Asian Spine J.  2017 Aug;11(4):586-593. 10.4184/asj.2017.11.4.586.

Validation of the Iranian Version of the ECOS-16 Questionnaire in Patients with Osteoporotic Vertebral Fractures

Affiliations
  • 1Functional Neurosurgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. parisa.azimi@gmail.com
  • 2School of Medicine, Capital Medical University, Beijing, China.
  • 3Mental Health Research Group, Health Metrics Research Centre, Iranian Institute for Health Sciences Research, Academic Center for Education, Culture and Research, Tehran, Iran.

Abstract

STUDY DESIGN: Prospective clinical study. PURPOSE: To translate and validate the Quality of Life Questionnaire of the European Foundation for Osteoporosis (ECOS-16) in patients with osteoporotic vertebral fractures in Iran. OVERVIEW OF LITERATURE: It is important to assess the psychometric properties of instruments measuring patient-reported outcomes.
METHODS
The translation was performed using the backward-forward translation method. The final version was generated by consensus among the translators. Every woman who had a T-score of <−2.5 completed ECOS-16. Patients were divided into two study groups according to the World Health Organization's criteria: those with at least one vertebral fracture (surgery group) and those with no fractures (control group). They were asked to respond to the questionnaire at three points in time: preoperative and twice within 1-week interval after surgery assessments (6-month follow-up). The 36-item short-form health survey (SF-36) also was completed. The psychometric properties of the questionnaire were assessed using internal consistency, test-retest reliability, convergent validity, discriminant validity, and responsiveness.
RESULTS
Of 137 recruited women, 39 underwent surgery and 98 did not. Analysis of the ECOS-16 scales showed an appropriate reliability with Cronbach's alpha of >0.70 for all scales. Test-retest reliability as indicated by intraclass correlation coefficient was found to be 0.85 (0.68-0.91). Additionally, the correlation of each item with its hypothesized domain of the ECOS-16 showed acceptable results, suggesting that the items had a substantial relationship with their own domains. Further analysis also indicated that the questionnaire was responsive to change (effect size, 0.85; standardized response mean, 0.93) (p<0.001). Significant correlations existed between scores of similar subscales of ECOS-16 and SF-36 (p<0.001).
CONCLUSIONS
ECOS-16 is an acceptable, reliable, valid, and responsive measure to assess the quality of life in patients with osteoporotic vertebral fractures.

Keyword

Iran; ECOS-16; Validity; Osteoporosis

MeSH Terms

Clinical Study
Consensus
Female
Global Health
Health Surveys
Humans
Iran
Methods
Osteoporosis
Prospective Studies
Psychometrics
Quality of Life
Reproducibility of Results
Weights and Measures
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