Reliability, validity and minimum clinical importance difference of the Chinese version of the Zurich claudication questionnaire

Abstract The Zurich Claudication Questionnaire (ZCQ) has been translated and validated in multiple languages but few people have verified the measurement performance of the Chinese version of Zurich Claudication Questionnaire (Ch-ZCQ). The purpose of this study is to assess the performance of the Ch...

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Main Authors: Yi-xuan Gao, Zhi-wen Weng, Hui Shao, Han Bo, Zhi-hui Chen, Meng Song, Lu-ping Liu, Ling-yun Zhang, Jia-yu Liu, Yu-han Wang, Meng-meng Zhang, Xi-you Wang, Ya-nan Sun, Chang-he Yu
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-01380-w
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author Yi-xuan Gao
Zhi-wen Weng
Hui Shao
Han Bo
Zhi-hui Chen
Meng Song
Lu-ping Liu
Ling-yun Zhang
Jia-yu Liu
Yu-han Wang
Meng-meng Zhang
Xi-you Wang
Ya-nan Sun
Chang-he Yu
Xi-you Wang
Ya-nan Sun
Chang-he Yu
author_facet Yi-xuan Gao
Zhi-wen Weng
Hui Shao
Han Bo
Zhi-hui Chen
Meng Song
Lu-ping Liu
Ling-yun Zhang
Jia-yu Liu
Yu-han Wang
Meng-meng Zhang
Xi-you Wang
Ya-nan Sun
Chang-he Yu
Xi-you Wang
Ya-nan Sun
Chang-he Yu
author_sort Yi-xuan Gao
collection DOAJ
description Abstract The Zurich Claudication Questionnaire (ZCQ) has been translated and validated in multiple languages but few people have verified the measurement performance of the Chinese version of Zurich Claudication Questionnaire (Ch-ZCQ). The purpose of this study is to assess the performance of the Ch-ZCQ in lumbar spinal stenosis (LSS) patients undergoing non-surgical treatment. It includes the reliability, validity, responsiveness and minimally clinical important difference (MCID) of the two dimensions of symptom severity (SS) and physical function (PF). The results shows that the internal consistency and test-retest reliability were good. The content validity index was 0.764. The structural validity was good and moderate suitability. The correlation between the two dimensions of ZCQ is good, which is strongly correlated with Oswestry Disability Index (ODI) and moderately correlated with 12-item Short Form Health Survey Version 2(SF-12v2). Discriminative validity had significant differences in the degree of classification. The ZCQ’s SS and PF dimensions demonstrated a moderate Effect Size (ES) of 0.46 and 0.35. The Standardized Response Mean (SRM) was low, with values of 0.34 and 0.25. Additionally, the Change Rate (CR) was 10% for both, indicating a low level of change. MCID SS= -0.21[95% CI (-0.36, -0.05)]; MCID PF= -0.16[95% CI (-0.36, -0.03)]. This study demonstrates the Ch-ZCQ to be a reliable and valid tool, which can effectively evaluate the effectiveness of nonsurgical treatments for patients with LSS. However, to optimize its application for the Chinese population, further refinement is needed to address the ceiling/floor effects of some items.
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spelling doaj-art-a5bb08d14c664bdbb40aad3fd9cfbb752025-08-20T03:04:30ZengNature PortfolioScientific Reports2045-23222025-05-011511810.1038/s41598-025-01380-wReliability, validity and minimum clinical importance difference of the Chinese version of the Zurich claudication questionnaireYi-xuan Gao0Zhi-wen Weng1Hui Shao2Han Bo3Zhi-hui Chen4Meng Song5Lu-ping Liu6Ling-yun Zhang7Jia-yu Liu8Yu-han Wang9Meng-meng Zhang10Xi-you Wang11Ya-nan Sun12Chang-he Yu13Xi-you WangYa-nan SunChang-he YuFirst clinical college, Beijing University of Chinese MedicineTuina and pain management department, Beijing University of Chinese Medicine Affiliated Dongzhimen HospitalTuina and pain management department, Beijing University of Chinese Medicine Affiliated Dongzhimen HospitalTuina and pain management department, Beijing University of Chinese Medicine Affiliated Dongzhimen HospitalLiaoning University of Traditional Chinese MedicineLiaoning University of Traditional Chinese MedicineTraditional Chinese medicine department, Yongshun Community Health Service CenterFirst clinical college, Beijing University of Chinese MedicineFirst clinical college, Beijing University of Chinese MedicineFirst clinical college, Beijing University of Chinese MedicineFirst clinical college, Beijing University of Chinese MedicineTuina and pain management department, Beijing University of Chinese Medicine Affiliated Dongzhimen HospitalTraditional Chinese medicine department, Xuanwu Hospital Capital Medical UniversityTuina and pain management department, Beijing University of Chinese Medicine Affiliated Dongzhimen HospitalAbstract The Zurich Claudication Questionnaire (ZCQ) has been translated and validated in multiple languages but few people have verified the measurement performance of the Chinese version of Zurich Claudication Questionnaire (Ch-ZCQ). The purpose of this study is to assess the performance of the Ch-ZCQ in lumbar spinal stenosis (LSS) patients undergoing non-surgical treatment. It includes the reliability, validity, responsiveness and minimally clinical important difference (MCID) of the two dimensions of symptom severity (SS) and physical function (PF). The results shows that the internal consistency and test-retest reliability were good. The content validity index was 0.764. The structural validity was good and moderate suitability. The correlation between the two dimensions of ZCQ is good, which is strongly correlated with Oswestry Disability Index (ODI) and moderately correlated with 12-item Short Form Health Survey Version 2(SF-12v2). Discriminative validity had significant differences in the degree of classification. The ZCQ’s SS and PF dimensions demonstrated a moderate Effect Size (ES) of 0.46 and 0.35. The Standardized Response Mean (SRM) was low, with values of 0.34 and 0.25. Additionally, the Change Rate (CR) was 10% for both, indicating a low level of change. MCID SS= -0.21[95% CI (-0.36, -0.05)]; MCID PF= -0.16[95% CI (-0.36, -0.03)]. This study demonstrates the Ch-ZCQ to be a reliable and valid tool, which can effectively evaluate the effectiveness of nonsurgical treatments for patients with LSS. However, to optimize its application for the Chinese population, further refinement is needed to address the ceiling/floor effects of some items.https://doi.org/10.1038/s41598-025-01380-wThe Zurich claudication questionnaireSpinal stenosisReliabilityValidityResponsiveness
spellingShingle Yi-xuan Gao
Zhi-wen Weng
Hui Shao
Han Bo
Zhi-hui Chen
Meng Song
Lu-ping Liu
Ling-yun Zhang
Jia-yu Liu
Yu-han Wang
Meng-meng Zhang
Xi-you Wang
Ya-nan Sun
Chang-he Yu
Xi-you Wang
Ya-nan Sun
Chang-he Yu
Reliability, validity and minimum clinical importance difference of the Chinese version of the Zurich claudication questionnaire
Scientific Reports
The Zurich claudication questionnaire
Spinal stenosis
Reliability
Validity
Responsiveness
title Reliability, validity and minimum clinical importance difference of the Chinese version of the Zurich claudication questionnaire
title_full Reliability, validity and minimum clinical importance difference of the Chinese version of the Zurich claudication questionnaire
title_fullStr Reliability, validity and minimum clinical importance difference of the Chinese version of the Zurich claudication questionnaire
title_full_unstemmed Reliability, validity and minimum clinical importance difference of the Chinese version of the Zurich claudication questionnaire
title_short Reliability, validity and minimum clinical importance difference of the Chinese version of the Zurich claudication questionnaire
title_sort reliability validity and minimum clinical importance difference of the chinese version of the zurich claudication questionnaire
topic The Zurich claudication questionnaire
Spinal stenosis
Reliability
Validity
Responsiveness
url https://doi.org/10.1038/s41598-025-01380-w
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