Simplified Chinese version of the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire: cross-cultural adaptation, reliability, and validity for patients with cervical spondylotic myelopathy

Abstract

Purpose

This study aimed to validate the simplified Chinese version of the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) for Chinese patients with cervical spondylotic myelopathy (CSM).

Methods

The construct validity was conducted using confirmatory factor analysis (CFA). The convergent validity was based on factor loading, composite reliability (CR), and Pearson correlation coefficients (r). Internal consistency reliability was evaluated using Cronbach’s α, test–retest reliability using intraclass correlation coefficients (ICC), and the ceiling and floor effects were also examined.

Results

A total of 168 native Chinese-speaking patients were enrolled. The CFA indicated that construct validity did not meet the preset criteria to be considered as good. Except for Q 4-1, the factor loading was higher than the standard of 0.5, and the CR values ranged from 0.70 to 0.85. Strong to moderate correlations were found between other scales and the simplified Chinese JOACMEQ. The scale showed good internal consistency reliability (Cronbach’s α 0.639–0.821), and test–retest reliability (ICC 0.760–0.916). Moreover, the ceiling effect was displayed from Q1 to Q4.

Conclusions

This study indicates that the simplified Chinese JOACMEQ is a reliable and valid measure of the functional status among Chinese patients with CSM.

IMPLICATIONS FOR REHABILITATION

• The JOACMEQ was translated into the simplified Chinese and culturally adapted for Chinese-speaking patients with CSM for the first time.

• The simplified JOACMEQ demonstrated an excellent level of internal consistency and good test–retest reliability.

• The simplified Chinese JOACMEQ was reliable and valid for the measurement of the functional status among the patients with CSM.

Keywords:

• Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ)
• cross-cultural adaptation
• test–retest reliability
• convergent validity
• simplified Chinese
• cervical spondylotic myelopathy

Acknowledgement

The authors thank the trustee in charge of the Clinical Outcome Committee of the Japanese Society for Spine Surgery and Related Research for the permission to translate JOACMEQ from Mamoru Kawakami.

Ethical approval

No interventional therapy or specimen collection was involved in our study, and the entire protocol was approved by the Ethics Committee of Longhua Hospital (No. 2016LCSY030). All subjects participating in the study were informed of the details and submitted the written informed consent.

Author contributions

All authors participated in drafting or critically revising the article for important intellectual content. In addition, all authors approved the final version. MY and ZJL contributed equally to the work and should be considered as co-first authors. XJC and YJW were the corresponding authors. Study concept and design were accomplished by XJC, YJW, MY, and ZJL. Data acquisition was conducted by MY, ZJL, BZ, BPX, SZ, YFP, XTW, ZRT, and JY. The revision was made by MY, and ZD. Data analysis and interpretation were completed by XJC, YJW, MY, and ZJL.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

All relevant data were presented in the paper and its Supplementary Material.

Additional information

Funding

This is a special project of National Natural Science Foundation of China [81704096, 81873317, 81804114], the Program for Innovative Research Team of Ministry of Science and Technology of China [2015RA4002], the Program for Innovative Research Team of Ministry of Education of China [IRT1270], Municipal Science and Technology Commission of Shanghai-TCM key project [16401970100], Shanghai TCM Medical Center of Chronic Disease [2017ZZ01010], National Thirteenth Five-Year Science and Technology Major Special Project for New Drug Innovation and Development [2017ZX09304001], the Shanghai Health and Family Planning Commission [201840004].