Skip to main content
Log in

Cross-cultural adaptation to Swedish and validation of the Copenhagen Hip and Groin Outcome Score (HAGOS) for pain, symptoms and physical function in patients with hip and groin disability due to femoro-acetabular impingement

  • Hip
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

There is a lack of standardised outcome measures in Swedish for active, young and middle-aged patients with hip and groin disability. The purpose of this study was to adapt the Danish version of the Copenhagen Hip and Groin Outcome Score (HAGOS) patient-reported outcome instrument for use in Swedish patients and evaluate the adaptation according to the Consensus-Based Standards for the Selection of Health Status Measurement Instruments checklist.

Methods

Cross-cultural adaptation was performed in several steps, including translation, back-translation, expert review and pretesting. The final version was evaluated for reliability, validity and responsiveness. Five hundred and two patients (337 men and 167 women, mean age 37, range 15–75) were included in the study.

Results

Cronbach’s alpha for the six HAGOS-S subscales ranged from 0.77 to 0.89. Significant correlations were obtained with the international Hip Outcome Tool average score (r s = 0.37–0.68; p < 0.01) and a standardised instrument, the EuroQol, EQ-5D total score (r s = 0.40–0.60, p = 0.01), for use as a measurement of health outcome. Test–retest reliability (intraclass correlation coefficient) ranged from 0.81 to 0.87 for the six HAGOS-S subscales. The smallest detectable change ranged from 7.8 to 16.1 at individual level and 1.6–3.2 at group level. Factor analysis revealed that the six HAGOS-S subscales had one strong factor per subscale. Effect sizes were generally medium or large.

Conclusion

The Swedish version of the HAGOS is a valid, reliable and responsive instrument that can be used both for research and in the clinical setting at individual and group level.

Level of evidence

Diagnostic study, Level I.

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. Beaton DE, Bombardier C, Guillemin F, Ferraz MB (2000) Guidelines for the process of cross-cultural adaptation of self-report measures. Spine 25:3186–3191

    Article  CAS  PubMed  Google Scholar 

  2. Busija L, Osborne RH, Nilsdotter A, Buchbinder R, Roos EM (2008) Magnitude and meaningfulness of change in SF-36 scores in four types of orthopedic surgery. Health Qual Life Outcomes 6:55

    Article  PubMed Central  PubMed  Google Scholar 

  3. Fitzpatrick R, Davey C, Buxton MJ, Jones DR (1998) Evaluating patient-based outcome measures for use in clinical trials. Health Technol Assess 2(i–iv):1–74

    CAS  PubMed  Google Scholar 

  4. Griffin DR, Parsons N, Mohtadi NG, Safran MR (2012) A short version of the International Hip Outcome Tool (iHOT-12) for use in routine clinical practice. Arthroscopy 28:611–616; quiz 616–618

    Article  PubMed  Google Scholar 

  5. Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D, Bonsel G, Badia X (2011) Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res 20:1727–1736

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. Hinman RS, Dobson F, Takla A, O’Donnell J, Bennell KL (2013) Which is the most useful patient-reported outcome in femoroacetabular impingement? Test-retest reliability of six questionnaires. Br J Sports Med

  7. Jonasson P, Karlsson J, Baranto A, Swärd L, Sansone M, Thomeé C, Ahldén M, Thomeé R (2013) A standardized outcome measure for pain, symptoms and physical function in patients with femoroacetabular impingement. Cross-cultural adaptation and validation of the iHOT12 according to the COSMIN checklist. Submitted

  8. Kemp JL, Collins NJ, Roos EM, Crossley KM (2013) Psychometric properties of patient-reported outcome measures for hip arthroscopic surgery. Am J Sports Med

  9. Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC (2009) Cosmin checklist manual

  10. Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC (2010) The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res 19:539–549

    Article  PubMed Central  PubMed  Google Scholar 

  11. Naal FD, Miozzari HH, Wyss TF, Notzli HP (2011) Surgical hip dislocation for the treatment of femoroacetabular impingement in high-level athletes. Am J Sports Med 39:544–550

    Article  PubMed  Google Scholar 

  12. Norman GR, Sloan JA, Wyrwich KW (2003) Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care 41:582–592

    PubMed  Google Scholar 

  13. Streiner DL, Norman GR (2008) Health measurement scales: A practical guide to their development and use. Oxford University Press, New York

    Book  Google Scholar 

  14. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC (2007) Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 60:34–42

    Article  PubMed  Google Scholar 

  15. Thorborg K, Holmich P, Christensen R, Petersen J, Roos EM (2011) The Copenhagen Hip and Groin Outcome Score (HAGOS): development and validation according to the COSMIN checklist. Br J Sports Med 45:478–491

    Article  CAS  PubMed  Google Scholar 

  16. Thorborg K, Roos EM, Bartels EM, Petersen J, Holmich P (2010) Validity, reliability and responsiveness of patient-reported outcome questionnaires when assessing hip and groin disability: a systematic review. Br J Sports Med 44:1186–1196

    Article  CAS  PubMed  Google Scholar 

  17. Weir JP (2005) Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res 19:231–240

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Roland Thomeé.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Cite this article

Thomeé, R., Jónasson, P., Thorborg, K. et al. Cross-cultural adaptation to Swedish and validation of the Copenhagen Hip and Groin Outcome Score (HAGOS) for pain, symptoms and physical function in patients with hip and groin disability due to femoro-acetabular impingement. Knee Surg Sports Traumatol Arthrosc 22, 835–842 (2014). https://doi.org/10.1007/s00167-013-2721-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-013-2721-7

Keywords

Navigation