Cross-cultural adaptation, validation and psychometric evaluation of the International Hip Outcome Tool 12 (iHOT12) to Hebrew

Abstract

Background

The “International Hip Outcome Tool 12” (iHOT₁₂) is a self-administered patient-reported outcome tool for measuring health-related quality of life and physical functioning in young and active patients with hip pathology. Since the iHOT₁₂ has become widely used, we sought to translate and validate it for Hebrew-speaking populations. The aims of this study were: (1) To translate and culturally adapt the iHOT₁₂ into Hebrew using established guidelines. (2) To test the new Hebrew version for validity, and (3) reliability.

Methods

The iHOT₁₂ was translated and culturally adapted from English to Hebrew (iHOT₁₂-H) according to the COSAMIN guidelines. For validity, the iHOT₁₂-H and Western Ontario and McMaster universities osteoarthritis index (WOMAC) were completed by 200 patients with hip pathology. Exploratory factor analysis was used to assess structural validity. Subsequently, 51 patients repeated the iHOT₁₂-H within a 2-week interval. Intraclass Correlation Coefficient (ICC), Cronbach alpha, and Standard Error of Measurement (SEM) were calculated to assess reliability.

Results

Construct validity: iHOT₁₂-H correlated strongly to the WOMAC scores (r = -0.82, P < 0.001, Spearman). Factor analysis revealed a two-factor structure. Cronbach’s alpha was 0.953 confirming internal consistency to be highly satisfactory. Test–retest correlation of the iHOT₁₂-H was excellent with an ICC = 0.956 (95% CI 0.924–0.974). There was no floor or ceiling effect.

Conclusion

The iHOT₁₂ Hebrew version has excellent reliability, good construct validity and can be used as a measurement tool for physical functioning and quality of life in young, physically active patients with hip pathology. This study will serve Israeli researchers in evaluating treatment effectiveness for these patients. Moreover, it will also enable multinational cooperation in the study of hip pathology.