Translation, Cross-Cultural Adaptation, and Validation of the Persian Version of the Harris Hip Score

Ghazal Hashemi Zenooz; Afshin Taheriazam; Zahra Mosallanezhad; Charles Philip Gabel; Markus Melloh; Hamid Reza Mokhtarinia

doi:10.1016/j.artd.2024.101384

Translation, Cross-Cultural Adaptation, and Validation of the Persian Version of the Harris Hip Score

Arthroplast Today. 2024 Apr 27:27:101384. doi: 10.1016/j.artd.2024.101384. eCollection 2024 Jun.

Authors

Ghazal Hashemi Zenooz¹, Afshin Taheriazam^{2

3}, Zahra Mosallanezhad¹, Charles Philip Gabel⁴, Markus Melloh⁵, Hamid Reza Mokhtarinia⁶

Affiliations

¹ Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
² Department of Orthopedics, Faculty of medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
³ Farhikhtegan Medical Convergence Sciences Research Center, Farhikhtegan Hospital Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
⁴ Access Physiotherapy, Coolum Beach, Sunshine Coast, QLD, Australia.
⁵ Queensland University of Technology, School of Public Health and Social Work, Brisbane, Australia.
⁶ Department of Ergonomics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

Abstract

Background: The Harris hip score (HHS), a self-administered questionnaire, is widely used to evaluate hip pathology affecting health-related quality of life and physical function. This study's purpose was HHS translation to Persian (HHS-Pr) and validation in patients with different hip pathologies.

Methods: Translation and cultural adaptation followed existing guidelines. Hip pathology patients (n = 151) completed the HHS, 12-Item Health Survey, and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Criterion validity was determined from comparisons between the HHS measures and the different corresponding WOMAC domains. Internal consistency used Cronbach's alpha (α), content validity the "content validity index," and floor/ceiling effect the end-range 15%. Test-retest reliability used the intraclass correlation coefficient (subsample n = 30) at 3-7 days that compared baseline with a repeated measure. Measurement precision and change sensitivity used longitudinal assessment (subgroup n = 30) from the standard error of the measurement and minimal detectable change.

Results: Cross-cultural adaptation required minor wording changes. The mean HHS-Pr was 57.77 ± 19.69. Criterion validity was significant with the WOMAC (r = -0.76) and 12-Item Health Survey Physical Component Summary (r = 0.47). Internal consistency was high before (α = 0.75) and after standardization (α = 0.86). Content validity was satisfactory (content validity index = 0.88). No floor/ceiling effects were found. Test-retest reliability (intraclass correlation coefficient = 0.85) was excellent, as was standard error of the measurement (raw score = 5.8) and minimal detectable change (raw score = 11.4).

Conclusions: The HHS-Pr demonstrated adequate validity, reliability, and sensitivity to change. These psychometric properties sufficiently measure functional status in patients with hip pathologies in a Persian-speaking population.

Keywords: Arthroplasty; Health status; Osteoarthritis; Persian; Validation.