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Author's Reply for Letter to the Editor on “American Orthopedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal Joint Scale: A Cross-Cultural Adaptation and Validation Study in the Persian Language”

  • Hamideh Mahdaviazad
    Affiliations
    Assistant Professor of Community and Preventive Medicine, Department of Family Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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  • Amir Reza Vosoughi
    Correspondence
    Address correspondence to: Amir Reza Vosoughi, MD, Chamran Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, Tel/ Fax: +98 713 6234504, +98 713 6246093.
    Affiliations
    Associate Professor of Orthopedic Surgery, Orthopedic Foot & Ankle Surgeon, Department of Orthopedic Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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      Dear colleague,
      At first, we appreciate your valuable concerns regarding our article entitled American Orthopedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal Joint Scale: A Cross-Cultural Adaptation and Validation Study in the Persian Language (
      • Mahdaviazad H
      • Kardeh B
      • Vosoughi AR.
      American Orthopedic Foot and Ankle Society hallux metatarsophalangeal-interphalangeal joint scale: a cross-cultural adaptation and validation study in the Persian language.
      ). In that study, we aimed to evaluate psychometric properties of the Persian version of American Orthopedic Foot and Ankle Society (AOFAS) Hallux (Metatarsophalangeal-Interphalangeal Joint) MTP-IP scale as a simple and time-saving outcome measure.
      Based on the guidelines published by Beaton et al (
      • Beaton DE
      • Bombardier C
      • Guillemin F
      • Ferraz MB.
      Guidelines for the process of cross-cultural adaptation of self-report measures.
      ), test of prefinal version of a questionnaire on 30 to 40 subjects from target setting is ideal, but not necessary, as a final stage of adaptation process (stage V). In this research, cultural adaptation was performed on 10 subjects due to some points and limitations. First, there are only 3 subjective items in the AOFAS Hallux MTP-IP scale, including pain, activity limitations, and footwear requirements. Second, no participant chose the “difficult to understand” in the first round of our study. Moreover, we addressed the convergent validity, discriminate validity and reliability on 101 subjects, the number we think that is enough for describing a successful cross-cultural adaptation.
      Because the senior author has an adult outpatient clinic of foot and ankle surgery, number of cases under 20 years of age with ability to read and write and also, accept to participate in the survey were infrequent.
      Regarding the results of convergent validity and discriminate validity (Table 4), each item of the AOFAS Hallux MTP-IP scale was correctly placed in its category (subscale). In construct validity, by comparing total score of AOFAS Hallux MTP-IP scale with each item of SF-36, all correlation coefficients were under 0.7 which are not strong correlations. Notably, these results had been stated in the discussion part as a weakness of validity of the scale.

      References

        • Mahdaviazad H
        • Kardeh B
        • Vosoughi AR.
        American Orthopedic Foot and Ankle Society hallux metatarsophalangeal-interphalangeal joint scale: a cross-cultural adaptation and validation study in the Persian language.
        J Foot Ankle Surg. 2020; 59: 729-732
        • Beaton DE
        • Bombardier C
        • Guillemin F
        • Ferraz MB.
        Guidelines for the process of cross-cultural adaptation of self-report measures.
        Spine. 2000; 25: 3186-3191

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