Italian cross-cultural adaptation and validation of the Oxford shoulder score Luigi Murena, MD, Ettore Vulcano, MD*, Fabio D’Angelo, MD, Maria Monti, MS, Paolo Cherubino, MD Dipartimento di Scienze Ortopediche e Traumatologiche ‘‘Mario Boni,’’ Universita ` dell’Insubria, Varese, Italy Background: The Oxford Shoulder Score (OSS) is an English-language questionnaire specifically designed to evaluate patients affected by shoulder pain. Although this scoring system has been translated into other languages, an Italian version of it is still not available. The aim of the present study was to trans- late, culturally adapt, and validate the Italian version of the OSS. Materials and methods: We recruited 140 patients with shoulder pain caused by degenerative or inflam- matory state or disorder of the shoulder. Patients completed the following questionnaires: Italian OSS, University of California, Los Angeles (UCLA) Shoulder Rating Scale, Constant-Murley shoulder assess- ment, and the Medical Outcome Study Short-Form 36 Health Survey (MOS SF-36). Internal consistency was tested using Cronbach coefficient a. Reproducibility was assessed by asking 110 patients to complete another OSS 48 hours after the first. Correlation between the total results of both tests was determined by the Pearson correlation coefficient. Validity was assessed by calculating the Pearson correlation coefficient between the OSS and the UCLA, Constant-Murley, and SF-36 assessments. Results: Cronbach a was 0.95. The Pearson correlation coefficient was r ¼ 0.97. With respect to validity, there was a significant correlation between the Italian OSS and the individual scores of UCLA, Constant- Murley, and SF-36. Discussion: Psychometric properties of the Italian OSS compared well with those reported for the English OSS. As demonstrated by the high values of Cronbach a and Pearson correlation coefficients, in accor- dance with the English version of the OSS, the Italian version proved to be a reliable, valid, and reproduc- ible measure of shoulder pain perception in Italian-speaking patients. Level of evidence: Level 1, Test of previously developed criteria, diagnostic test study. Ó 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. Keywords: Oxford shoulder score; shoulder; validation; quality of life; Italian translation A growing number of questionnaires evaluating quality of life of patients from several fields of medicine and surgery have been developed during the last few years, 10,19,37 and nearly all of these measurement methods are in the English language. These questionnaires specifically ascertain the patient’s needs and problems of everyday life and enable the patients to self-assess information about their physical and psychologic status. 18 Although many joint-specific scoring systems have been developed and translated in several lan- guages, 2,3,5,11,12,14,26,27,32,39,40 including questionnaires evaluating the upper limb, 19 no shoulder-specific ques- tionnaires assessing quality of life have been designed other *Reprint requests: Dr Ettore Vulcano, Universita ` dell’Insubria, Dipar- timento di Scienze Ortopediche e Traumatologiche ‘‘Mario Boni’’, Viale Borri 57, 21100 Varese, Italy. E-mail address: ettorevulcano@hotmail.com (E. Vulcano). J Shoulder Elbow Surg (2010) 19, 335-341 www.elsevier.com/locate/ymse 1058-2746/2010/$36.00 - see front matter Ó 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. doi:10.1016/j.jse.2009.07.068