The burden of osteoarthritis: development and validation of a new assessment tool (BONe’S)

Abstract

Objective:

To develop and validate a specific individual burden questionnaire, BONe’S (Burden of Osteoarthritis New Scale), assessing osteoarthritis (OA) patients in the broadest sense.

Research design and methods:

Items included in BONe’S were identified by literature review, and patient/healthcare practitioner interviews, and refined via item reduction and exploratory factor analysis (EFA). Internal consistency was calculated using Cronbach’s α; concurrent validity was assessed by calculating the correlation between BONe’S and the Short Form (SF)-12 Health Survey and Psychological General Well-Being Index (PGWBI). Discriminant validity was analyzed by age, gender and number of OA locations.

Results:

From an initial list of 56 items, the final BONe’S questionnaire consisted of 20 questions (5 dimensions) based on EFA. BONe’S was evaluated in patients with OA (n = 200; mean age 69.4 ± 7.0 years, 86% of patients aged >60 years, 91.5% women). BONe’S demonstrated excellent internal coherence (Cronbach’s α: 0.86). Individual BONe’S dimensions correlated well with the overall BONe’S score (highest: ‘Independence’ [r = 0.91]; lowest: ‘Hygiene & Beauty’ [r = 0.56]), and to each other dimension, and also correlated well (inversely) with the SF-12 and, to a slightly lesser extent, the PGWBI. The only exception was ‘Budget’, but this dimension was important and relevant in the subpopulation of active OA patients (r = 0.40). The mean BONe’S score for subjects with one or two affected joints was significantly lower than for subjects with three or more affected joints. The BONe’S score also differed according to gender and age. The original French BONe’S has also been adapted (linguistically and culturally) to English, Russian and Portuguese. Limitations include the fact that BONe’S was developed in a predominantly female population, in patients receiving a pharmacological intervention, has not been evaluated in a large population and has not been compared with other OA tools, including WOMAC, Lequesne and KOOS.

Conclusion:

The BONe’S questionnaire is a short (20-item) validated tool for evaluating the specific individual burden of OA in a holistic manner.

Keywords::

• Individual burden
• Osteoarthritis
• Questionnaire
• Validation

Transparency

Declaration of funding

This study was funded by Pierre Fabre Laboratories.

Declaration of financial/other relationships

C.T. and S.B. are employed by Pierre Fabre Laboratories. F.R., P.B. and L.G. have received consulting fees from Pierre Fabre Laboratories for their contribution to this project. J.-N.D. has disclosed that he has no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.

Acknowledgments

The authors thank David P. Figgitt PhD, Content Ed Net, for providing editorial assistance in the preparation of this manuscript. Funding for editorial assistance was provided by Pierre Fabre Laboratories, Paris, France.

Note: a copy of the BONe’S questionnaire and the algorithm used to calculate the BONe’S score are available, on written request, from MAPI.

Author contribution

Conception and design of the study – F.R., P.B., L.G., S.B., J.-N.D., C.T. Acquisition of data – F.R., P.B., L.G., S.B., J.-N.D., C.T. Analysis and interpretation of data – S.B., C.T. Drafting the article or revising it critically for important intellectual content – F.R., P.B., L.G., S.B., J.-N.D., C.T. Final approval of the version to be submitted – F.R., P.B., L.G., S.B., J.-N.D., C.T. Responsibility for the integrity of the work as a whole, from inception to finished article – C.T.