Diagnostic validation of the Chinese version of the five-part questionnaire for screening joint hypermobility in young adults

Abstract

Abstract Joint hypermobility shows considerable variability across populations, yet validated screening tools for Mandarin-speaking cohorts are lacking. The Five-Part Questionnaire (5PQ) is widely used internationally, but its properties have not been evaluated in Chinese populations. This study assessed the validity and reliability of the Chinese version of the 5PQ (5PQ-CN) in a cohort of young Chinese university students. Participants completed the 5PQ-CN and underwent clinician-administered Beighton Score (BS) assessment, using the internationally recommended cut off of ≥ 5 to identify generalised joint hypermobility (GJH). Diagnostic validity was examined using sensitivity, specificity, predictive values, accuracy, and the area under the receiver operating characteristic curve (AUC). Test-retest reliability was evaluated using Cohen’s kappa (κ) and intraclass correlation coefficients (ICC). A total of 1,910 participants were recruited; 615 were included in the validity analysis and 325 in the reliability subgroup. The 5PQ-CN showed 78.6% sensitivity, 65.8% specificity, 72.2% accuracy, and an AUC of 0.722. Test-retest reliability demonstrated substantial agreement (κ = 0.703) and moderate consistency for the total score (ICC = 0.707). The 5PQ-CN is a valid and reliable self-report instrument for screening GJH in young Chinese adults within a university setting. Its high feasibility and sensitivity make it a useful complement to clinician-based assessments, particularly in large-scale or resource-limited epidemiological settings.