit. A new five-factor model of 26 items demonstrated acceptable level of goodness of fit (comparative fit index= 0.929, incremental fit index= 0.930, Tucker Lewis fit index= 0.920, root mean square error of approximation= 0.073 and Chisquared/degree of freedom= 2.183) indices to signify a model fit. The Cronbach's alpha value for the new model ranged from 0.776 to 0.946. The composite reliability values of each construct ranged between 0.819 and 0.921, indicating satisfactory to high level of convergent validity. Conclusion: The five-factor model with 26 items in the Malay version of KOOS questionnaire demonstrated a good degree of goodness of fit and was found to be valid, reliable and simple as an assessment tool for symptoms, pain, activity of daily living, sports and recreational activity and quality of life for Malaysian adults suffering from knee osteoarthritis.

Keywords: KOOS; construct validity; knee-related quality of life; osteoarthritis.

References

    1. Rodriguez-Merchan EC. Knee instruments and rating scales designed to measure outcomes. J Orthop Trauma. 2012;13(1):1–6.
    1. Collins NJ, Misra D, Felson DT, Crossley KM, Roos EM. Measures of knee function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), Lysholm Knee Scoring Scale, Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS) Arthritis Care Res (Hoboken) 2011;63(11):S208–28.
    1. Roos EM, Lohmander LS. The Knee injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes. 2003;1:64.
    1. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15(12):1833–40.
    1. Roos EM, Toksvig-Larsen S. Knee injury and Osteoarthritis Outcome Score (KOOS) — validation and comparison to the WOMAC in total knee replacement. Health Qual Life Outcomes. 2003;1:17.
    1. Salavati M, Mazaheri M, Negahban H, Sohani SM, Ebrahimian MR, Ebrahimi I et al. Validation of a Persian-version of Knee injury and Osteoarthritis Outcome Score (KOOS) in Iranians with knee injuries. Osteoarthritis Cartilage. 2008;16(10):1178–82.
    1. Xie F, Li SC, Roos EM, Fong KY, Lo NN, Yeo SJ et al. Cross-cultural adaptation and validation of Singapore English and Chinese versions of the Knee injury and Osteoarthritis Outcome Score (KOOS) in Asians with knee osteoarthritis in Singapore. Osteoarthritis Cartilage. 2006;14(11):1098–103.
    1. Goncalves RS, Cabri J, Pinheiro JP, Ferreira PL. Cross-cultural adaptation and validation of the Portuguese version of the Knee injury and Osteoarthritis Outcome Score (KOOS) Osteoarthritis Cartilage. 2009;17(9):1156–62.
    1. Brown TA. New York: The Guilford Press; 2006. Confirmatory factor analysis for applied research.
    1. Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum. 1986;29(8):1039–49.
    1. Hair JF, Black WC, Babin BJ, Anderson RE, Tatham RL. New Jersey: Pearson Prentice Hall; 2010. Multivariate Data Analysis. 7th ed.
    1. Roos EM, Roos HP, Ekdahl C, Lohmander LS. Knee injury and Osteoarthritis Outcome Score (KOOS)--validation of a Swedish version. Scand J Med Sci Sports. 1998;8(6):439–48.
    1. Zainudin A. Malaysia: MPWS Rich Publication; 2015. SEM Made Simple, A Gentle Approach to Learning Structural Equation Modeling.
    1. Garver MS, Mentzer JT. Logistics research methods: employing structural equation modeling to test for construct validity. J Bus Logist. 1999;20(1):33.
    1. Gefen D, Straub DW, Rigdon EE. An update and extension to SEM guidelines for admnistrative and social science research. MIS Quarterly. 2011;35(2):iii–xiv.
    1. Van de Schoot R, Lugtig P, Hox J. A checklist for testing measurement invariance. Eur J Dev Psychol. 2012;9(4):486–92.
    1. Byrne BM. New York: Taylor and Francis Group; 2010. Structural equation modeling with AMOS: Basic concepts, applications, and programming. 2nd ed.

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다