Use of Patient-Reported Outcome Measures in Foot and Ankle Research

2013 ◽  
Vol 95 (16) ◽  
pp. e118 ◽  
Author(s):  
Kenneth J. Hunt ◽  
Daniel Hurwit
Keyword(s):  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Foot And Ankle ◽  
Patient Reported ◽  
Ankle Research

scholarly journals Minimal Clinically Important Difference of Patient Reported Outcome Measures of Lower Extremity Injuries in Orthopedics

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0007 ◽  
Author(s):  
Derya Çelik ◽  
Özge Çoban ◽  
Önder Kılıçoğlu
Keyword(s):  
Lower Extremity ◽  
Outcome Measures ◽  
Minimal Clinically Important Difference ◽  
Rating Scale ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Foot And Ankle ◽  
Clinically Important Difference ◽  
Outcome Score ◽  
Patient Reported

Purpose: MCID scores for outcome measures are frequently used evidence-based guides to gage meaningful changes. To conduct a systematic review of the quality and content of the the minimal clinically important difference (MCID) relating to 16 patient-rated outcome measures (PROM) used in lower extremity. Methods: We conducted a systematic literature review on articles reporting MCID in lower extremity outcome measures and orthopedics from January 1, 1980, to May 10, 2016. We evaluated MCID of the 16 patient reported outcome measures (PROM) which were Harris Hip Score (HHS), Oxford Hip Score (OHS), Hip Outcome Score (HOS), Hip Disability and Osteoarthritis Outcome Score (HOOS), The International Knee Documentation Committee Subjective Knee Form (IKDC), The Lysholm Scale, The Western Ontario Meniscal Evaluation Tool (WOMET), The Anterior Cruciate Ligament Quality of Life Questionnaire (ACL-QOL), The Lower Extremity Functional Scale (LEFS), The Western Ontario and Mcmaster Universities Index (WOMAC), Knee İnjury And Osteoarthritis Outcome Score (KOOS), Oxford Knee Score (OKS), Kujala Anterior Knee Pain Scale, The Victorian Institute of Sports Assessment Patellar Tendinosis (Jumper’s Knee) (VİSA-P), Tegner Activity Rating Scale, Marx Activity Rating Scale, Foot And Ankle Outcome Score (FAOS), The Foot Function Index (FFI), Foot And Ankle Ability Measure (FAAM), The Foot And Ankle Disability Index Score and Sports Module, Achill Tendon Total Rupture Score(ATRS), The Victorian İnstitute Of Sports Assesment Achilles Questionnaire(VİSA-A), American Orthopaedic Foot and Ankle Society (AOFAS). A search of the PubMed/MEDLINE, PEDro and Cochrane Cen¬tral Register of Controlled Trials and Web of Science databases from the date of inception to May 1, 2016 was conducted. The terms “minimal clinically important difference,” “minimal clinically important change”, “minimal clinically important improvement” “were combined with one of the PROM as mentioned above. Results: A total of 223 abstracts were reviewed and 119 articles chosen for full text review. Thirty articles were included in the final evaluation. The MCID was mostly calculated for WOMAC and frequently reported in knee and hip osteoartritis, knee and hip atrhroplasties, femoraasetabular impingement syndrome and focal cartilage degeneration. In addition, Receiver Operating Characteristic (ROC) analysis was the most used method to report MCID. Conclusions: MCID is an important concept used to determine whether a medical intervention improves perceived outcomes in patients. Despite an abundance of methods reported in the literature, little work in MCID estimation has been done in the PRAM related to lower extremity. There is a need for future studies in this regard.

scholarly journals Assessment of the structural validity of three foot and ankle specific patient-reported outcome measures

2020 ◽  
Vol 26 (2) ◽  
pp. 169-174 ◽  
Author(s):  
Ville T. Ponkilainen ◽  
Erkki J. Tukiainen ◽  
Mikko M. Uimonen ◽  
Arja H. Häkkinen ◽  
Jussi P. Repo
Keyword(s):  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Foot And Ankle ◽  
Structural Validity ◽  
Specific Patient ◽  
Patient Reported

Large variation in use of patient-reported outcome measures: A survey of 188 foot and ankle surgeons

2018 ◽  
Vol 24 (3) ◽  
pp. 246-251 ◽  
Author(s):  
R. Zwiers ◽  
H. Weel ◽  
W.H. Mallee ◽  
G.M.M.J. Kerkhoffs ◽  
C.N. van Dijk ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Foot And Ankle ◽  
Patient Reported

scholarly journals Readability and Suitability of Patient-Reported Outcome Measures in Foot and Ankle Surgery: A Health Literacy Assessment

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0021
Author(s):  
Christina Freibott ◽  
Seth C. Shoap ◽  
J. Turner Vosseller
Keyword(s):  
Outcome Measures ◽  
Grade Level ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Reading Level ◽  
Foot And Ankle ◽  
Reading Grade Level ◽  
Ankle Surgery ◽  
Patient Reported ◽  
Grade Reading Level

Category: Other; Ankle; Hindfoot; Midfoot/Forefoot; Trauma Introduction/Purpose: Health literacy is consistently reported as one of the best predictors of health status. This becomes even more important considering the complex medical information that is communicated to a patient during a clinical visit. Patient reported outcome measures (PROMs) are used on a standard of care basis in orthopedic surgery, and consistently included in research projects to elucidate meaningful clinical information. While there have been published assessments on the reading grade level of orthopedic PROMs in general, few address foot and ankle specific outcome measures. There have been no reports on aesthetic component of these PROMs, which have a major impact on readability. The purpose of this study is to report on the literacy, readability, and suitability of PROMs in foot and ankle surgery. Methods: A PubMed search was conducted to identify the most frequently utilized foot and ankle PROMs. Two recent systematic reviews identified 86 total PROMs in orthopedic surgery, 8 of which were foot and ankle specific. For the readability component, the Flesh-Kincaid reading grade level was assessed for each PROM. For the aesthetic component, the Suitability Assessment of Materials (SAM) was utilized to assess for content, literacy demand, graphics, layout, typography, learning stimulation, motivation and cultural appropriateness. SAM is a validated measure for analyzing print materials, and designate rankings of not suitable, adequate, or superior, based on results of the analysis. SAM scores were evaluated for all included PROMs by two investigators and averaged together for increased validity. Descriptive statistics were performed on all results. Statistical analysis was performed with SPSS Version 24.0. Results: The average Flesh-Kincaid grade for all PROMs was 6.12 (+-2.2, range 3.9-8.5). 5 of the 8 (62.5%) PROMs were at or below the AMA-recommended 6th grade reading level, with 6 of 8 (75.0%) below the NIH-recommended 8th grade reading level. The average SAM score for all included foot and ankle PROMs was ‘adequate,’ receiving a score of 1. 1 PROM was designated ‘not suitable,’ with the remaining 7 deemed ‘adequate.’ The area that scored the lowest on the SAM assessment was the ‘graphics’ section. Conclusion: The PROMs used in foot and ankle surgery perform well on the Flesh-Kincaid score in comparison to both the AMA and NIH reading grade level standards. The highest rating for the SAM score was average, indicating room for improvement in suitability. The inclusion of graphics and illustrations would make these scores more easily understood by patients, which can improve their healthcare experience and improve patient satisfaction and health outcomes.

scholarly journals Patient-Reported Outcome Measures for Patients with Diabetes Mellitus Associated with Foot and Ankle Pathologies: A Systematic Review

2019 ◽  
Vol 8 (2) ◽  
pp. 146 ◽  
Author(s):  
Ana Ortega-Avila ◽  
Pablo Cervera-Garvi ◽  
Laura Ramos-Petersen ◽  
Esther Chicharro-Luna ◽  
Gabriel Gijon-Nogueron
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Psychometric Properties ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Type I ◽  
Foot And Ankle ◽  
Foot Health ◽  
Patient Reported

Background: Diabetes mellitus (DM) is a chronic and complex disease, which is a major cause of morbidity and mortality and affects all age groups. It commonly produces secondary effects on the foot, often making daily activities impossible. Patient-reported outcome measures (PROMs) provide a standardised method of obtaining patients’ outlooks on their functional status and wellbeing. Although many instruments have been proposed for obtaining data on persons with DM whose feet are affected by the disease, in many cases the psychometric properties of the instrument have yet to be established. The principal objective of our review was to identify PROMs specific for patients with DM affecting the foot and ankle and to evaluate the psychometric properties and methodological quality of these instruments. Methods: In this systematic review, we investigate studies (published in English or Spanish) based on the use of one or more PROMs specific to foot and ankle pathologies for patients with DM (type I or II). To do so, the databases PubMed, Scopus, CINAHL, PEDro and Google Scholar were searched for studies that analysed psychometric or clinimetric properties in this respect. These were assessed according to Terwee or COSMIN criteria. Results: Of the 1016 studies identified in the initial search, only 11 were finally included in the qualitative review. Analysis according to Terwee and COSMIN criteria showed that the Foot Health Status Questionnaire (FHSQ) presented the greatest number of positive values. Conclusions: The FHSQ is the highest-quality PROM currently available for the foot and ankle, for patients with DM.

scholarly journals Patient Perceptions of Patient Reported Outcome Measures in Orthopedic Surgery (PROMOS): A Snapshot of Data for Foot and Ankle Patients

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0048
Author(s):  
Kempland C. Walley ◽  
Emily Vannatta ◽  
Chris M. Stauch ◽  
Madelaine W. Fritsche ◽  
Mark Dunleavy ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Perceptions ◽  
Foot And Ankle ◽  
Opiate Use ◽  
Ankle Surgery ◽  
Patient Reported ◽  
History Of ◽  
To Receive

Category: Other Introduction/Purpose: Used intimately to qualify the use of new surgical devices, advance new surgical techniques and evaluate faculty performance with regard to patient satisfaction and outcomes, patient reported outcome measures (PROMs) are commonplace across all sub-specialties in orthopaedics. Despite their theorized utility, these interactive tools are burdensome in clinic and their true utility is anecdotally in question. No prior study to the best of our knowledge has investigated the degree at which patients find them useful or even appropriate measures to objectify their injuries or state of recovery. The purpose of this study is to ascertain patient perceptions of the utility of commonly used patient reported outcome measures (PROMs) in foot and ankle surgery. Methods: After IRB approval, consecutive patients visiting a foot and ankle surgery outpatient clinic (either new or return) will be asked to complete a survey assessing their attitudes toward commonly used PROMs relevant to foot and ankle surgery. Upon verbal consent, patients will be asked a short series of demographic questions including: age, whether they are a new patient, sex, education level, disability status, current region of residence, and history of opiate use. After completion, patients will be shown the Visual Analog Scale (VAS) tool to quantify pain and asked two questions: 1) concerning effectiveness and 2) concerning their personal perceptions. Next, patients will be shown a single PROM used pertaining to their injury (eg, Foot & Ankle Disability Index (FADI)). All patient will comment on their perceptions of the VAS and one additional PROM specific to the sub-specialty in which there are seeking treatment. Results: We report a total of 39 patients in this preliminary data set (49% males, 51% females) with a mean age of 51 (range, 19 - 83). A majority of patients reported that both VAS and FADI are effective PROMs in foot and ankle surgery. Additionally, patients reported that there is no benefit to artificially inflating their PROMs to receive better/more-prompt patient care. These findings were independent of history of opiate use, disability, gender, or age cohort (Figure 1). Conclusion: The results of this study show that the majority of patients visiting a foot and ankle surgeon in the outpatient setting perceive both VAS and FADI are effective tools to describe their respective foot/ankle condition. Patients report, in this preliminary sample, do not ‘game’ these PROMs to receive better care though these study findings are subject to the Hawthorne Effect.

scholarly journals Comparison of Visual Analog Pain Score Reported to Physician vs Nurse in Postoperative Foot and Ankle Patients

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0005
Author(s):  
Trevor McBride ◽  
Kevin Martin ◽  
Aaron Joseph Wilke ◽  
Jamie Chisholm
Keyword(s):  
Outcome Measures ◽  
Nursing Staff ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Clinic Visit ◽  
Time Interval ◽  
Foot And Ankle ◽  
Pain Scores ◽  
Patient Reported ◽  
Vas Scores

Category: Patient Reported Outcome Measures Introduction/Purpose: The relativity of pain adds to the increasing ambiguity of deciding proper treatment procedures. Reliable and validated patient reported outcome measures have attempted to solve this problem, but there are still flaws due to the subjective nature of pain. This study is the third part to two previous studies that found both operative and new nonoperative patients overemphasize their pain scores when reporting to the treating physician as compared to a nurse. This current study aims to examine if this phenomenon holds true with orthopedic postoperative patients. The importance of this study is to observe this phenomenon, as to better understand subjective pain scores. We hypothesize there will be no differences in postoperative patients’ pain scores when reporting to a treating physician versus a nurse. Methods: This study is a retrospective cohort of consecutive postoperative foot and ankle patients treated by a single surgeon. The patients were asked to rate their pain intensity by the nursing staff and then by the surgeon using a standard horizontal visual analog scale (VAS) 0 to 10, from “no pain” to “worst pain” at 2, 6, and 12 weeks postoperatively. Differences in reported pain levels were analyzed within each clinic visit. Results: Two hundred and one patients each with 3 follow up encounters were included in our cohort. The mean 2, 6, and 12- week postoperative VAS scores reported to the physician were 2.85, 2.04, and 2.33 respectively; in comparison, the scores reported to the nurse were 2.52 (p=0.0005), 1.77 (p=0.002), and 2.02 (p=0.005) respectively. There was no significant relationship between time and type of provider. Conclusion: This study found that postoperative patients report their pain more consistently to physicians and nursing staff with no clinically significant differences noted. These findings stand in stark contrast to our two previous studies which noted new and preoperative patients reported significantly higher VAS scores to the physician. The reason for reporting inconstancies is unclear, but postoperatively patients no longer need to emphasize their impairments or injury. Postoperatively, they also have a defined time interval and more acute recollection of their pain potentially leading to more consistency in reporting.

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