Validation of the Arabic Version of the WHO-ILAR COPCORD Core Questionnaire for Community Screening of Rheumatic Diseases in Kuwaitis

ADEL AL-AWADHI, SAMUEL OLUSI, MOHAMED MOUSSA, NAJI AL-ZAID, DIA SHEHAB, ADEEBA AL-HERZ, KHALID AL-JARALLAH, IQBAL AL-SALEM, and AVERLYN PEDRO

ABSTRACT.

Objective. (1) To adapt the Community Oriented Program for the Control of Rheumatic Disease (COPCORD) Core Questionnaire (CCQ) for use as a rheumatic screening instrument among Kuwaitis, including translation, back translation, assessment of cross cultural equivalence, and reliability. (2) To determine the screening characteristics of the Arabic version of the CCQ for detecting rheumatic diseases compared to clinical examination by a rheumatologist.

Methods. Translation and assessment of cross cultural equivalence were undertaken using standard methods. Back translation was done by an Arabic-speaking rheumatologist. Interviewer agreement was assessed using a convenience sample. Sensitivity, specificity, and positive and negative predictive values were assessed first by administering the CCQ followed by full clinical examinations of a randomly selected sample of 359 Kuwaiti persons aged 15 years or older.

Results. (1) Cross cultural equivalence and back translation of the translated questionnaire were satisfactory. Interviewer agreement was acceptable. (2) The prevalence of rheumatic diseases based only on CCQ screening was 69% compared to 73% based on clinical examination. The sensitivity and specificity of the Arabic CCQ were 94.4% and 97%, respectively, and the positive and negative predictive values of the instrument were 98.8% and 86.4%, respectively.

Conclusion. The Arabic version of the CCQ appears promising as a screening tool to detect rheumatic diseases in Arabic speaking communities. The findings suggest that the Arabic CCQ followed by clinical examinations in positive respondents can provide an acceptable estimate of prevalence of rheumatic diseases. We intend to use this instrument to screen for the prevalence of rheumatic diseases among Kuwaiti nationals. (J Rheumatol 2002;29:1754-9)

Key Indexing Terms:

COPCORD-CCQ ARABIC VERSION
CROSS CULTURAL ADAPTATION
SCREENING CHARACTERISTICS
RHEUMATIC DISEASE PREVALENCE
KUWAIT
PILOT STUDY

---

From the Departments of Medicine, Pathology and Community Medicine, Faculty of Medicine, Kuwait University, Kuwait.

Supported by Kuwait University and Kuwait Foundation for Advancement of Science (grant MM 01/01).

A. Al-Awadhi, MD, FACP, FRCPC, Associate Professor, Consultant Physician and Rheumatologist, Department of Medicine; S. Olusi, MBBS, PhD, FWACP, FMCPath, FRCPath, Professor, Department of Pathology; M. Moussa, PhD, Professor, Department of Community Medicine; N. Al-Zaid, PhD, Professor, Department of Physiology; D. Shehab, MD, FRCPC, Associate Professor, Department of Medicine; A. Al-Herz, MD, FRCPC, Consultant Physician and Rheumatologist, Mubarak Hospital, Ministry of Health; K. Al-Jarallah, MD, FRCPC, Associate Professor, Department of Medicine; I. Al-Salem, MD, MRCP, Consultant Physician and Rheumatologist, Amiri Hospital, Ministry of Health; A. Pedro, PhD, Director of Institutional Research and Analysis, University of New Brunswick, Fredericton, New Brunswick, Canada.

Address reprints requests to Dr. A.M. Al-Awadhi, Department of Medicine, Faculty of Medicine, Kuwait University, PO Box 24923, Al-Safat, 13110 Kuwait. E-mail: adelalawadhi@yahoo.com

Submitted November 7, 2001; revision accepted February 7, 2002.

---