Several questionnaires have been used to assess the health status of patients with Kashin-Beck disease (KBD) in clinical trials, but the evidence regarding the responsiveness of these instruments in KBD patients is limited. Therefore, the aim of this study was to evaluate and compare the responsiveness of the Chinese version of the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) and 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in KBD patients undergoing intra-articular injection of hyaluronic acid (HA). A sample of 232 KBD patients treated with intra-articular injection of HA completed the WOMAC, 12-item WHODAS 2.0 and joint dysfunction index (JDI) both pre- and post-treatment. Responsiveness was assessed using correlation and receiver operating characteristic (ROC) curve analyses following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Overall, there were significant improvements in the mean scores on the WOMAC and on the 12-item WHODAS 2.0, except for in the cognition domain. Correlation analysis showed that changes in the WOMAC and 12-item WHODAS 2.0 scores had moderate or weak positive associations with the changes in the JDI. However, acceptable areas under the ROC curve (value > 0.7) were found for all domains and for the total score on the WOMAC, but only for the mobility domain and the total score on the 12-item WHODAS 2.0. These results demonstrated that the WOMAC was more responsive than the 12-item WHODAS 2.0 in KBD patients treated with intra-articular injection of HA. Our findings support the continued use of the WOMAC as an outcome measure in assessing disability in KBD patients.

中文翻译：

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克欣-贝克病患者WOMAC和12项WHODAS 2.0反应的比较

在临床试验中，已经使用了一些问卷来评估Kashin-Beck病（KBD）患者的健康状况，但是有关这些仪器对KBD患者的反应性的证据有限。因此，本研究的目的是评估和比较中文版西安大略省和麦克马斯特大学骨关节炎指数（WOMAC）和12个项目的世界卫生组织残疾评估表2.0（WHODAS 2.0）对KBD接受内镜治疗的患者的反应性关节注射透明质酸（HA）。232例接受HA关节内注射治疗的KBD患者的样本在治疗前后均完成了WOMAC，12个项目的WHODAS 2.0和关节功能障碍指数（JDI）。使用基于关联性和接收器工作特性（ROC）曲线分析的反应性进行评估，这些曲线分析是基于基于COnsensus的健康测量仪器（COSMIN）选择表的标准进行的。总体而言，除了在认知领域外，WOMAC和12个项目WHODAS 2.0的平均得分均有显着提高。相关分析表明，WOMAC和12个项目的WHODAS 2.0得分的变化与JDI的变化呈中等或弱正相关。但是，在所有域和WOMAC上的总得分中，ROC曲线下的区域均可接受（值> 0.7），但在12个项目WHODAS 2.0上，仅对于迁移域和总得分。这些结果表明，WOMAC比12个项目WHODAS 2更具响应性。关节内注射HA治疗的KBD患者为0。我们的研究结果支持继续使用WOMAC作为评估KBD患者残疾的结果指标。