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AB0771 Cross-cultural validation of the copcord methodology and health assessment questionnaire disability index (haq-di) in maya-yucateca and mixteco indigenous populations in mexico
  1. I. Pelaez-Ballestas1,
  2. J. Alvarez-Nemegyei2,
  3. F. Julian-Santiago3,
  4. A. Loyola-Sanchez4,
  5. M. V. Goycochea-Robles5,
  6. I. García-Olivera6,
  1. 1Rheumatology, Hospital General de Mexico, Mexico
  2. 2Medicine Faculty, Mayab-Anahuac University, Merida
  3. 3Medicine Faculty, UNAM, Mexico, Mexico
  4. 4McMaster University, Toronto, Canada
  5. 5Rheumatology, HGR1-IMSS, Mexico
  6. 6Rheumatology, Hospital Especialidades, Oaxaca, Mexico


Objectives Translate and validate the COPCORD (Community Oriented Program for the Control of Rheumatic Diseases) methodology among Mexican indigenous ethnicities (Maya-Yucateco and Mixteco) as a classification tool for rheumatic diseases, and apply the extended version of the Health Assessment Questionnaire Disability Index (svHAQ-Di).

Methods Subjects: ≥ 18 years-old pertaining to Mexican Maya-Yucateca (Yucatan) and Mixteco (Oaxaca) ethnic groups. Translation of the COPCORD questionnaire and the svHAQ-Di from Mexican Spanish to Maya-Yucateco and Mixteco languages by two licensed translators in each participating community; review the translations with bilingual members of the community (phase 1) creating the preliminary version and back-translation by five bilingual individuals for the pilot draft (phase 2), which was applied to 100 native monolingual subjects with the help of bilingual translators (phase 3). Consistency was assessed through the application of the pilot version to 30 monolingual individuals twice with 24-hour intervals.

Analysis Descriptive analysis. We applied the Chronbach’s α coefficient, correlations coefficient, intraclass correlation coefficient (ICC), logistic regression and diagnostic test analysis (sensitivity, specificity, LR+ and ROC curves) considering the diagnosis established by a specialist.

Results Modifications: the visual analog scale (0-10) was substituted for intensity and severity of pain by numerical misunderstanding of intensity by a metric Likert type with four options (none, little, much, and a lot). The need to assess physical activities appropriate to the rural-indigenous context was prevalent, so 212 subjects completed the questionnaire [112 (52.8%) Maya-Yucateco and 100 (47.1%) Mixteco group], with an average age of 18.2 (SD 43.9); 148 (69.8%) were women with a (IQR) 1 (0-6) years average education level; 68 (32.0 IC 95% 25.8-38.8) reported musculoskeletal pain in the last seven days. The pain most frequently reported included: 22.2% knee, 22.8% spine, 10.8% shoulder and 9.6% hand, while 39 (18%) reported suffering severe pain and 46/68 (67.6%) required treatment. A 48/68 (70.5 95% CI 58.2-81.0) rheumatic diagnosis was established in community: 12 (5.7; 95% CI 2.9-9.6) OA, ten (4.7; 95% CI 2.2-8.5) low back pain, nine (4.2; 95% CI 1.9-7.9) regional pain syndromes and six (2.8; 95% CI 1.0-6.0) AR. The results of the COPCORD questionnaire compared with the diagnosis established by a specialist are as follows: sensitivity: 63.6, specificity: 75.9, LR+: 2.6 and ROC curves: 0.69; 95% CI 0.61-0.77. The reproducibility of the instrument showed adequate external (r 0.70, p=0.001; ICC: 0.69, 95% CI: 0.43-0.84) and internal (Cronbach’s α coefficient: 0.81) consistency

Conclusions The COPCORD questionnaire is valid for application in Maya-Yucateco and Mixteco populations with transcultural adaptations, application with the help bilingual speakers and adequacy of physical and occupational local activities. These versions work well as a screening test.

Acknowledgements Funding: CONACYT- S0008- FONSEC SSA/IMSS/ISSSTE-162154

Disclosure of Interest None Declared

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