Translation and validation of the Swedish version of the early-onset scoliosis 24-item questionnaire.

PURPOSE: This study aimed to translate and validate the Early-Onset Scoliosis 24-Item Questionnaire (EOSQ-24) into Swedish.

METHODS

Following international guidelines, the EOSQ-24 was double forward translated by independent translators, reviewed by experts, and distributed to caregivers. A single back translation was performed, and the Swedish version was finalized. The Swedish EOSQ-24 was made available online for clinically active spinal surgeons to use during outpatient visits, where it was distributed to caregivers of early-onset scoliosis (EOS) patients aged 0-15 years. Internal consistency was assessed using Cronbach's alpha, item-total correlation, and analysis of floor and ceiling effects. Convergent validity was examined using the EuroQol-5D 3 level (EQ-5D) and the Scoliosis Research Society 22-Item Questionnaire revised (SRS-22r).

RESULTS

Responses from 140 caregivers were collected. Ceiling effects ranged from 21 to 74%, with no floor effects > 15%. Internal consistency was excellent (Cronbach's alpha = 0.9), except for two domains: "General Health" (0.6) and "Pulmonary Function" (0.4). The item-total correlation was poor for "Pulmonary Function". EOSQ-24 domains showed significant convergent validity with SRS-22r (Spearman's rho 0.5 to 0.8) and the EQ-5D (Spearman's rho -0.6 to -0.8). Stepwise regression showed lower scores for patients with neuromuscular scoliosis, indicating sensitivity for scoliosis etiology.

CONCLUSION

The Swedish EOSQ-24 is a valid, disease-specific questionnaire with excellent internal consistency suitable for use in a clinical setting. Minor inconsistencies are not unique for the Swedish translation.

LEVEL OF EVIDENCE: II.