title: Validation and clinical relevance of a French-Canadian version of the spinal appearance questionnaire in adolescent patients.
abstract: METHODS
  Prospective validation study of a crosscultural adaptation of the Spinal Appearance Questionnaire (SAQ).
  
  
  OBJECTIVE
  To provide a French-Canadian version of the SAQ.
  
  
  BACKGROUND
  The SAQ is widely used for the assessment of appearance in adolescent idiopathic scoliosis patients.
  
  
  METHODS
  French translation/back-translation of the Spinal Appearance Questionnaire-French version (SAQ-fv) was done by an expert committee. Its reliability was measured using the intradomain correlation coefficient, concurrent validity by using the Scoliosis Research Society (SRS) Outcomes Questionnaire, and discriminant validity using analysis of variance, on 182 consecutive patients attending a scoliosis clinic.
  
  
  RESULTS
  Intradomain correlations were weak to excellent (ρ = 0.34-0.76, P < 0.01), indicating that the scales' items demonstrated a satisfactory internal coherence. Scores comparison between SAQ-fv items and SRS Outcomes Questionnaire domains showed weak to moderate correlations (ρ = 0.35-0.53, P < 0.01) for the self-image domain, as expected in this test of convergent validity. A clear gradient in SAQ-fv scores according to Cobb angles was found in every domain, and patients' perception of their rib prominence was significantly related to the rib hump measurement, showing good discriminant validity. Body mass index, age, Risser, and gender did not influence the questionnaire scores. Preoperative patients' and parents' scores were significantly more affected when compared with other groups (observation, braced, and postoperative). Distribution of scores in the first section of the questionnaire shows a positive skew toward the wellbeing end of the response scales. However, the other section shows an inversed bell-shape distribution.
  
  
  CONCLUSIONS
  The SAQ-fv showed satisfactory reliability and validity in French-Canadian adolescents with different severity of idiopathic scoliosis. Spinal deformity appearance evaluation using this tool was found to be independent of patient's general characteristics. In addition, the SAQ-fv is able to discriminate between relevant clinical values, thus providing useful information for the clinical management of adolescent idiopathic scoliosis patients.
authors.affiliation: Research Center, Sainte-Justine University Hospital Center, Montréal, QC, Canada.
authors.forename: Marjolaine
authors.initials: M
authors.lastname: Roy-Beaudry
authors.forename: Marie
authors.initials: M
authors.lastname: Beauséjour
authors.forename: Julie
authors.initials: J
authors.lastname: Joncas
authors.forename: Martin
authors.initials: M
authors.lastname: Forcier
authors.forename: Sara
authors.initials: S
authors.lastname: Bekhiche
authors.forename: Hubert
authors.initials: H
authors.lastname: Labelle
authors.forename: Guy
authors.initials: G
authors.lastname: Grimard
authors.forename: Stefan
authors.initials: S
authors.lastname: Parent
mesh_terms: D000293:Adolescent; D002170:Canada; D005602:France; D006801:Humans; D007802:Language; D015203:Reproducibility of Results; D012600:Scoliosis / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards*; D014175:Translating