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SICOT J. 2019 Jan;5:7. doi: 10.1051/sicotj/2019001. Epub 2019 Feb 8.

Reliability and validity of the Arabic version of the Early Onset Scoliosis 24 Items Questionnaire (EOSQ-24).

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Faculty of Medicine and Health Sciences, An-Najah National University, Nablus 41414, Palestine.
Assistant Program Manager, Waltham Forest Clinical Commissioning Group, London, E11, UK.
Asst. Prof. & Head of Department, Bio-Statistics, GD-PGMI, 54000, Pakistan.
Department of Orthopaedic Surgery, Columbia University Medical Center, 630 West 168th Street, #1504, 10032, New York City, NY, USA.
Assistant Professor in Epidemiology, School of Public Health, Al-Quds University 90612, Palestine.
Pediatric Orthopedic Surgeon, Associate Professor, Poly Technique University-Palestine, PO Box 3985, Ramallah, West bank, 602, Palestine.



Early Onset Scoliosis (EOS) is a complex pathology that covers a variety of etiologies, with onset before the age of 10 years. Surgical treatment of EOS should have the objectives of fulfilling maximum pulmonary function, spine length, with minimal hospitalizations, complications, and family burden. Radiographic parameters are an important standard in assessing treatment outcomes. However, the Early Onset Scoliosis Questionnaire-24 (EOSQ-24) was developed to measure the wider dimensions of outcomes involving the quality of life of patients and caregivers post-treatment. The aim of this study was to evaluate the validity and reliability of culturally adapted Arabic version of the EOSQ-24.


Translation and cross-cultural adaptation, based on published guidelines, were performed on the original English EOSQ-24 by a committee. The Arabic version of EOSQ-24 was applied to the caregivers of all 58 EOS patients who were treated surgically after signing a consent form. Reliability was assessed using Cronbach's α and item-total statistics for the whole questionnaire initially and for the each domain separately. Data quality was assessed by mean, median, percentage of missing data, ceiling and floor effects. Discriminative validity was examined using non parametric tests.


The response for all items was excellent with only 1.7% (0-1) of responses missing. The floor effect ranged from 0% to 36.2% of patients and the ceiling effect ranged from 0 to 46.6%. Cronbach's α test reliability was found excellent (0.919), as was the internal consistency of all domains, with Cronbach α ranging from 0.903 to 0.918. Corrected item-total correlations were good for all domains (>0.3). Only one item (Question 21) showed low corrected item-total correlations (r = 0.222). However, Cronbach's α did not increase significantly when this item was deleted (0.920).


The first adapted Arabic version of EOSQ-24 is found to have good validity and reliability, and it can be used to assess children in Arab societies with EOS.

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