Original Article

Hand Therapy
0(0) 1–7
Cross-cultural adaptation and ! The Author(s) 2020
Article reuse guidelines:
measurement properties of the sagepub.com/journals-permissions
DOI: 10.1177/1758998320910177
Patient-Rated Tennis Elbow journals.sagepub.com/home/hth

Evaluation for the Persian language

Erfan Shafiee1,4 , Maryam Farzad1,2,4 , Joy Macdermid1,2,3 ,

Amirreza Smaeel Beygi4 , Atefeh Vafaei4 and
Amirreza Farhoud5

Abstract
Introduction: The Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire is a tool designed for self-assessment
of forearm pain and disability in patients with tennis elbow. The aims of this study were to translate and cross-culturally
adapt the PRTEE questionnaire into Persian and evaluate its reliability and construct validity.
Methods: The PRTEE questionnaire was translated into and cross-culturally adapted to Persian in 90 consecutive
patients with tennis elbow, according to well-established guidelines. Reliability was tested by means of test–retest
and internal consistency. The measurement error was measured by calculating the standard error of measurement.
Based on the standard error of measurement, the minimum detectable change was calculated. To evaluate construct and
convergent validity, correlation with the PRTEE with the Disabilities of the Arm, Shoulder and Hand questionnaire and
Visual analogue scale was used.
Results: In the process of cross-cultural adaptation, two items (6 and 8) were modified. In item 6, the term “door
knob” was changed to “turn a key”, and in the item 8, “cup of coffee” was changed to “cup of milk”. Item-total
correlations were greater than 0.55 (ranged from 0.55 to 0.76), internal consistency was high (Cronbach’s alpha,
0.94) and a high intraclass correlation coefficient (0.98) indicated excellent reliability of the P-PRTEE. The standard
error of measurement and minimum detectable change were 5.40 and 14.24, respectively. The Persian version of the
PRTEE questionnaire (P-PRTEE) shows strong construct and convergent validity (r values ¼ 0.85, p < 0.05).
Conclusions: The P-PRTEE is valid and reliable in assessing disability and pain in Persian patients with tennis elbow.
The excellent psychometric properties of the P-PRTEE endorse the use of this questionnaire in clinical settings.

Keywords
Tennis elbow, lateral epicondylitis, reliability, validity, psychometric properties, cross-cultural adaptation
Date received: 18 October 2019; accepted: 11 February 2020

1
Physical Therapy and Surgery, Western University, London, Ontario
2
Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph’s Health
Introduction Centre, London, Ontario
3
Tennis elbow (TE), also known as lateral epicondylitis Rehabilitation Science, McMaster University, Hamilton, Ontario
4
Occupational therapy, University of Social Welfare and Rehabilitation
is a common musculoskeletal condition associated with
Sciences, Tehran, Iran
pain at the elbow joint due to the degeneration of 5
Imam Hospital Complex, Tehran University of Medical Sciences, Joint
extensor carpi radialis brevis origin or the other exten- Reconstruction Center, Tehran, Iran
sor tendons of forearm.1 Work-related or sport-related
Corresponding author:
pain is the most common complaint of the patients Erfan Shafiee, Occupational Therapy Department, University of Western
with TE.2 Pain is caused by overuse, repetitive resisted Ontario, London, Ontario N6A 3K7, Canada.
wrist extension, muscle imbalance, training errors, and Email: eshafiee@uwo.ca
2 Hand Therapy 0(0)
psychological factors. This results in loss of function,
limitations, and disability.3
Detection of pain and limitations in function can
help to evaluate the effectiveness of treatments and
changes of symptoms over time. For decades, the mea-
surement of outcomes in elbow pathologies has relied
on general patient-reported outcome measures. Mostly
the Disabilities of the Arm, Shoulder and Hand ques-
tionnaire (DASH) has been used to measure function
and symptoms in patients with upper extremity condi-
tions. The DASH consists of 30 items and is confirmed
to have acceptable measurement properties to evaluate
function and disability.4 It has been used in patients
with TE.5,6 However, it is thought that disease-
specific questionnaires can better diagnose, screen,
and determine the outcomes. Several assessment tools
and questionnaires have been developed for elbow
conditions.4,7,8
The Patient-rated Elbow Evaluation (PREE) is one
such questionnaire which is designed to measure pain
and disability in patients with elbow injuries.9 In 2005,
the PREE was modified to the Patient-Rated Tennis
Elbow Evaluation questionnaire (PRTEE) as a
disease-specific, patient-reported questionnaire.6,10
The PRTEE has been specifically designed to mea-
sure pain and function in patients with TE over time. It
provides a very quick and easy way to evaluate pain
and function in patients with TE. Good psychometric
properties of the PRTEE are reported in different
languages.11–20 The PRTEE is a 15-item questionnaire
with two subscales addressing both pain and function
(5 pain items, and 10 function items). Items are scored
on a 0 to 10 scale, where 0 is the best possible score in
each subscale. It takes an average of 6 min to complete
the PRTEE. The total score is calculated as the sum
of the pain items, plus half sum of the function items.
The maximum score is 50 in each subscale and 100 in
total, with higher scores indicating severe pain and
limitations.10
There is no Persian version of the PRTEE available
now for the general Persian population, except for a
study, which reported psychometric properties of the
Persian version of the PRTEE in tennis players.20 In
order to use this questionnaire for a Persian-speaking
population, a rigorous process of cultural adaptation
and evaluation of psychometric properties was needed.
The aims of this study were to: (i) cross-culturally
adapt the PRTEE into Persian language and culture;
and (ii) test its measurement properties (reliability and
construct validity).
Methods
This study consisted of two phases: firstly, the PRTEE
was translated into and cross-culturally adapted for the
Persian language. In the second phase, reliability and
construct validity were assessed. The medical ethical
committee of the University of Social Welfare and
Rehabilitation (USWR) approved the study protocol
(IR.USWR.REC.1398.141).
Phase1: Translation and cross-cultural adaptation
process
The process of translation was performed in five stages
based on the guidelines developed by Beaton et al.21:
(i) Initial translation: Two bilingual health professio-
nals (a hand therapist and a hand surgeon) whose
first language is Persian performed the initial
translations separately. None of them were
aware of the questionnaire concepts.
(ii) Synthesis of the translations: Two translators and
one observer (ES) synthesized the results of the
translations through consensus.
(iii) Back translation: Two translators who were
blind to the original questionnaire did the back
translation to identify ambiguous wording in the
translations.
(iv) Expert committee review: To achieve cross-
cultural equivalency, an expert committee consol-
idated all the versions of the questionnaire and
developed the pre-final version. The committee
comprised a methodologist, hand surgeon, hand
therapist, and language professionals. Once the
semantic and idiomatic equivalence was achieved,
the final back-translated English version was
sent to the developer of the PRTEE (JM) to
check the items conceptually for potential areas
of discrepancy.
(v) Test of the pre-final version: In order to determine
cognitive equivalence and debriefing, cognitive
interviews with patients were used on the final ver-
sion of the Persian PRTEE (P-PRTEE) question-
naire. Patients with a confirmed diagnosis of TE
were interviewed for pilot testing to investigate
their understanding of each individual item.22
Interviews continued until saturation was reached.
Each participant was asked whether they had any
difficulty to understand the sentences. Participants
were also asked what they thought each question
means. The meaning of the items, tasks, and the
selected responses were also discussed.
Phase 2: Psychometric testing
Test–retest reliability, internal consistency, and mea-
surement error were used to assess reliability.23
Construct validity was assessed by hypothesis testing,
where the strength of the relationship between the
Shafiee et al.
P-PRTEE and the DASH questionnaire was investigat-
ed.24 The DASH questionnaire was used for conver-
gent validity, because it measures the same construct
as the PRTEE questionnaire. The visual analogue scale
(VAS) was also used to evaluate the construct validity
of the PRTEE pain subscale.
The DASH is a 30-item self-report questionnaire
that measures physical function and symptoms in
patients with musculoskeletal disorders. Each item is
rated from 1 to 5, which means less difficulty or
unable to do the activities, respectively. The total
score is from 0 to 100, with 0 reflecting no difficulty
and 100 severe disability. In this study we used the
Persian version of DASH questionnaire.25 The VAS
is a measurement instrument used to quantify the
pain intensity level of patients. Patients are asked to
rate their pain on a 0 to 10 VAS, with higher scores
indicating more pain intensity.26
Participants
Between January 2018 and May 2019, 90 consecutive
patients with TE were included. Clinical diagnosis of
TE was confirmed by imaging results (simple radiogra-
phy to rule out other pathologies), positive provocative
tests, and a pain score of 3 cm on the VAS. Patients
under 18 years old, with concomitant pathology in the
wrist or shoulder, numbness in the dorsal radial part of
hand, and inability to complete the questionnaire were
excluded. Written informed consent was obtained from
all of the participants at baseline. Demographic data
were collected at baseline. Participants were asked to
complete the Persian version of both the PRTEE and
DASH questionnaires and to rate their pain based on
the VAS on a single occasion. Participants were also
asked to fill out the P-PRTEE questionnaire 48 h after
initial data gathering.
Data analysis
Descriptive statistics were used to summarize partici-
pant characteristics.
To estimate the test–retest reliability, the intraclass
correlation coefficient (ICC) was used. An ICC greater
than 0.75 was considered as excellent reliability.27
Internal consistency was assessed by means of
Cronbach’s alpha. Values greater than 0.70 were con-
sidered as acceptable reliability.28
To measure internal consistency and item discrimi-
nation index, item total correlation was used. Values of
0.4 and above were considered as very good internal
consistency.29
Standard error of measurement (SEM) is a measure
of within-subject variability defined as the standard
deviation at the baseline measure adjusted for the
3
internal consistency (SEM ¼ SD冑 1  r), which was
used to measure the error of measurement.30
Based on the SEM, the minimum detectable change
(MDC; MDC95 ¼ SEM  1.96 冑2) was determined,
which describes the amount of true change in patient
status beyond measurement error with 95% certainty.
To investigate the construct validity, the relationship
between the P-PRTEE and the DASH and between the
pain subscale of the P-PRTEE and VAS were evaluated
with the use of the Pearson correlation coefficient (r).
An r value greater than 0.70 was considered a strong
correlation.31
The level of statistical significance was set at
p < 0.05. All analyses were conducted using SPSS
version 23.
Results
Phase 1: Translation and cross-cultural adaptation
Most terms in the PRTEE were simple, easy to trans-
late and understand. However, to culturally adapt,
some items were modified. Items number 6 and
8 were modified in order to improve the practical
equivalence and understanding of the translated ques-
tions. The modifications were done to improve under-
standing of the aimed activity due to cultural
differences.
The phrase “doorknob” was omitted as it is not
commonly used in the Persian population. This item
was changed to “using a key to open a closed door”,
after discussion with the developer to retain the con-
cept of a common functional task requiring forearm
rotation. Also, due to uncommon use of “coffee”, it
was changed to “tea” in the item “lift a full coffee
cup or glass of milk to your mouth’’.
The final version of the P-PRTEE was approved by
the developer to be used for cognitive interviews.
Cognitive interviews were conducted with five partici-
pants (3 female and 2 male, mean age of 40 years,
ranged from 32 to 57) with TE. From the cognitive
interviews, patients revealed that the P-PRTEE is
easy to complete and they understood the items appro-
priately when asked.
Phase 2: Psychometric testing
A total of 90 consecutive patients with TE were
enrolled from January 2018 to May 2019. The mean
age was 46 years (standard deviation (SD ¼ 11); ranged
from 22 to 68). Symptom duration less than one month
was seen in 18 (20%) patients and the remainder had
symptoms more than one month. Sixty-two percent of
patients were female, and 93% of patients were right
handed (Table 1).
4 Hand Therapy 0(0)

The ICC was 0.98 (95%CI ¼ 0.97 to 0.99), indicating A strong, significant correlation was found between
excellent test–retest reliability. Cronbach’s alpha of the total score of the P-PRTEE and the DASH ques-
0.94 and item total correlation of 0.55 (ranged from tionnaire, indicating good construct validity of the
0.55 to 0.76) indicated excellent internal consistency P-PRTEE (r values ¼ 0.85, p < 0.05). A strong correla-
of the P-PRTEE. The lowest correlation (r ¼ 0.55) tion was found between the function subscale of
belonged to two items of the pain subscale and total the P-PRTEE and the DASH (r ¼ 0.91, p < 0.05).
score of the P-PRTEE (pain at rest and when your pain A strong correlation was found between the pain sub-
was at its worst). The highest correlation (r ¼ 0.76) was scale of the P-PRTEE and the DASH questionnaire
between the item “turn a key using my affected hand” (r ¼ 0.74, p < 0.05). Pain, measured by the VAS, had
and the total score of the P-PRTEE questionnaire a strong correlation with pain subscale of the
(Table 2). The SEM was calculated based on the for- P-PRTEE (r ¼ 0.77, p < 0.05).
mula and was 5.4. Minimal detectable change, calcu-
lated based on the SEM value was 14.24.
Discussion
The Persian version of the Patient-Rated Tennis
Table 1. Demographic data of participants. Elbow Evaluation (P-PRTEE) questionnaire was
cross-culturally adapted and shows excellent psycho-
N (%) or
metric properties in terms of reliability (internal con-
Variables mean (SD)
sistency and test–retest) and construct validity.
Sex We followed the guidelines of the cross-cultural
Female 56 (62%) adaptation developed by Beaton et al. for translation.21
Male 34 (38%) In the process of the cross-cultural adaptation of
Mean age the P-PRTEE, we changed the term “doorknob” to
years 46.4 (10.7)
“turn a key”, and the term “coffee” to “tea”, to be
Injured hand
Right 84 (93%)
more reflective of the Persian culture. Except for
Left 6 (7%) these two terms in items number 6 and 8, no difficulties
Duration were found in the translated version of the
<1 Month 18 (20%) questionnaire.
1–6 Months 56 (62%) The P-PRTEE showed excellent test–retest reliabili-
6–12 Months 6 (7%) ty (ICC ¼ 0.98). This result was expected, as it was sim-
>1 year 10 (11%) ilar to other studies.11,12,14,16,20 However, it was higher
PRTEE total score—baseline than the original version of the PRTEE32 (ICC ¼ 0.89)
53.7 (21.2) 53.7 (21.2)
and the French version15 (ICC ¼ 0.86). This difference
SD: standard deviation. in the ICC value could be due to the difference of time

Table 2. Mean and SD of the items and item total correlation for the PRTEE.

Item total Cronbach’s alpha

Item Mean (SD) correlation if item deleted

When you are at rest 4.2 (3.1) 0.55 0.94

When doing a task with repeated arm movement 6.3 (2.4) 0.68 0.93
When carrying a plastic bag of groceries 6.5 (2.7) 0.59 0.93
When your pain was at its least 2.7 (2.6) 0.72 0.94
When your pain was at its worst 7.9 (2.4) 0.55 0.94
Turn a key using my affected hand 3.5 (3.1) 0.76 0.94
Carry a grocery bag or briefcase by the handle 6.4 (2.6) 0.60 0.93
Lift a full coffee cup or glass of milk to your mouth 3.4 (2.9) 0.68 0.94
Open a jar 6.5 (3.2) 0.59 0.93
Pull up pants 3.9 (3.1) 0.71 0.93
Wring out a washcloth or wet towel 6.2 (3.2) 0.69 0.94
Personal activities (dressing, washing) 4.2 (2.7) 0.64 0.93
Household work (cleaning, maintenance) 5.8 (3.0) 0.57 0.94
Work (your job or everyday work) 6.04 (3.0) 0.68 0.94
Recreational or sporting activities 6.07 (2.9) 0.72 0.94
Shafiee et al.
interval for the test–retest evaluation in the French ver-
sion (30 min), and the original version (one week later)
in comparison to our study (48 h). We decided the 48-h
time interval, because it seems long enough for patients
to reduce the likelihood of remembering and repeating
their responses while their conditions would not be
changed.
The high Cronbach’s alpha of the Persian version of
PRTEE (0.94) is similar to that of the Italian11 (0.95),
German33 (0.94), Swedish13 (0.94), and Greek version18
(0.95). High values of Cronbach’s alpha (greater than
0.90) can indicate redundancy of the items, and further
studies are needed to assess the effect of deleting some
items in future development.28
Two items of the pain subscale showed low correla-
tion with total score of the PRTEE suggesting that
these questions are not appropriate to measure pain
in this context (pain at rest and how often do you
have pain). Further factor analysis and Rasch analysis
need to be undertaken to assess this. The strongest cor-
relation was found between the item “turn a key using
my affected hand” and total score of the PRTEE
(r ¼ 0.76). This strong correlation was expected, as
the lateral epicondyle is the origin of the common supi-
nator muscles that is involved in extension and supina-
tion of the wrist.
The small value of SEM (5.4) indicates that the
P-PRTEE can evaluate changes precisely. The finding
of MDC value (MDC95 ¼ 14.24) will help clinicians to
determine relatively true changes following their inter-
ventions or over time.
In terms of construct validity, the total score of the
P-PRTEE showed a high correlation with the total
score of the DASH questionnaire (r ¼ 0.85), which indi-
cates excellent construct validity of the P-PRTEE.
Previous studies reported moderate to strong correla-
tions with the DASH ranging between 0.6512,34 to
0.88.11,13 This variation in the reported construct valid-
ity could be due to the different approaches in mea-
surement of disability between the PRTEE and the
DASH. In other words, what is measured by the
DASH is the ability to perform activities in general,
whilst the PRTEE measures the ability of patients to
perform activities using their affected hand.
As there is no gold standard for the evaluation of
pain and disability in the patients with TE, the VAS
and the DASH questionnaires were used to evaluate
the construct validity of the P-PRTEE. The DASH is
believed to be the best instrument in the assessment of
disability in patients with hand and upper limb injuries.
The Persian version of the DASH is known to be reli-
able and valid in the hand injuries.25 Therefore, the
DASH was used for the construct validity evaluation.
The pain and function subscales of the P-PRTEE had a
strong correlation with the DASH questionnaire
5
(r ¼ 0.91 and 0.74, respectively). Furthermore, the
VAS and the pain subscale of the P-PRTEE had a
strong correlation (r ¼ 0.77). These findings support
the construct validity of the P-PRTEE.
There are some limitations to this study. Firstly, the
sample size was too small to perform factor analysis for
better determination of construct validity. Secondly, it
might have been better to enroll patients before and
after treatments to evaluate responsiveness of this ques-
tionnaire. Findings of item total correlation and MDC
are the strengths of this study which can be used in
future research.
Conclusions
The P-PRTEE as a disease-specific patient-reported
measure captures different aspects of pain and function
in patients with TE. The results of our study indicate
excellent psychometric properties of the P-PRTEE and
endorse the use of this questionnaire in clinical settings.
This questionnaire can be used to evaluate pain and
function, and also detect changes through time in the
Persian population with TE.
Acknowledgement
The authors would like to thank Prof. Macdermid for her
support in this paper.
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with
respect to the research, authorship, and/or publication of this
article.
Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.
Informed consent
Written informed consent was obtained from the patients for
their anonymized information to be published in this article.
Ethical approval
Ethical approval for this study was obtained from ethics com-
mittee of the University of Social Welfare and Rehabilitation
Sciences (IR.USWR.rec.1394.71).
Guarantor
MF.
Contributorship
MF and ES researched literature and conceived the study. AB
and AV were involved in protocol development, gaining eth-
ical approval, patient recruitment, and data analysis. AF was
the surgeon in this study to confirm the diagnosis of TE. JM
6 Hand Therapy 0(0)
was supervisor of this study and controlled all the process of
this study. MF and ES wrote the first draft of the manuscript.
All authors reviewed and edited the manuscript and approved
the final version of the manuscript.
ORCID iDs
Erfan Shafiee https://orcid.org/0000-0002-5449-2878
Maryam Farzad https://orcid.org/0000-0002-5470-5319
Joy Macdermid https://orcid.org/0000-0001-9311-7379
Amirreza Smaeel Beygi https://orcid.org/0000-0002-5394-
510X
References
1. Dines JS, Bedi A, Williams PN, et al. Tennis injuries:
epidemiology, pathophysiology, and treatment. J Am
Acad Orthop Surg 2015; 23: 181–189.
2. Viola L. A critical review of the current conservative ther-
apies for tennis elbow (lateral epicondylitis). Australas
Chiropr Osteopathy 1998; 7: 53.
3. Alizadehkhaiyat O, Fisher AC, Kemp GJ, et al. Pain,
functional disability, and psychologic status in tennis
elbow. Clin J Pain 2007; 23: 482–489.
4. Hudak PL, Amadio PC and Bombardier C. Development
of an upper extremity outcome measure: the DASH (dis-
abilities of the arm, shoulder, and head). Am J Ind Med
1996; 29: 602–608.
5. Janssen S and De Smet L. Responsiveness of the DASH
questionnaire for surgically treated tennis elbow. Acta
Chir Belg 2008; 108: 583–585.
6. MacDermid JC. Outcome evaluation in patients with
elbow pathology: issues in instrument development and
evaluation. J Hand Ther 2001; 14: 105–114.
7. Michener LA, McClure PW and Sennett BJ. American
Shoulder and Elbow Surgeons Standardized Shoulder
Assessment Form, patient self-report section: reliability,
validity, and responsiveness. J Shoulder Elbow Surg 2002;
11: 587–594.
8. Dowrick AS, Gabbe BJ, Williamson OD, et al. Outcome
instruments for the assessment of the upper extremity
following trauma: a review. Injury 2005; 36: 468–476.
9. Vincent J and MacDermid JC. The Patient-Rated Elbow
Evaluation (PREE). J Physiother 2012; 58: 274.
10. MacDermid J. Update: the patient-rated forearm evalu-
ation questionnaire is now the patient-rated tennis elbow
evaluation. J Hand Ther 2005; 18: 407–410.
11. Cacchio A, Necozione S, MacDermid JC, et al. Cross-
cultural adaptation and measurement properties of the
Italian version of the Patient-Rated Tennis Elbow
Evaluation (PRTEE) questionnaire. Phys Ther 2012; 92:
1036–1045.
12. Altan L, Ercan I and Konur S. Reliability and validity of
Turkish version of the patient rated tennis elbow evalu-
ation. Rheumatol Int 2010; 30: 1049–1054.
13. Nilsson P, Baigi A, Marklund B, et al. Cross-cultural
adaptation and determination of the reliability and valid-
ity of PRTEE-S (Patientskattad Utv€ardering av
Tennisarmbåge), a questionnaire for patients with lateral
epicondylalgia, in a Swedish population. BMC
Musculoskelet Disord 2008; 9: 79.
14. Van Ark M, Zwerver J, Diercks RL, et al. Cross-cultural
adaptation and reliability and validity of the Dutch
Patient-Rated Tennis Elbow Evaluation (PRTEE-D).
BMC Musculoskelet Disord 2014; 15: 270.
15. Blanchette MA and Normand MC. Cross-cultural adap-
tation of the patient-rated tennis elbow evaluation to
Canadian French. J Hand Ther 2010; 23: 290–299.
16. Lee D-R and Kim J-S. Reliability and validity of the
Korean Version of Patient-Rated Tennis Elbow
Evaluation. J Korean Soc Phys Med 2014; 9: 25–33.
17. Kaux JF, Delvaux F, Schaus J, et al. Cross-cultural adap-
tation and validation of the Patient-Rated Tennis Elbow
Evaluation Questionnaire on lateral elbow tendinopathy
for French-speaking patients. J Hand Ther 2016; 29:
496–504.
18. Stasinopoulos D, Papadopoulos C, Antoniadou M, et al.
Greek adaptation and validation of the Patient-Rated
Tennis Elbow Evaluation (PRTEE). J Hand Ther 2015;
28: 286–290.
19. Chung B and Wiley JP. Validity, responsiveness and reli-
ability of the Patient-Rated Tennis Elbow Evaluation.
Hand Ther 2010; 15: 62–68.
20. Mansoori A, Noorizadeh Dehkordi S, Mansour Sohani
S, et al. Cross-cultural adaptation and determination of
the validity and reliability of the Persian Version of the
Patient-Rated Tennis Elbow Evaluation (PRTEE) ques-
tionnaire in Iranian tennis players. Func Disabil J 2019; 2:
17–26.
21. Beaton DE, Bombardier C, Guillemin F, et al. Guidelines
for the process of cross-cultural adaptation of self-report
measures. Spine (Phila 1976) 2000; 25: 3186–3191.
22. Willis GB. Research synthesis: the practice of cross-
cultural cognitive interviewing. Public Opin Q 2015; 79:
359–395.
23. Cho E and Kim S. Cronbach’s coefficient alpha: well
known but poorly understood. Organ Res Methods
2015; 18: 207–230.
24. Brahma S. Assessment of construct validity in manage-
ment research: a structured guideline. J Manag Res 2009;
9: 59–71.
25. Mousavi SJ, Parnianpour M, Abedi M, et al. Cultural
adaptation and validation of the persian version of the
Disabilities of the Arm, Shoulder and Hand (DASH) out-
come measure. Clin Rehabil 2008; 22: 749–757.
26. Nahler G and Nahler G. Visual analogue scale (VAS).
Dictionary of Pharmaceutical Medicine, Springer Verlag,
Vienna, 2009, pp.189.
27. Shrout PE and Fleiss JL. Intraclass correlations: uses in
assessing rater reliability. Psychol Bull 1979; 86: 420–428.
28. Tavakol M and Dennick R. Making sense of Cronbach’s
alpha. Int J Med Educ 2011; 2: 53–55.
29. Hwang IH. The usability of item-total correlation as the
index of item discrimination. Korean J Med Educ 2000;
12: 45–51.
Shafiee et al.
30. Cerin E. Standard error of measurement. In:
Encyclopedia of quality of life and well-being research.
Dordrecht: Springer, 2014.
31. Hemphill JF. Interpreting the magnitudes of correlation
coefficients. Am Psychol 2003; 58: 78–79.
32. Rompe JD, Overend TJ and MacDermid JC. Validation
of the Patient-rated Tennis Elbow Evaluation
Questionnaire. J Hand Ther 2007; 20: 3–10.
7
33. John M, Angst F, Pap G, et al. Cross-cultural adapta-
tion, reliability and validity of the patient rated elbow
evaluation (PREE) for German-speaking patients. Clin
Exp Rheumatol 2007; 25: 195–205.
34. Vincent J and MacDermid JC. Patient-rated
tennis elbow evaluation questionnaire. J Physiother
2014; 60: 240.