Translation, cross-cultural adaptation, and validation of the Norwegian version of the Keratoconus Outcomes Research Questionnaire

Abstract Purpose To translate and adapt the Keratoconus Outcomes Research questionnaire (KORQ) to Norwegian language, culture, and environment, and to validate the translated version in a Norwegian population with keratoconus. Methods KORQ was translated to Norwegian using a multi-step methodology....

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Main Authors: Eilin Lundanes, Svein Magne Roten, Helle Kristine Falkenberg, Lena Leren, Vibeke Sundling
Format: Article
Language:English
Published: SpringerOpen 2025-05-01
Series:Journal of Patient-Reported Outcomes
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Online Access:https://doi.org/10.1186/s41687-025-00896-z
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author Eilin Lundanes
Svein Magne Roten
Helle Kristine Falkenberg
Lena Leren
Vibeke Sundling
author_facet Eilin Lundanes
Svein Magne Roten
Helle Kristine Falkenberg
Lena Leren
Vibeke Sundling
author_sort Eilin Lundanes
collection DOAJ
description Abstract Purpose To translate and adapt the Keratoconus Outcomes Research questionnaire (KORQ) to Norwegian language, culture, and environment, and to validate the translated version in a Norwegian population with keratoconus. Methods KORQ was translated to Norwegian using a multi-step methodology. Persons with keratoconus submitted responses to KORQ-NO and NEI VFQ-25 through a digital platform, and a retest of KORQ-NO was performed over the telephone. Additional data from a clinical intervention study was included. The psychometric properties of KORQ-NO were assessed by Rasch analysis. Test-retest reliability, construct validity, and responsiveness were explored by Intraclass Correlation Coefficients, Spearman correlations and Wilcoxon Signed-rank test. Results KORQ-NO and NEI VFQ-25 were completed by 165 participants with keratoconus. With few adjustments, the “Activity limitations” (AL) and “Symptoms” (S) subscales of KORQ-NO exhibit acceptable psychometric properties with good model fit, high internal reliability, and well-targeted items to the population. Deletion of four items (AL3, AL3b, AL12, AL15) improved dimensionality of the “Activity limitations” subscale. Differential item functioning was present in two items (AL4 and AL6). Participants and optometrists confirmed content validity, and KORQ-NO exhibited good test-retest reliability (AL ICC = 0.90 and S ICC = 0.81), construct validity, and responsiveness. Conclusions Successful translation and adaptation of KORQ to Norwegian language, culture and environment was confirmed by acceptable psychometric properties, with good validity, reliability, and responsiveness. The authors support the use of KORQ-NO in research, clinical practice, and as documentation for national insurance benefit applications.
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spelling doaj-art-2cb09eca93aa4dd39e2d07c80b26b4ac2025-08-20T03:48:19ZengSpringerOpenJournal of Patient-Reported Outcomes2509-80202025-05-019111310.1186/s41687-025-00896-zTranslation, cross-cultural adaptation, and validation of the Norwegian version of the Keratoconus Outcomes Research QuestionnaireEilin Lundanes0Svein Magne Roten1Helle Kristine Falkenberg2Lena Leren3Vibeke Sundling4National Centre for Optics, Vision and Eye Care, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern NorwayNational Centre for Optics, Vision and Eye Care, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern NorwayNational Centre for Optics, Vision and Eye Care, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern NorwayNational Centre for Optics, Vision and Eye Care, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern NorwayNational Centre for Optics, Vision and Eye Care, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern NorwayAbstract Purpose To translate and adapt the Keratoconus Outcomes Research questionnaire (KORQ) to Norwegian language, culture, and environment, and to validate the translated version in a Norwegian population with keratoconus. Methods KORQ was translated to Norwegian using a multi-step methodology. Persons with keratoconus submitted responses to KORQ-NO and NEI VFQ-25 through a digital platform, and a retest of KORQ-NO was performed over the telephone. Additional data from a clinical intervention study was included. The psychometric properties of KORQ-NO were assessed by Rasch analysis. Test-retest reliability, construct validity, and responsiveness were explored by Intraclass Correlation Coefficients, Spearman correlations and Wilcoxon Signed-rank test. Results KORQ-NO and NEI VFQ-25 were completed by 165 participants with keratoconus. With few adjustments, the “Activity limitations” (AL) and “Symptoms” (S) subscales of KORQ-NO exhibit acceptable psychometric properties with good model fit, high internal reliability, and well-targeted items to the population. Deletion of four items (AL3, AL3b, AL12, AL15) improved dimensionality of the “Activity limitations” subscale. Differential item functioning was present in two items (AL4 and AL6). Participants and optometrists confirmed content validity, and KORQ-NO exhibited good test-retest reliability (AL ICC = 0.90 and S ICC = 0.81), construct validity, and responsiveness. Conclusions Successful translation and adaptation of KORQ to Norwegian language, culture and environment was confirmed by acceptable psychometric properties, with good validity, reliability, and responsiveness. The authors support the use of KORQ-NO in research, clinical practice, and as documentation for national insurance benefit applications.https://doi.org/10.1186/s41687-025-00896-zKeratoconus outcomes research questionnaireTranslationCross-cultural adaptationValidityReliabilityRasch analysis
spellingShingle Eilin Lundanes
Svein Magne Roten
Helle Kristine Falkenberg
Lena Leren
Vibeke Sundling
Translation, cross-cultural adaptation, and validation of the Norwegian version of the Keratoconus Outcomes Research Questionnaire
Journal of Patient-Reported Outcomes
Keratoconus outcomes research questionnaire
Translation
Cross-cultural adaptation
Validity
Reliability
Rasch analysis
title Translation, cross-cultural adaptation, and validation of the Norwegian version of the Keratoconus Outcomes Research Questionnaire
title_full Translation, cross-cultural adaptation, and validation of the Norwegian version of the Keratoconus Outcomes Research Questionnaire
title_fullStr Translation, cross-cultural adaptation, and validation of the Norwegian version of the Keratoconus Outcomes Research Questionnaire
title_full_unstemmed Translation, cross-cultural adaptation, and validation of the Norwegian version of the Keratoconus Outcomes Research Questionnaire
title_short Translation, cross-cultural adaptation, and validation of the Norwegian version of the Keratoconus Outcomes Research Questionnaire
title_sort translation cross cultural adaptation and validation of the norwegian version of the keratoconus outcomes research questionnaire
topic Keratoconus outcomes research questionnaire
Translation
Cross-cultural adaptation
Validity
Reliability
Rasch analysis
url https://doi.org/10.1186/s41687-025-00896-z
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