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               <mods:abstract>Background: The Manchester Foot Pain and Disability Index (MFPDI) is a self-assessment questionnaire developed in&#xd;
the UK to measure foot pain and disability in the general population1. It has been translated and validated in several&#xd;
languages 2,3&#xd;
Objectives: The aim of this study was to conduct cross-cultural adaptation and validation of the MFPDI into Spanish&#xd;
Methods: The cross-cultural adaptation process was undertaken using International Society for Pharmacoeconomics&#xd;
and Outcomes Research (ISPOR)4 recommendations. This involved 8 stages: i) Forward translation, ii) Reconciliation,&#xd;
iii) Back translation, iv) Back translation review, v) Harmonisation, vi) Pilot, vii) Pilot review, and viii) Proofreading. In the&#xd;
validation phase, the MFPDI datasets from the UK (original) and Spain (adapted) were pooled and subjected to Rasch&#xd;
analysis. Fit to the Rasch model, unidimensionality, reliability and cross-cultural invariance is reported&#xd;
Results: The pooled dataset comprised 1015 patients (Spain n=333 and UK n=682) with characteristics summarised in&#xd;
Table 1. Rasch analysis confirmed three subscales for both the Spanish and UK datasets and fit to the Rasch model X2&#xd;
(df) = 15.945 (12), p = 0.194 and 31.024 (21), p = 0.073, for Spain and UK . The reliability (Person Separation Index -&#xd;
PSI) was .85 and .82 for Spain and UK respectively. Significant cross-cultural non-invariance was present on the&#xd;
Functional and Personal appearance subscales. Adjustment for the bias was achieved by ‘splitting’ the affected&#xd;
subscales and creation of cultural-specific subscales for each country and cultural-general subscale. Fit to the Rasch&#xd;
model was satisfied following cross-cultural adjustment (Table 1). The MFPDI was calibrated into interval-level scales for&#xd;
Spain and UK to enable future data pooling or comparisons.&#xd;
Sampl&#xd;
e&#xd;
size&#xd;
Gender Age Item Fit&#xd;
Residual&#xd;
Person Fit&#xd;
Residual&#xd;
Chi Square&#xd;
Interaction&#xd;
PSI&#xd;
Analysis N Female&#xd;
(%)&#xd;
Mean&#xd;
(SD)&#xd;
Mean SD Mean SD Value&#xd;
(df)&#xd;
p&#xd;
Spain 333 248&#xd;
(74.4)&#xd;
51.6&#xd;
(15.2)&#xd;
-0.164 3.07 -&#xd;
0.364&#xd;
0.93 15.95&#xd;
(12)&#xd;
0.19 0.85&#xd;
UK 682 416&#xd;
(61.0)&#xd;
55.2&#xd;
(16.7)&#xd;
-0.366 2.80 -&#xd;
0.429&#xd;
0.99 31.02&#xd;
(21)&#xd;
0.07 0.82&#xd;
Pooled 1015 663&#xd;
(65.4)&#xd;
52.8&#xd;
(15.8)&#xd;
-0.766 4.40 -&#xd;
0.441&#xd;
1.06 49.17&#xd;
(27)&#xd;
0.01 0.84&#xd;
DIFAdjusted&#xd;
-0.420 2.98 -&#xd;
0.415&#xd;
0.98 57.94&#xd;
(45)&#xd;
0.09 0.84&#xd;
Table 1: P = Χ2 interaction probability, (non-significant P = Fit to the model), PSI = Person separation index&#xd;
Conclusions: A gold standard translation process (ISPOR) has been used to develop a Spanish (for Spain) version of&#xd;
the MFPDI, a widely used foot-specific patient-reported outcome measure. Rasch analysis has confirmed that the MFPDI&#xd;
is a robust 3-subscale measure of foot pain, function and appearance in both its English and Spanish versions. Future&#xd;
work can make cross-cultural comparisons using the calibrated scales</mods:abstract>
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               <mods:subject>
                  <mods:topic>Pies</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Dolor</mods:topic>
               </mods:subject>
               <mods:titleInfo>
                  <mods:title>PSYCHOMETRIC CHARACTERISTICS OF A SPANISH TRANSLATION OF THE MANCHESTER FOOT PAIN AND DISABILITY INDEX: VALIDATION AND RASCH ANALYSIS</mods:title>
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               <mods:genre>conference output</mods:genre>
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