Translation, cross-cultural adaptation, and validation of a Chinese version of the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire.
METHODS
Translation and psychometric testing of a questionnaire.


OBJECTIVE
To adapt the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) cross-culturally to Chinese language and to investigate the psychometric properties of the translated Chinese JOACMEQ.


BACKGROUND
The recently developed JOACMEQ is a self-reported questionnaire used to assess the severity of the cervical spondylotic myelopathy. Despite its acceptance in the literature, the JOACMEQ has not been translated and validated for Chinese-speaking patients.


METHODS
Translation and cross-cultural adaptation of the original JOACMEQ was performed according to published guidelines. A total of 105 patients with a predominant complain of neck pain that included but not limited to patients with a clinically confirmed cervical spondylotic myelopathy were included. Psychometric testing of the responses included construct validity (factor analysis), internal consistency (Cronbach α), test-retest reproducibility (intraclass correlation coefficient), and concurrent validity (Spearman ρ). The discriminatory power of differentiating those with myelopathy from those without was assessed by the area under the receiver operating characteristic curve and with the optimal cutoff points determined.


RESULTS
Construct validity testing revealed a comparable factorial structure of the Chinese JOACMEQ with the original JOACMEQ. The Cronbach α of the Chinese JOACMEQ was 0.88, indicating good internal consistency. Good to excellent test-retest reliability was demonstrated for all 5 domain scores (intraclass correlation coefficient range = 0.79-0.90). A significant strong association between the Chinese Neck Disability Index and the quality of life domain of the Chinese JOACMEQ (Spearman ρ= -0.76, P < 0.01) was identified. The upper and lower extremity function domain scores were found to be significant, with the area under the receiver operating characteristic curve found to be 0.75 (P = 0.04) and 0.82 (P = 0.02), respectively.


CONCLUSIONS
The results indicated that the Chinese JOACMEQ successfully retained the psychometric properties of the original JOACMEQ and support the usefulness of the Chinese JOACMEQ as an appropriate supplementary diagnostic and outcome measure for Chinese patients suspected of cervical spondylotic myelopathy.
*Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan †School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan ‡Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; and §Department of Physical Therapy and Graduate Institute of Rehabilitation Science, Chang Gung University, Taoyuan, Taiwan.
Andy
A
Chien
Dar-Ming
DM
Lai
Chih-Hsiu
CH
Cheng
Shwu-Fen
SF
Wang
Wei-Li
WL
Hsu
Jaw-Lin
JL
Wang
D000328:Adult; D000368:Aged; D019540:Area Under Curve; D002574:Cervical Vertebrae; D002681:China; D003469:Culture; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology*; D010865:Pilot Projects; D011594:Psychometrics; D012372:ROC Curve; D015203:Reproducibility of Results; D057566:Self Report; D012720:Severity of Illness Index; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000209:etiology*; D055009:Spondylosis / Q000150:complications*; D011795:Surveys and Questionnaires; D063189:Symptom Assessment; D014175:Translating; D055815:Young Adult