title: Reliability and Validity of the Adapted Turkish Version of the Early-onset Scoliosis-24-Item Questionnaire (EOSQ-24).
abstract: BACKGROUND
  Early-onset scoliosis (EOS) can have negative effects on the developing thorax, lungs, and quality of life in general. Children with EOS can face various health problems and require recurring hospitalization and surgeries. Radiographic parameters are insufficient to evaluate the severity and efficacy of treatment in EOS. Early-onset Scoliosis Questionnaire (EOSQ)-24 questionnaire is a new instrument developed for this specific age group. To date, reliability of this questionnaire has not yet been interrogated in wide patient groups from different cultures. The aim of this study was to evaluate the validity and reliability of culturally adapted Turkish version of the EOSQ-24.
  
  
  METHODS
  Forward translation and back translation of the English version of the EOSQ-24 was done, and all steps for cross-cultural adaptation process were performed properly by an expert committee. Turkish version of the EOSQ-24 and Child Health Questionnaire-Parent Form-50 (CHQ-PF-50) were applied to 61 (24 male, 37 female) EOS patients. The average age of these patients was 9.1 ± 3.1 years (0.4 to 14.3 y), and 50 of them had undergone surgical treatment. Data quality was assessed by mean, median, percentage of missing data, and extent of ceiling and floor effects. Reliability was assessed by internal consistency using Cronbach's α and item-total correlations. The construct validity was evaluated by comparing the results of the EOSQ-24 with the Turkish version of the CHQ-PF-50. Subgroup analyses were applied for sex, diagnosis, treated/untreated, mobilization ability, and complications.
  
  
  RESULTS
  The item response to the EOSQ-24 was high with a small number of missing answers (1.6% to 3.3%). Of the 24 items, 22 were evenly distributed. This resulted in a floor effect in 0% to 21.7% of patients, and a ceiling effect in 1.6% to 68.3%. The calculated Cronbach's α for the 24-item scale was 0.909, indicating excellent reliability. Construct validity showed that high correlations between the EOSQ and the CHQ by means of similar domains. Correlation coefficient was between 0.348 and 0.688 (P=0.0001). Subgroup analyses also showed significant difference in treated/untreated patients (P=0.032) and mobilization ability (P=0.001).
  
  
  CONCLUSIONS
  The Turkish adaptation of the EOSQ-24 exhibits favorable psychometric properties and excellent reliability, validating its use in this population.
authors.affiliation: *Department of Orthopaedics and Traumatology, Faculty of Medicine †Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University ‡Department of Biostatistics, Faculty of Medicine, Ankara University, Ankara, Turkey §Department of Orthopaedic Surgery, Columbia University, New York, NY.
authors.forename: Halil G
authors.initials: HG
authors.lastname: Demirkiran
authors.forename: Gizem I
authors.initials: GI
authors.lastname: Kinikli
authors.forename: Zeynep D
authors.initials: ZD
authors.lastname: Olgun
authors.forename: Saygin
authors.initials: S
authors.lastname: Kamaci
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Yavuz
authors.forename: Michael G
authors.initials: MG
authors.lastname: Vitale
authors.forename: Muharrem
authors.initials: M
authors.lastname: Yazici
mesh_terms: D017668:Age of Onset; D002648:Child; D002657:Child Development; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods; D011594:Psychometrics / Q000379:methods / Q000592:standards; D011788:Quality of Life; D015203:Reproducibility of Results; D012600:Scoliosis / Q000453:epidemiology / Q000523:psychology / Q000601:surgery; D011795:Surveys and Questionnaires; D014177:Translations; D014421:Turkey / Q000453:epidemiology