Skip to main content
Log in

Validity, reliability, and comparison of the WOMAC osteoarthritis index and Lequesne algofunctional index in Turkish patients with hip or knee osteoarthritis

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

To assess validity and reliability of the Western Ontario and McMaster Universities (WOMAC) osteoarthritis (OA) index and Lequesne algofunctional index in Turkish patients with hip or knee OA and to compare the results of the instruments for these two particular sites of involvement. Two disease-specific instruments: WOMAC LK 3.1 and Lequesne indices were administered to 117 outpatients with OA (44 hip and 73 knee) living in Turkey. These indices were administered twice 7–10 days apart to ensure the test–retest reliability. All patients were asked to reply a generic health-related quality-of-life instrument (Short Form-36, SF-36) and a structured interview assessing demographic and other characteristics. Internal consistency and reliability was evaluated by Cronbach’s alpha and intra-class correlation coefficients (ICC). Construct validity was tested by correlating the WOMAC or Lequesne with each other, and also with SF-36 and visual analog scale (VAS). The Cronbach’s alphas of the WOMAC and Lequesne subscales were ranged 0.78–0.95 and 0.51–0.85 for hip and 0.78–0.94 and 0.61–0.71 for knee OA, respectively. Test–retest reliability of the WOMAC and Lequesne subscales yielded ICCs of 0.77–0.94 and 0.51–0.85 for hip and 0.80–0.98 and 0.61–0.71 for knee OA, respectively. WOMAC and Lequesne showed moderate-good correlations between comparable subscales of SF-36 (physical functioning and bodily pain) and weak-moderate correlations between VAS. All subscales and total WOMAC had better internal consistency and more satisfactory concurrent validity compared with Lequesne. Our results indicated that WOMAC is a more reliable index for use in Turkish patients with hip or knee OA than Lequesne.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Altman RD, Lozada CJ (2008) Clinical features of osteoarthritis. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH (eds) Rheumatology, 4th edn. Mosby Elsevier, Spain, pp 1703–1710

    Google Scholar 

  2. Thumboo J, Chew LH, Soh CH (2001) Validation of the Western Ontario and McMaster Universities osteoarthritis index in Asian patients with osteoarthritis in Singapore. Osteoarthritis Cartilage 9:440–446

    Article  CAS  PubMed  Google Scholar 

  3. Salaffi F, Leardini G, Canesi B, Mannoni A, Fioravanti A, Caporali R, Lapadula G, Punzi L (2003) Reliability and validity of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index in Italian patients with osteoarthritis of the knee. Osteoarthritis Cartilage 11:551–560

    Article  CAS  PubMed  Google Scholar 

  4. Xie F, Thumboo J, Lo NN, Yeo SJ, Yang KY, Yeo W, Chong HC, Fong KY, Li SC (2007) Cross-cultural adaptation and validation of Singapore English and Chinese versions of the Lequesne Algofunctional Index of knee in Asians with knee osteoarthritis in Singapore. Osteoarthritis Cartilage 15:19–26

    Article  CAS  PubMed  Google Scholar 

  5. Faucher M, Poiraudeau S, Lefevre-Colau MM, Rannou F, Fermanian J, Revel M (2002) Algo-functional assessment of knee osteoarthritis: comparison of the test-retest reliability and construct validity of the WOMAC and Lequesne indexes. Osteoarthritis Cartilage 10:602–610

    Article  CAS  PubMed  Google Scholar 

  6. Bae SC, Lee HS, Yun HR, Kim TH, Yoo DH, Kim SY (2001) Cross-cultural adaptation and validation of Korean Western Ontario and McMaster Universities (WOMAC) and Lequesne Osteoarthritis Indices for clinical research. Osteoarthritis Cartilage 9:746–750

    Article  CAS  PubMed  Google Scholar 

  7. Bellamy N (2008) Principles of outcome assessment. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH (eds) Rheumatology, 4th edn. Mosby Elsevier, Spain, pp 12–20

    Google Scholar 

  8. Lequesne M (1991) Indices of severity and disease activity for osteoarthritis. Semin Arthritis Rheum 20(6 Suppl 2):48–54

    Article  CAS  PubMed  Google Scholar 

  9. Lequesne MG, Mery C, Samson M, Gerard P (1987) Indexes of severity for osteoarthritis of the hip and knee. Scand J Rheumatol 65(suppl):85–89

    Article  CAS  Google Scholar 

  10. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15(12):1833–1840

    CAS  PubMed  Google Scholar 

  11. Escobar A, Quintana JM, Bilbao A, Azkarate J, Güenaga JI (2002) Validation of the Spanish version of the WOMAC questionnaire for patients with hip or knee osteoarthritis. Clin Rheumatol 21:466–471

    Article  CAS  PubMed  Google Scholar 

  12. Tuzun EH, Eker L, Aytar A, Daskapan A, Bayramoglu M (2005) Acceptibility, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis Cartilage 13:28–33

    Article  CAS  PubMed  Google Scholar 

  13. Kellgren JH, Lawrence JS (1987) Radiologic assessment of osteoarthritis. Ann Rheum Dis 16:494–501

    Article  Google Scholar 

  14. Bellamy N (2003) WOMAC Osteoarthritis Index User Guide VI

  15. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J (1988) Validation study of WOMAC: a health status instrument for measuring clinically-important patient-relevant outcomes following total hip or knee arthroplasty in osteoarthritis. J Orthop Rheumatol 1:95–108

    Google Scholar 

  16. Lequesne MG (1997) The algofunctional indices for hip and knee osteoarthritis. J Rheumatol 24:779–781

    CAS  PubMed  Google Scholar 

  17. Guillemin F, Bombardier C, Beaton D (1993) Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol 46(12):1417–1432

    Article  CAS  PubMed  Google Scholar 

  18. Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–483

    Article  PubMed  Google Scholar 

  19. Ware JE Jr, Kosinski M, Bayliss MS, McHorney CA, Rogers WH, Raczek A (1995) Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: summary of results from the Medical Outcomes Study. Med Care 33(4Suppl):AS264–AS279

    PubMed  Google Scholar 

  20. Kocyigit H, Aydemir O, Fisek G, Olmez N, Memis A (1999) Kısa Form-36 (KF-36)’nın Turkce versiyonunun guvenilirligi ve gecerliligi. Ilac ve Tedavi Dergisi 12:102–106

    Google Scholar 

  21. Stucki G, Sangha O, Stucki S, Michel BA, Tyndall A, Dick W, Theiler R (1998) Comparison of the WOMAC (Western Ontario and McMaster Universities) osteoarthritis index and a self-report format of the self-administered Lequesne-Algofunctional index in patients with knee and hip osteoarthritis. Osteoarthritis Cartilage 6:79–86

    Article  CAS  PubMed  Google Scholar 

  22. Theiler R, Sangha O, Schaeren S, Michel BA, Tyndall A, Dick W, Stucki G (1999) Superior responsiveness of the pain and function sections of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) as compared to the Lequesne-algofunctional Index in patients with osteoarthritis of the lower extremities. Osteoarthritis Cartilage 7:515–519

    Article  CAS  PubMed  Google Scholar 

  23. Faucher M, Poiraudeau S, Lefevre-Colau MM, Rannou F, Fermanian J, Revel M (2003) Assessment of the test-retest reliability and construct validity of a modified Lequesne index in knee osteoarthritis. Jt Bone Spine 70:520–525

    Article  Google Scholar 

  24. Wigler I, Neumann L, Yaron M (1999) Validation study of a Hebrew version of WOMAC in patients with osteoarthritis of the knee. Clin Rheumatol 18:402–405

    Article  CAS  PubMed  Google Scholar 

  25. Söderman P, Malchau H (2000) Validity and reliability of Swedish WOMAC osteoarthritis index. Acta Orthop Scand 71:39–46

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

This study was supported by the Research Council of Cukurova University.

Disclosures

None

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sibel Basaran.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Basaran, S., Guzel, R., Seydaoglu, G. et al. Validity, reliability, and comparison of the WOMAC osteoarthritis index and Lequesne algofunctional index in Turkish patients with hip or knee osteoarthritis. Clin Rheumatol 29, 749–756 (2010). https://doi.org/10.1007/s10067-010-1398-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-010-1398-2

Keywords

Navigation