Observational studyJournal of orthopaedic surgery and research2026
Translation, cultural adaptation, and validation of the Persian version of the 4-Domain Sports PROM questionnaire.
Observational study in Journal of orthopaedic surgery and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAlthough most Patient-Reported Outcome Measures (PROMs) in sports medicine are anatomy-specific and limited in scope, the 4-Domain Sports PROM (4-DSP) offers a comprehensive, athlete-centered, and anatomy-independent alternative. Validating the Persian version addresses a critical need for Iran's substantial athletic community, which experiences a high prevalence of sports-related injuries. PURPOSE: To translate, culturally adapt, and validate the Persian 4-DSP for Persian-speaking athletes. STUDY
designCross-sectional observational study following COSMIN and STROBE guidelines.
methodsFollowing Beaton and ISPOR guidelines, the 4-DSP underwent forward-backward translation. Psychometric evaluation involved 112 Persian-speaking athletes (61 men, 51 women; mean age: 27.45±4.52 years) with orthopedic injuries 3-12 months prior. Face validity was assessed by 20 athletes using I-FVI. Content validity was evaluated by 10 experts using I-CVI, S-CVI/Ave, S-CVI/UA, and modified Kappa. Test-retest reliability was assessed using ICC with 24-48-hour intervals. Internal consistency (Cronbach's alpha), measurement error (SEM, MDC), feasibility (missing data), and interpretability (floor/ceiling effects) were also evaluated. Analyses were performed using SPSS v29.
resultsAll items showed acceptable face validity (I-FVI≥0.83); scale-level indices were excellent (S-FVI/Ave=0.95, S-FVI/UA=0.36). Content validity was robust (I-CVI≥0.78, S-CVI/Ave=0.95, modified kappa=0.94; S-CVI/UA=0.45). Test-retest reliability was excellent for the total score (ICC=0.91; 95% CI: 0.87-0.94) and good-to-excellent across domains (ICC: 0.84-0.93). Internal consistency was acceptable (α=0.77). Missing data were <2%, and no floor/ceiling effects were detected (<15%). SEM and MDC values supported clinical interpretation.
conclusionThe Persian 4-DSP demonstrates excellent face and content validity, very good reliability, and acceptable internal consistency, supporting its use as a feasible, culturally adapted tool for assessing treatment outcomes in Persian-speaking athletes. Future research should address convergent validity and responsiveness to fully establish construct validity.
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