1. Arabic Translation, Cross-
Cultural Validation of The
Lowe Limb Outcome
Questionnaire ®
Tuesday, January 1, 13

2. What Is Evidence Without
the Outcomes?
• The musculoskeletal literature is filled with
clinical justifications based on outcome
results, such as ‘‘excellent,’’ ‘‘good’’, or
‘‘poor’’
M. Suk, The Orthopedic clinics, 139-143 (2010)
Tuesday, January 1, 13

3. Methodology
Responsiveness
Validity Reliability
Ability of the
Extent to which the Ability of the instrument
instrument to
instrument measures to
change as the status
what it is supposed measure something the
of the patient
to measure same way twice
changes
M. Suk, JAAOS, 16, 123-129 (2008)
Tuesday, January 1, 13

4. Not Valid
Tuesday, January 1, 13

5. Not Reliable
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6. Not Responsive
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7. Valid, Reliable and Responsive
Tuesday, January 1, 13

8. What is an excellent Result?
“Although researchers may
be able to statistically note a
1 to 2mm difference in
KT-1000 testing in a patient
with a reconstructed (ACL),
they have been unable to
detect an associated
difference in patient
satisfaction”
J Am Acad Orthop Surg 2009;17-1:31-9
Tuesday, January 1, 13

9. • There are more than 200 orthopedic
musculoskleletal outcome instruments
• None validated in Arabic
J Am Acad Orthop Surg 2008;16-3:123-9
Tuesday, January 1, 13

10. Arabic Translation, Cross-
Cultural Validation of The
Lowe Limb Outcome
Questionnaire ®
Tuesday, January 1, 13

11. Primary Objective
• To translate and cross-cultural adapt the
Lower Limb Questionnaire© into Arabic
and confirm its:
• Validity
• Reliability
• Responsiveness
Tuesday, January 1, 13

12. • 7 Question instrument
• Scored using an Excel work Sheet
Tuesday, January 1, 13

13. Study Design
• Two Stages:
• Translation and Cross-Cultural
Adaptation
• Testing
Tuesday, January 1, 13

14. Stage One
• Permission
Tuesday, January 1, 13

15. Stage One
• Step 2: Initial Translation
• From English to Arabia
• 2 Translators (T1,T2)
Tuesday, January 1, 13

16. Stage One
• Step 2: Synthesis of these translations
• 3rd unbiased person
• Mediator between (T1 and T2)
• Reaching one T-12
Tuesday, January 1, 13

17. Stage One
• Step 3: Back-translation
• Working from the T-12
• From Arabic to English
• Two translators (BT-1, BT-2)
Tuesday, January 1, 13

18. Stage One
• Step 4: Expert Committee
• Methodologist
• Health professional
• language professional
• Translators (both forward and backward)
• Translation synthesis recorder
Tuesday, January 1, 13

19. Stage One
• Step 5: Test of the pre-final version
• 30 Subjects
• Interviewed
Tuesday, January 1, 13

20. Stage One
Spine (Phila Pa 1976) 2000;25-24:3186-91
Tuesday, January 1, 13

21. Stage Two
(Testing Stage)
• Validity Testing:
• No Golden Standard
• Age
• SF-12
Tuesday, January 1, 13

22. Stage Two
• Reliability Testing
• Internal consistency :“Cronbach's α”
• Test-Retest: One week apart by
answering the questionnaire alone and
will be tested using “Pearson Coefficient”
Tuesday, January 1, 13

23. Stage Two
• Responsiveness Testing
• Correlation Between:
• Physician’s opinion
• Patient’s opinion
• SF-12
Tuesday, January 1, 13

24. POTENTIAL SUBJECTS
BOOKLET
DISTRIBUTION
FILLED
BOOKLET
Within 1 week
FILL THE
QUESTIONNAIRE
Within 2 months
FILL 2ND
BOOLET
Tuesday, January 1, 13

25. Thanks
Tuesday, January 1, 13