Cross-cultural adaptation, reliability and construct validity of the Arabic Scleroderma Assessment Questionnaire in...

Systemic sclerosis (SSc) is a multisystem autoimmune disease characterized by fibrosis, vasculopathy, and internal organ involvement, resulting in substantial symptom burden and impaired quality of life. Reliable patient-reported outcome measures adapted to Arabic-speaking populations are lacking.

To develop a cross-cultural adaptation of the English version of the Scleroderma Assessment Questionnaire to the Arabic language (Ar-SAQ) and to assess its reliability and construct validity in SSc patients.

Translation and cultural adaptation process followed internationally accepted guidelines for patient-reported outcomes. After expert evaluation and pretesting for semantic clarity, the final version was administered to 193 SSc patients. Test-retest reliability was assessed over four weeks using intraclass correlation coefficients (ICC). Construct validity was analysed through correlation between total and domain scores of the Arabic questionnaire and the European Scleroderma Trial and Research Group activity index.

Patients included 171 females (88.6%) with a mean age of 44.6 ± 10.6 years. The Ar-SAQ demonstrated satisfactory reproducibility, with ICC results ranging from moderate to excellent (0.50-0.95). The musculoskeletal, respiratory, gastrointestinal, and total index of disease status indices showed good to excellent reliability (ICC = 0.90-0.95). The vascular index showed moderate reproducibility (0.50), consistent with naturally fluctuating vascular symptoms in SSc. Construct validity was confirmed by a significant positive correlation with the European Scleroderma Trial and Research Group activity index.

The Ar-SAQ is a reliable and valid instrument for assessing patient-reported disease status in Egyptian SSc patients and may serve as a foundation for further validation in other Arabic-speaking populations. Key Points • A culturally adapted Arabic version of the Scleroderma Assessment Questionnaire was developed following standardized cross-cultural adaptation guidelines. • The Arabic Scleroderma Assessment Questionnaire demonstrated good to excellent reliability and acceptable construct validity in Egyptian patients with systemic sclerosis. • This instrument provides a feasible patient-reported measure of disease status that may support clinical assessment and research in Arabic-speaking populations.