Chinese cross-culturally adapted patient-reported outcome measures (PROMs) for knee disorders: a systematic review and assessment using the Evaluating the Measurement of Patient-Reported Outcomes (EMPRO) instrument

• Published in: Journal of orthopaedic surgery and research Vol. 17; no. 1; p. 508
• Main Authors: Ngwayi, James Reeves Mbori, Obie, Kenedy Uzoma, Tan, Jie, Xu, JianBiao, Alizada, Mujahid, Porter, Daniel Edward
• Format: Journal Article
• Language: English
• Published: England BioMed Central 24.11.2022; BMC
• Subjects: Adaptation; Chinese languages; Clinical outcomes; Cross-cultural adaptation; Culture; Designers; EMPRO; Humans; Joint replacement surgery; Knee; Knee PROMs; Language; Measurement properties; Meniscus; Orthopedics; Osteoarthritis; Patient Reported Outcome Measures; Quality of Life; Quantitative psychology; Reproducibility of Results; Surveys and Questionnaires; Systematic Review; Validity; United States > US; China; Cross-cultural adaptation; EMPRO; Knee PROMs; Measurement properties
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-022-03399-5

Knee patient-reported outcome measures (PROMs) are widely used in research in China, but there is limited evidence on the quality of cross-culturally adapted and original Chinese PROMs. We investigated Chinese language knee PROMs to provide evidence for clinicians on their quality and to guide PROM choices. A systematic literature search of databases: PUBMED, CINAHL, EMBASE, and CNKI, using adequate search strings and a three-step screen process identified relevant studies. An independent standardized assessment of the selected studies based on the Evaluating the Measurement of Patient-Reported Outcomes (EMPRO) tool was performed. Inter-rater reliability was assessed using intraclass coefficients (ICC). Thirty-three articles corresponding to 23 knee PROMs were evaluated with EMPRO global scores (100) ranging from 11.11 to 55.42. The attributes 'reliability,' 'validity,' and 'cultural and language adaptation' were significantly better evaluated compared to the attributes 'responsiveness,' 'interpretability,' and 'burden' (for all comparisons p < 0.0001). Moderate-to-excellent inter-rater agreement was observed with ICC values ranging from 0.538 to 0.934. We identified six PROMs with a minimum acceptable threshold (> 50/100). The osteoarthritis of knee and hip quality of life, the lower extremity function scale, and the Western Ontario Meniscal Evaluation tool ranked highest. Nevertheless, no single PROM had evidence encompassing all EMPRO attributes, necessitating further studies, especially on responsiveness, interpretability, and burden. We identified duplication of effort as shown by repeated translations of the same PROM; this inefficiency could be ameliorated by rapid approval of Chinese language PROMs documented on original PROM developers' platforms.