Research Article
Establishing the Psychometric Properties of the ICOAP
Questionnaire through Intra-Articular Treatment of
Osteoarthritic Pain: Implementation for the Greek Version
George E. Manolarakis,
1,2
Nick Kontodimopoulos,
1
Dimitra Sifaki-Pistolla,
3
and Dimitris Niakas
1
1
Faculty of Social Sciences, Hellenic Open University, Patras, Greece
2
Sitia’s General Hospital, Sitia, Crete, Greece
3
Medical School, Department of Social Medicine, University of Crete, Heraklion, Crete, Greece
Correspondence should be addressed to George E. Manolarakis; gem2017@med.cornell.edu
Received 21 September 2015; Revised 30 December 2015; Accepted 28 January 2016
Academic Editor: Henning Bliddal
Copyright © 2016 George E. Manolarakis et al. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Objectives. In this prospective study, we intend to establish the psychometric properties of ICOAP for its use in studies involving
the Hellenic population. Methods. SF-36 Health Survey was used as a standard against ICOAP scores from a sample of 89 patients
(mean age: 71.07, 69 females) with hip and knee OA pain who underwent 2 treatment cycles of 4 intra-articular injections of sodium
hyaluronate, separated by a 12-week medication-free time interval. Both questionnaires were flled twice with no missing data
during follow-up. Results. ROC analysis accomplished ICOAP’s criterion-related validation. Wilcoxon Signed-Rank Test and paired
samples -test endorsed ICOAP’s responsiveness along with Efect Size values, standard response mean, and Relative Efciency.
Comparisons between the areas under curves (AUC) on ROC plots established external responsiveness. Cronbach’s-alpha value
favored ICOAP’s internal consistency. Tis, along with intraclass correlation, results in both advocated reliability and content
validity. Interitem discrimination was demonstrated by the ease of completion of ICOAP as well as the degree of familiarity with it.
Tese fndings inaugurated construct validity in collaboration with Spearman’s and One-Way ANOVA results. Conclusions. ICOAP
is a valid, reliable, and responsive QoL instrument and suitable for studies of osteoarthritic joint pain in the Greek setting.
1. Introduction
During recent decades, the ongoing increase in life
expectancy has shifed the interest of health professionals
towards new ways of disease management. In the case
of osteoarthritis (OA), this interest addresses the most
important need of every arthritic patient: to live a pain-free
life at the lowest functional compromise.
Keeping in mind a variety of conservative and surgical
treatment methods that are still in use, it becomes obvious
that osteoarthritic pain comes into play as a major health-
related quality of life (HRQoL) determinant that challenges
any country’s health system efciency in terms of burden of
disease.
Among developed HRQoL questionnaires focused
on osteoarthritic pain, the Intermittent and Constant
Osteoarthritis Pain (ICOAP) questionnaire for hip and knee
osteoarthritis, a relatively new assessment tool, is the frst
to introduce the distinction of OA hip and knee pain in its
two components: constant (ICOAP-CP) and intermittent
(ICOAP-IP) pain. Tis distinction provides detailed
information for each of these two kinds of pain separately as
well as for total pain, thus forming a global view which difers
from “pain on activity” as measured by all the preexisted
questionnaires [1].
In this study, we attempt to establish the psychometric
properties, namely, validity, reliability, and responsiveness, of
the Greek version of the ICOAP questionnaire from a sample
Hindawi Publishing Corporation
Arthritis
Volume 2016, Article ID 6201802, 11 pages
http://dx.doi.org/10.1155/2016/6201802