Reliability and validity of a cross-culturally adapted Hindi version of the SRS-22r questionnaire in Indian patients

Study designCross-sectional, observational.Objectives(i) To develop a cross-culturally adapted Hindi translation of the Scoliosis Research Society (SRS)-22r (refined) questionnaire and (ii) validate it in Hindi-speaking Indian patients with adolescent idiopathic scoliosis (AIS).Background dataHealth-related quality of life (HRQoL)-based questionnaires have superseded objective clinical and radiological measurements as tools to assess the outcome of health-related interventions. The SRS-22r is an extensively validated HRQoL-based questionnaire for AIS patients and has been adapted and translated in other languages.MethodologyA Hindi version of SRS-22r was developed in accordance with standard guidelines for cross-cultural adaptation. The final Hindi version was administered to 108 AIS patients. Subsequently, 58/108 patients answered the Hindi version again after 10-14 days. Another 50/108 bilingual patients answered the original English version after 10-14 days. In addition, 52/108 patients answered a previously validated Hindi version of Short Form (SF)-36 health survey. Content analysis, floor/ceiling effects, internal consistency, test/retest reproducibility and concurrent validity with the English version and the SF-36 questionnaire were determined for the Hindi version of SRS-22r.ResultsHigh ceiling effect was noted for the pain and satisfaction with management domains of Hindi version of SRS-22r. Overall internal consistency was good (Cronbach alpha =0.77)-all domains, except the function domain (alpha =0.61) had good or excellent internal consistency. The test/retest reliability for all domains was excellent (intraclass coefficient/ICC>0.80). The concurrent validity with the English version showed an excellent correlation for all domains (ICC>0.80). Concurrent validity with SF-36 showed good correlation between relevant domains of SRS-22r and SF-36, except for the self-image and satisfaction with management domains of SRS-22r.ConclusionBased on the results proving its reliability and validity, the adapted Hindi version of SRS-22r can be effectively used in Hindi-speaking, Indian AIS patients.Level of evidence3