Development of a Questionnaire for Identification of the Risk Factors for Osteoarthritis of the Knees, in developing countries. A pilot study in Iran and Bangladesh. An ILAR- COPCORD phase III study

Abstract: Knee osteoarthritis (OA) is one of the most prevalent rheumatic disorders in Asia- Pacific. Identification of modifiable risk factors is important for development of strategies for primary and secondary prevention of knee OA. Objective: Developing a core questionnaire for identification of risk factors of knee OA at community level. Methods: Steps performed: 1) item generation from literature, existing knee OA questionnaires and patient focus group discussions. 2) Development of a preliminary APLAR-COPCORD English questionnaire. 3) Translation into target language, back translation and development of a pre-final target language version. 4) Adaptation of the pre-final target language version through tests of comprehensibility, content validity, testretest reliability, and 5) finalization of the English questionnaire. Investigators in Bangladesh, Iran, China, Philippines and Indonesia participated in steps 1 and 2. Subsequent steps were carried on by Bangladeshi and Iranian investigators. Results: Fifty-three items were generated. Fourteen were obtainable from physical examination and placed in an examination sheet. Two radiological items were not included. A preliminary English questionnaire comprising remaining 37 items was constructed and translated into Bengali and Persian. The preliminary Bengali and Persian versions were adapted as a result of tests of comprehensibility, content validity and testretest reliability. The English questionnaire was adapted through repeated exchange of ideas and experiences among participating investigators. A 35-item English core questionnaire was finally developed.