title: Cross-Cultural and Construct Validity of the Animated Activity Questionnaire.
abstract: The Animated Activity Questionnaire (AAQ) assesses activity limitations in patients with hip/knee osteoarthritis and consists of video animations; the patients choose the animation that best matches their own performance. The AAQ has shown good validity and reliability. This study aims to evaluate cross-cultural and construct validity of the AAQ.
  
  
  
  Cross-cultural validity was assessed using ordinal logistic regression analysis to evaluate differential item functioning (DIF) across 7 languages. Construct validity was assessed by testing correlations between the AAQ and a patient-reported outcome measure (PROM) and performance-based tests.
  
  
  
  Data from 1,239 patients were available. Compared to the Dutch language (n = 279), none of the 17 items showed DIF in English (n = 202) or French (n = 193), 1 item showed uniform DIF in Spanish (n = 99) and Norwegian (n = 62), and 2 items showed uniform DIF in Danish (n = 201). In all these languages, the occurrence of DIF did not influence the total score, which remained comparable with the original Dutch version. For Italian (n = 203) versus Dutch, however, 6 items showed uniform DIF, and 1 item showed nonuniform DIF, indicating some problems with the cross-cultural validity between these countries. With regard to construct validity, the correlations with PROM (0.74) and performance-based tests (0.36-0.68) were partly as expected (>0.60).
  
  
  
  The AAQ, an innovative tool to measure activity limitations that can be placed on the continuum between PROMs and performance-based tests, showed a good overall cross-cultural validity, and seems to have great potential for international use in research and daily clinical practice in many European countries.
authors.affiliation: EMGO Institute for Health and Care Research, VU University Medical Center, and the Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands.
authors.forename: Wilfred F
authors.initials: WF
authors.lastname: Peter
authors.affiliation: EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Henrika C W
authors.initials: HCW
authors.lastname: de Vet
authors.affiliation: Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Maarten
authors.initials: M
authors.lastname: Boers
authors.affiliation: MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Jaap
authors.initials: J
authors.lastname: Harlaar
authors.affiliation: Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands.
authors.forename: Leo D
authors.initials: LD
authors.lastname: Roorda
authors.affiliation: Joint Research, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Rudolf W
authors.initials: RW
authors.lastname: Poolman
authors.affiliation: Joint Research, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Vanessa A B
authors.initials: VAB
authors.lastname: Scholtes
authors.affiliation: Glasgow Caledonian University, School of Health and Life Sciences, Glasgow, UK.
authors.forename: Martijn
authors.initials: M
authors.lastname: Steultjens
authors.affiliation: Glasgow Caledonian University, School of Health and Life Sciences, Glasgow, UK.
authors.forename: Gordon J
authors.initials: GJ
authors.lastname: Hendry
authors.affiliation: Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
authors.forename: Ewa M
authors.initials: EM
authors.lastname: Roos
authors.affiliation: University of Lorraine, EA 4360 APEMAC, Inserm CIC-EC 1433, University Hospital, Nancy, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Guillemin
authors.affiliation: Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Benedetti
authors.affiliation: Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Cavazzuti
authors.affiliation: Basurto University Hospital, Bizkaia, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Escobar
authors.affiliation: Diakonhjemmet Hospital, Oslo, Norway.
authors.forename: Hanne
authors.initials: H
authors.lastname: Dagfinrud
authors.affiliation: EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Caroline B
authors.initials: CB
authors.lastname: Terwee
mesh_terms: D000368:Aged; D003431:Cross-Cultural Comparison; D004185:Disability Evaluation; D005060:Europe; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000175:diagnosis* / Q000208:ethnology; D020370:Osteoarthritis, Knee / Q000175:diagnosis* / Q000208:ethnology; D000071066:Patient Reported Outcome Measures; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*; D014177:Translations