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Validation and Clinical Relevance of a French-Canadian Version of the Spinal Appearance Questionnaire in Adolescent Patients

Roy-Beaudry, Marjolaine MSc*; Beauséjour, Marie MASc*,†; Joncas, Julie RN*; Forcier, Martin MSc*; Bekhiche, Sara*; Labelle, Hubert MD*,‡; Grimard, Guy MD*,‡; Parent, Stefan MD, PhD*,‡

doi: 10.1097/BRS.0b013e3181e040e7
Health Services Research

Study Design. Prospective validation study of a crosscultural adaptation of the Spinal Appearance Questionnaire (SAQ).

Objective. To provide a French-Canadian version of the SAQ.

Summary of Background Data. The SAQ is widely used for the assessment of appearance in adolescent idiopathic scoliosis patients.

Methods. French translation/back-translation of the Spinal Appearance Questionnaire-French version (SAQ-fv) was done by an expert committee. Its reliability was measured using the intradomain correlation coefficient, concurrent validity by using the Scoliosis Research Society (SRS) Outcomes Questionnaire, and discriminant validity using analysis of variance, on 182 consecutive patients attending a scoliosis clinic.

Results. Intradomain correlations were weak to excellent (ρ = 0.34–0.76, P < 0.01), indicating that the scales' items demonstrated a satisfactory internal coherence. Scores comparison between SAQ-fv items and SRS Outcomes Questionnaire domains showed weak to moderate correlations (ρ = 0.35–0.53, P < 0.01) for the self-image domain, as expected in this test of convergent validity. A clear gradient in SAQ-fv scores according to Cobb angles was found in every domain, and patients' perception of their rib prominence was significantly related to the rib hump measurement, showing good discriminant validity. Body mass index, age, Risser, and gender did not influence the questionnaire scores. Preoperative patients' and parents' scores were significantly more affected when compared with other groups (observation, braced, and postoperative). Distribution of scores in the first section of the questionnaire shows a positive skew toward the wellbeing end of the response scales. However, the other section shows an inversed bell-shape distribution.

Conclusion. The SAQ-fv showed satisfactory reliability and validity in French-Canadian adolescents with different severity of idiopathic scoliosis. Spinal deformity appearance evaluation using this tool was found to be independent of patient's general characteristics. In addition, the SAQ-fv is able to discriminate between relevant clinical values, thus providing useful information for the clinical management of adolescent idiopathic scoliosis patients.

The French version of the Spinal Appearance Questionnaire (SAQ) showed satisfactory reliability and validity in young French-Canadian patients with different levels of severity of idiopathic scoliosis. Spinal Appearance Questionnaire French version (SAQ-fv) is able to discriminate between clinical values and provides relevant information on spinal deformity appearance evaluation.

*Research Center, Sainte-Justine University Hospital Center, Montréal, QC, Canada

Institut de recherche en santé publique de l', Université de Montreal, Montréal, QC, Canada

Department of surgery, Université de Montreal, Montréal, QC, Canada

Address correspondence and reprint requests to Stefan Parent, MD, PhD, Division of Orthopaedic, Sainte-Justine University Hospital Center, 3175 Côte Sainte-Catherine, Montréal, QC, Canada H3T 1C5; E-mail: stefan.parent@umontreal.ca

Acknowledgment date: August 3, 2009. First revision date: January 21, 2010. Second revision date: March 5, 2010. Acceptance date: March 8, 2010.

The manuscript submitted does not contain information about medical device(s)/drug(s).

CIHR (Canadian Institute of Health Research) funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

© 2011 Lippincott Williams & Wilkins, Inc.