Open Access Open Badges Research article

Cross-cultural adaptation and validation of Behçet's disease quality of life questionnaire

Zahi Touma1, Lilian Ghandour2, Abla Sibai2*, Houry Puzantian3, Ayad Hamdan4, Omar Hamdan5, Jeanine Menassa5, Imad Uthman5 and Thurayya Arayssi6*

Author Affiliations

1 University of Toronto, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto, Ontario, Canada

2 Department of Epidemiology and Population Health, American University of Beirut, Beirut, Lebanon

3 School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA

4 Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA

5 Department of Internal Medicine, Division of Rheumatology, American University of Beirut, Beirut, Lebanon

6 Weill Cornell Medical College-Qatar, Education City, Doha Qatar

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BMC Medical Research Methodology 2011, 11:52  doi:10.1186/1471-2288-11-52

Published: 20 April 2011



Currently, there is one Behçet's disease (BD) specific self reporting questionnaire developed and published in the literature, The Leeds BD-quality of life (QoL). We conducted a cross-cultural adaptation and validation of the Arabic version of the Leeds BD-QoL


A cross-sectional study was conducted among 41 consecutive patients attending rheumatology clinics at the American University of Beirut Medical Center between June and December 2007. The BD-QoL questionnaire, the Katz Index of Activities of Daily Living (ADL) and the Lawton Instrumental Activities of Daily Living (IADL) questionnaires were co-administered during the same visit, and severity scores were calculated. Cross-cultural adaptation of BD-QoL was performed using forward and backward translations of the original questionnaire. Internal consistency and test-retest reliability of the final version were determined. Exploratory Factor Analysis (EFA) was used to assess the dimensionality of the scale items. External construct validity was examined by correlating Arabic BD-QoL with the severity score, ADL and IADL.


The 30 items of the adapted Arabic BD-QoL showed a high internal consistency (KR-20 coefficient 0.89) and test-retest reliability (Spearman's test 0.91). The convergence of all 30 items suggests that the 30-item adapted Arabic BD-QoL scale is unidimensional. BD-QoL did not correlate with any of the patients' demographics. Still, it was positively correlated with patient severity score (r 0.4, p 0.02), and IADL (but not ADL).


This cross-cultural adaptation has produced an Arabic BD-QoL questionnaire that is now available for use in clinical settings and in research studies, among Arabic speaking patients.

Behçet's disease; Quality of life; Arabic version of BD-QoL; Cross-cultural adaptation; Validity and reliability