title: The burden of osteoarthritis: development and validation of a new assessment tool (BONe'S).
abstract: OBJECTIVE
  To develop and validate a specific individual burden questionnaire, BONe'S (Burden of Osteoarthritis New Scale), assessing osteoarthritis (OA) patients in the broadest sense.
  
  
  METHODS
  Items included in BONe'S were identified by literature review, and patient/healthcare practitioner interviews, and refined via item reduction and exploratory factor analysis (EFA). Internal consistency was calculated using Cronbach's α; concurrent validity was assessed by calculating the correlation between BONe'S and the Short Form (SF)-12 Health Survey and Psychological General Well-Being Index (PGWBI). Discriminant validity was analyzed by age, gender and number of OA locations.
  
  
  RESULTS
  From an initial list of 56 items, the final BONe'S questionnaire consisted of 20 questions (5 dimensions) based on EFA. BONe'S was evaluated in patients with OA (n = 200; mean age 69.4 ± 7.0 years, 86% of patients aged >60 years, 91.5% women). BONe'S demonstrated excellent internal coherence (Cronbach's α: 0.86). Individual BONe'S dimensions correlated well with the overall BONe'S score (highest: 'Independence' [r = 0.91]; lowest: 'Hygiene & Beauty' [r = 0.56]), and to each other dimension, and also correlated well (inversely) with the SF-12 and, to a slightly lesser extent, the PGWBI. The only exception was 'Budget', but this dimension was important and relevant in the subpopulation of active OA patients (r = 0.40). The mean BONe'S score for subjects with one or two affected joints was significantly lower than for subjects with three or more affected joints. The BONe'S score also differed according to gender and age. The original French BONe'S has also been adapted (linguistically and culturally) to English, Russian and Portuguese. Limitations include the fact that BONe'S was developed in a predominantly female population, in patients receiving a pharmacological intervention, has not been evaluated in a large population and has not been compared with other OA tools, including WOMAC, Lequesne and KOOS.
  
  
  CONCLUSIONS
  The BONe'S questionnaire is a short (20-item) validated tool for evaluating the specific individual burden of OA in a holistic manner.
authors.affiliation: Service de Rééducation, Pôle Ostéo-Articulaire , C.H.U. Cochin, Paris , France.
authors.forename: François
authors.initials: F
authors.lastname: Rannou
authors.forename: Philippe
authors.initials: P
authors.lastname: Bertin
authors.forename: Laurent
authors.initials: L
authors.lastname: Grange
authors.forename: Sébastien
authors.initials: S
authors.lastname: Branchoux
authors.forename: Jean-Noël
authors.initials: JN
authors.lastname: Dachicourt
authors.forename: Charles
authors.initials: C
authors.lastname: Taieb
mesh_terms: D000368:Aged; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000191:economics* / Q000523:psychology; D011594:Psychometrics; D011795:Surveys and Questionnaires