Cross-cultural adaptation and validation of the Simplified Chinese version of Copenhagen Hip and Groin Outcome Score (HAGOS) for total hip arthroplasty

Abstract

Background: To translate and cross-culturally adapt the Copenhagen Hip and Groin Outcome Score (HAGOS) into a Simplified Chinese version (HAGOS-C) and evaluate the reliability, validity, and responsiveness of the HAGOS-C in total hip arthroplasty (THA) patients. Methods: The cross-cultural adaptation was performed according to the internationally recognized guidelines of the American Academy of Orthopaedic Surgeons Outcome Committee. A total of 192 participants were recruited in this study. The intra-class correlation coefficient (ICC) was used to determine reliability. Construct validity was analyzed by evaluating the correlations between HAGOS-C and EuroQoL 5-dimension (EQ-5D), as well as the short form (36) health survey (SF-36). Responsiveness of HAGOS-C was evaluated according to standard response means (SRM) and standard effect size (ES) between the first test and the third test (6months after primary THA). Results: The original version of the HAGOS was well cross-culturally adapted and translated into Simplified Chinese. HAGOS-C was indicated to have excellent reliability (ICC=0.748-0.936, Cronbach's alpha=0.787-0.886). Moderate to substantial correlations between subscales of HAGOS-C and EQ-5D (r=0.544-0.751, p<0.001), as well as physical function (r=0.567-0.640, p<0.001), role physical (r=0.570-0.613, p<0.001), bodily pain (r=0.467-0.604, p<0.001), and general health (r=0.387-0.432, p<0.001) subscales of SF-36, were observed. The ES of 0.805-1.100 and SRM of 1.408-2.067 revealed high responsiveness of HAGOS-C. Conclusions: HAGOS-C was demonstrated to have excellent acceptability, reliability, validity, and responsiveness in THA, which could be recommended for patients in mainland China.