The DOI matches its Crossref record; 68 of the 71 references it cites were found in a registry or an index.
Reliability and validity of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index in Italian patients with osteoarthritis of the knee
Open accessAbstract
Objective The Western Ontario and McMaster Universities (WOMAC) Osteoarthritis (OA) Index is a tested questionnaire to assess symptoms and physical functional disability in patients with OA of the knee and the hip. We adapted the WOMAC for the Italian language and tested its metric properties in 304 patients with symptomatic OA of the knee.Methods Three hundred and four consecutive patients, attending 29 rheumatologic outpatient clinic in northern, central, and southern Italy, were asked to answer two disease-specific questionnaires (WOMAC and Lequesne algofunctional index) and one generic instrument (Medical Outcomes Study SF-36 Health Survey-MOS SF-36). A sample of 258 patients was readministered the WOMAC 7-10 days after the first visit and the structured interview, which also assessed demographic and other characteristics. Internal consistency was assessed using Cronbach's alpha, reliability using intraclass correlation coefficients (ICCs), and construct and discriminant validity using Spearman's correlations, Wilcoxon rank sum test, and Kruskal-Wallis test.Results All WOMAC subscales (pain, stiffness, and physical function) were internally consistent with Cronbach's coefficient alpha of 0.91, 0.81, and 0.84, respectively. Test-retest reliability was satisfactory with ICCs of 0.86, 0.68, and 0.89, respectively. In comparison with the SF-36, the expected correlations were found when comparing items measuring similar constructs, supporting the concepts of convergent construct validity. Very high correlations were also obtained between WOMAC scores and Lequesne OA algofunctional index. WOMAC physical function, but not WOMAC stiffness and pain subscales, was weakly associated with radiological OA severity (P=0.03). Also, WOMAC pain score was inversely correlated (P=0.01) with years of formal education. Examination of discriminant validity showed that the scores on the WOMAC and SF-36 followed hypothesized patterns: the WOMAC discriminated better among subjects with varying severity of knee problems, whereas the SF-36 discriminated better among subjects with varying levels of self-reported health status and comorbidity.Conclusion The Italian version of WOMAC is a reliable and valid instrument for evaluating the severity of OA of the knee, with metric properties in agreement with the original, widely used version.
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“The Italian translation of the WOMAC showed adequate internal consistency, test-retest reliability, and construct validity.25”
From Acceptance and commitment therapy for prevention of chronic pain after total knee arthroplasty. (2026) · cites this paper as [25]
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Cites
Coefficient Alpha and the Internal Structure of Tests
Cronbach, L. J. (1951) · Psychometrika · doi:10.1007/bf02310555 · Cited by 43,931
(1992) · PubMed · Cited by 33,716
The MOS 36-ltem Short-Form Health Survey (SF-36): I. Conceptual Framework and Item Selection
Ware, J. E., & Sherbourne, C. D. (1992) · Medical Care · doi:10.1097/00005650-199206000-00002 · Cited by 30,033
Psychometric theory (2nd ed.).
Sitgreaves, R. (1979) · Contemporary Psychology · doi:10.1037/018882 · Cited by 14,384
Radiological Assessment of Osteo-Arthrosis
Kellgren, J., & Lawrence, J. S. (1957) · Annals of the Rheumatic Diseases · doi:10.1136/ard.16.4.494 · Cited by 12,472
Health Measurement Scales: A Practical Guide to Their Development and Use
Streiner, D. L., Norman, G. R., & Cairney, J. (1989) · Cited by 9,595
Altman, R., Asch, E., Bloch, D., Bole, G., Borenstein, D., Brandt, K., Christy, W., Cooke, T. D., Greenwald, R., Hochberg, M., et al. (1986) · Arthritis & Rheumatism · doi:10.1002/art.1780290816 · Cited by 6,777
The Sickness Impact Profile: Development and Final Revision of a Health Status Measure
Bergner, M., Bobbitt, R. A., Carter, W. B., & Gilson, B. S. (1981) · Medical Care · doi:10.1097/00005650-198108000-00001 · Cited by 4,619
Measuring Health: A Guide to Rating Scales and Questionnaires
McDowell, I., & Newell, C. (1987) · Cited by 4,207
(1994) · Medical Entomology and Zoology · Cited by 4,156
Research works printed but not linked: 3
- Leardini, 2001, A multicentric study of annual costs of knee osteoarthritis in Italy, Arthritis Rheum, 44, S313
- Lequesne, 1998, Comparison between the WOMAC and the Lequesne indices in patients with knee and hip osteoarthritis, Osteoarthritis Cartilage, 6, 141
- Stuki, 1996, Evaluation of a German version of the WOMAC osteoarthritis index, Z Rheumatol, 55, 40
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Hawker, G. A., Mian, S., Kendzerska, T., & French, M. (2011) · Arthritis Care & Research · doi:10.1002/acr.20543 · Cited by 4,924
Sex, gender, and pain: a review of recent clinical and experimental findings
Fillingim, R. B., King, C. D., Ribeiro-Dasilva, M. C., Rahim-Williams, B., & Riley, J. L. (2009) · The Journal of Pain · doi:10.1016/j.jpain.2008.12.001 · Cited by 2,766
“Data from an Italian community based cohort also using theWOMAC found females had significantly greater hip and knee pain than males.(355)”
MethodCollins, N. J., Misra, D., Felson, D. T., Crossley, K. M., & Roos, E. M. (2011) · Arthritis Care & Research · doi:10.1002/acr.20632 · Cited by 1,238
SF-36 total score as a single measure of health-related quality of life: Scoping review
Lins-Kusterer, L., & Carvalho, F. M. (2016) · SAGE Open Medicine · doi:10.1177/2050312116671725 · Cited by 1,258
An Interdisciplinary Expert Consensus Statement on Assessment of Pain in Older Persons
Hadjistavropoulos, T., Herr, K., Turk, D. C., Fine, P. G., Dworkin, R. H., Helme, R. D., Jackson, K. C., Parmelee, P. A., Rudy, T. E., Beattie, B. L., et al. (2006) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e31802be869 · Cited by 570
Metadata
- Authors
- Salaffi, F., Leardini, G., Canesi, B., Mannoni, A., Fioravanti, A., Caporali, R., Lapadula, G., & Punzi, L.
- Affiliations
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT)
- Azienda Sanitaria di Firenze (IT)
- University of Siena (IT)
- University of Pavia (IT)
- Azienda Universitaria Ospedaliera Consorziale - Policlinico Bari (IT)
- University of Padua (IT)
- Corresponding author
- Salaffi, F
- Venue
- Osteoarthritis and Cartilage
- Publisher
- Elsevier BV
- Published
- 2003-08
- Volume
- 11
- Issue
- 8
- Pages
- 551-560
- ISSN
- 1063-4584 (ISSN-L)
- OpenAlex
- W2087139148
- Cited by
- 331
- References
- 71
- Citations by year
- 2026: 22 · 2025: 33 · 2024: 28 · 2023: 33 · 2022: 25 · 2021: 16 · 2020: 23 · 2019: 13 · 2018: 18 · 2017: 16 · 2016: 10 · 2015: 12 · 2014: 16 · 2013: 6 · 2012: 11
- FWCI
- 3.22
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Osteoarthritis and Cartilage (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
- Università Politecnica delle Marche (Università Politecnica delle Marche) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
- Health Sciences › Medicine › Surgery › Total Knee Arthroplasty Outcomes
- Keywords
- knee osteoarthritis, questionnaire reliability, construct validity, test-retest reliability, SF-36, Lequesne algofunctional index, pain, stiffness, physical function, radiographic severity, educational attainment, health status, comorbidities, patient-reported outcomes, cross-cultural adaptation, Italy, North America
- MeSH terms
- Aged, Aged, 80 and over, Cross-Sectional Studies, Disability Evaluation, Female, Humans, Italy, Male, Middle Aged, Pain, Surveys and Questionnaires, Reproducibility of Results, Cohort Studies, Comorbidity, Muscle, Skeletal, Osteoarthritis, Knee
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