title: Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index.
abstract: OBJECTIVE
  To evaluate the acceptability, reliability, validity and responsiveness of the Turkish version of Western Ontario and McMaster Universities (WOMAC) osteoarthritis (OA) index in physiotherapy outpatient practice in Turkey.
  
  
  METHODS
  Data were obtained from 72 patients with OA of the knee. They were asked to answer two disease-specific questionnaires (WOMAC LK 3.1 and Lequesne-Algofunctional Index of Severity for the knee) and one generic instrument (Medical Outcomes study SF-36 Survey-SF-36). Acceptability was assessed in terms of refusal rate, rates of missing responses, and administration time. Reliability was assessed using Cronbach's alpha. Content validity was assessed by examining the floor and ceiling effects, and skew of the distributions. Convergent and divergent validity was assessed by examining the Pearson's correlation coefficients. Responsiveness was determined by examining effect size (ES), standardized response means (SRM) and P values generated using Wilcoxon's test.
  
  
  RESULTS
  The overall response rate was 100%. Alpha values for all WOMAC subscales exceeded the value of 0.70 at both baseline and follow-up assessments. Frequency distributions of scores were symmetrical. Subscales had negligible floor and ceiling effects. Both pain and physical function subscales were fairly correlated with the subscales measuring similar constructs of SF-36, whereas they were weakly correlated with other dimensions of SF-36. A good correlation was obtained between WOMAC total and Lequesne index. The pain and physical function subscales of WOMAC index were the most responsive subscales.
  
  
  CONCLUSIONS
  The Turkish WOMAC OA index is acceptable, valid, reliable and responsive for use in Turkish patients with knee OA.
authors.affiliation: Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Başkent University, Ankara, Turkey. htuzun@baskent.edu.tr
authors.forename: E H
authors.initials: EH
authors.lastname: Tüzün
authors.forename: L
authors.initials: L
authors.lastname: Eker
authors.forename: A
authors.initials: A
authors.lastname: Aytar
authors.forename: A
authors.initials: A
authors.lastname: Daşkapan
authors.forename: M
authors.initials: M
authors.lastname: Bayramoğlu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003431:Cross-Cultural Comparison; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000523:psychology / Q000534:rehabilitation*; D010147:Pain Measurement / Q000379:methods; D010342:Patient Acceptance of Health Care; D026741:Physical Therapy Modalities; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014421:Turkey