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Lee MJ, Lee E, Bradburn M, Hind D, Strong EB, Din F, Wysocki AP, Lund J, Moffatt C, Morton J, Senapati A, Jones H, Brown SR. Research and practice priorities in pilonidal sinus disease: a consensus from the PITSTOP study. Colorectal Dis 2024. [PMID: 38671581 DOI: 10.1111/codi.16946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/01/2024] [Indexed: 04/28/2024]
Abstract
AIM Pilonidal sinus disease is a common condition treated by colorectal surgeons. There is a lack of literature in the field to guide optimal management of this condition. As part of the PITSTOP study, we aimed to identify policy and research priorities to provide direction to the field. METHOD Patients and surgeons were invited to participate. A 'So what, now what' exercise was conducted, informed by data from PITSTOP. This generated statements for research and practice priorities. A three-round online Delphi study was conducted, ranking statements based on policy and research separately. Statements were rated 1 (not important) to 9 (important). Statements that were rated 7-9 by more than 70% of participants were entered into the consensus meeting. Personalized voting feedback was shown between rounds. A face-to-face meeting was held to discuss statements, and participants were asked to rank statements using a weighted choice vote. RESULTS Twenty-two people participated in the focus group, generating 14 research and 19 policy statements. Statements were voted on by 56 participants in round 1, 53 in round 2 and 51 in round 3. A total of 15 policy statements and 19 research statements were discussed in the consensus round. Key policy statements addressed treatment strategies and intensity, surgeon training opportunities, need for classification and the impact of treatment on return to work. Research recommendations included design of future trials, methodology considerations and research questions. CONCLUSION This study has identified research and policy priorities in pilonidal sinus disease which are relevant to patients and clinicians. These should inform practice and future research.
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Affiliation(s)
- Matthew J Lee
- Department of Oncology and Metabolism, School of Clinical Medicine, University of Sheffield, Sheffield, UK
- Academic Directorate of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Ellen Lee
- Sheffield Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Mike Bradburn
- Sheffield Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Daniel Hind
- Sheffield Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Emily B Strong
- Sheffield Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Farhat Din
- Academic Coloproctology, Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital, Edinburgh, UK
| | | | - Jon Lund
- Royal Derby Hospital, University Hospitals of Derby and Burton, Derby, UK
| | | | - Jonathan Morton
- Addenbrookes Hospital, Cambridge University Hospitals, Cambridge, UK
| | - Asha Senapati
- St Mark's Hospital, London, UK
- Queen Alexandra Hospital, Portsmouth, UK
| | - Helen Jones
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Steven R Brown
- Academic Directorate of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
- Sheffield Clinical Trials Research Unit, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
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Worrall S, Harris EJ, Silverio SA, Fallon V. The identification and measurement of postpartum anxiety in England: A Delphi survey. J Psychiatr Res 2023; 168:381-391. [PMID: 37976556 DOI: 10.1016/j.jpsychires.2023.10.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 08/14/2023] [Accepted: 10/18/2023] [Indexed: 11/19/2023]
Abstract
Postpartum anxiety has negative consequences for both mother and infant, so effective identification and measurement is vital to enable intervention. Despite NICE recommendations to prioritise the measurement of postpartum anxiety in mothers, current clinical measurement in England remains both fragmented and flawed. The Postpartum Specific Anxiety Scale [PSAS] offers an alternative, as it measures maternal-focused anxieties which can enable specifically targeted interventions. However, it is only currently used as a research tool and may require modification for clinical use. To inform modification of the PSAS, nineteen stakeholders from a variety of organisations participated in a two-round Delphi consensus survey to measure its clinical relevance and potential for effective identification of clinical anxiety. Descriptive analyses revealed all subscales of the PSAS scored highly across all domains, excluding Practical Infant Care Anxieties. Analyses also indicated good consensus between stakeholders across specific items, suggesting that the some items on the PSAS are relevant and effective at identifying clinical postpartum anxiety. Participants also expressed a need for a shorter version of the PSAS for clinical use, and that additional items may need including. Future research must now adapt the existing PSAS based on the results of this study and pilot the adapted measure in a clinical population.
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Affiliation(s)
- Semra Worrall
- Department of Psychology, Institute of Population Health, University of Liverpool, UK
| | - Elizabeth J Harris
- Department of Psychology, Institute of Population Health, University of Liverpool, UK
| | - Sergio A Silverio
- Department of Women & Children's Health, School of Life Course & Population Sciences, King's College London, UK.
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, University of Liverpool, UK
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Bissenbakker KH, Møller A, Jønsson ABR, Brodersen JB. Generating Items for Measuring Needs-Based Quality of Life and Self-Perceived Health Inequity in Patients with Multimorbidity: Development of the MultiMorbidity Questionnaire (MMQ). Patient Relat Outcome Meas 2023; 14:269-282. [PMID: 37840835 PMCID: PMC10576455 DOI: 10.2147/prom.s427183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/30/2023] [Indexed: 10/17/2023] Open
Abstract
Purpose To describe the processes of developing domains and items for the MultiMorbidity Questionnaire (MMQ), a multimorbidity-specific PROM for the assessment of Needs-based QoL. Patients and Methods We developed items and domains for the MMQ through 17 qualitative content validity questionnaire interviews with adults with multimorbidity by testing items from an item bank (covering items with content inspired by existing Needs-based QoL measures for single diseases). The interviews alternated between an explorative part and more focused cognitive interview techniques. Results Testing the 47 items from the first draft of the MMQ items showed that the Needs-based approach as a framework did not cover all the QoL aspects our informants stated as being important. Therefore, the conceptual framework was supplemented by Self-perceived health inequity, and new items were generated. MMQ, measuring Needs-based QoL (MMQ1) and Self-perceived health inequity (MMQ2), was assembled. MMQ1 covers the domains: "Physical ability" (10 items), "Limitations in everyday life" (15 items), "Worries" (11 items), "My social life" (11 items), "Self-image" (12 items), and "Personal finances" (2 items). Self-perceived health inequity proved to be a relevant framework for other aspects of QoL not covered by the Needs-based approach to QoL. MMQ2 covers the domains: "Experiences of being stigmatized" (five items), "Experiences of not being seen and heard" (four items), "Insufficient understanding of the burden of disease" (three items) and "Experiences of feeling powerless" (five items). Conclusion We have developed the final MMQ draft, a multimorbidity-specific PROM for the assessment of Needs-based QoL (MMQ1) and Self-perceived health inequity (MMQ2) with high content validity (regarding content relevance and comprehensiveness). The final MMQ draft will be assessed for its psychometric properties using Modern Test Theory.
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Affiliation(s)
- Kristine Henderson Bissenbakker
- Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- The Research Unit for General Practice in Region Zealand, Primary and eHealth Care, Region Zealand, Denmark
| | - Anne Møller
- Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- The Research Unit for General Practice in Region Zealand, Primary and eHealth Care, Region Zealand, Denmark
| | | | - John Brandt Brodersen
- Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- The Research Unit for General Practice in Region Zealand, Primary and eHealth Care, Region Zealand, Denmark
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Symon A, Lightly K, Howard R, Mundle S, Faragher B, Hanley M, Durocher J, Winikoff B, Weeks A. Introducing the participant-generated experience and satisfaction (PaGES) index: a novel, longitudinal mixed-methods evaluation tool. BMC Med Res Methodol 2023; 23:214. [PMID: 37759174 PMCID: PMC10537543 DOI: 10.1186/s12874-023-02016-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 08/09/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Patient-Reported Outcomes or Experience Measures (PROMS / PREMS) are routinely used in clinical studies to assess participants' views and experiences of trial interventions and related quality of life. Purely quantitative approaches lack the necessary detail and flexibility to understand the real-world impact of study interventions on participants, according to their own priorities. Conversely, purely qualitative assessments are time consuming and usually restricted to a small, possibly unrepresentative, sub-sample. This paper, which reports a pilot study within a randomised controlled trial of induction of labour, reports the feasibility, and acceptability of the Participant-Generated Experience and Satisfaction (PaGES) Index, a new mixed qualitative / quantitative PREM tool. METHODS The single-sheet PaGES Index was completed by hypertensive pregnant women in two hospitals in Nagpur, India before and after taking part in the 'Misoprostol or Oxytocin for Labour Induction' (MOLI) randomised controlled trial. Participants recorded aspects of the impending birth they considered most important, and then ranked them. After the birth, participants completed the PaGES Index again, this time also scoring their satisfaction with each item. Forms were completed on paper in the local language or in English, supported by Research Assistants. Following translation (when needed), responses were uploaded to a REDCap database, coded in Excel and analysed thematically. A formal qualitative evaluation (qMOLI) was also conducted to obtain stakeholder perspectives of the PaGES Index and the wider trial. Semi-structured interviews were conducted with participants, and focus groups with researchers and clinicians. Data were managed using NVivo 12 software and analysed using the framework approach. RESULTS Participants and researchers found the PaGES Index easy to complete and administer; mothers valued the opportunity to speak about their experience. Qualitative analysis of the initial 68 PaGES Index responses identified areas of commonality and difference among participants and also when comparing antenatal and postnatal responses. Theme citations and associated comments scores were fairly stable before and after the birth. The qMOLI phase, comprising 53 one-to-one interviews with participants and eight focus groups involving 83 researchers and clinicians, provided support that the PaGES Index was an acceptable and even helpful means of capturing participant perspectives. CONCLUSIONS Subjective participant experiences are an important aspect of clinical trials. The PaGES Index was found to be a feasible and acceptable measure that unites qualitative research's explanatory power with the comparative power of quantitative designs. It also offers the opportunity to conduct a before-and-after evaluation, allowing researchers to examine the expectations and actual experiences of all clinical trial participants, not just a small sub-sample. This study also shows that, with appropriate research assistant input, the PaGES Index can be used in different languages by participants with varying literacy levels. TRIAL REGISTRATION Clinical Trials.gov (21/11/2018) (NCT03749902).
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Affiliation(s)
- Andrew Symon
- Mother and Infant Research Unit, University of Dundee, 11 Airlie Place, Dundee, DD1 4HJ, UK
| | - Kate Lightly
- Clinical Research Fellow, University of Liverpool, Liverpool Women's Hospital, Crown Street, Liverpool, L8 7SS, UK.
| | - Rachel Howard
- Medical Student, University of Liverpool, Liverpool, L69 3BX, UK
| | - Shuchita Mundle
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Nagpur, India
| | - Brian Faragher
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Molly Hanley
- Medical Student, University of Liverpool, Liverpool, L69 3BX, UK
| | - Jill Durocher
- Gynuity Health Projects (GHP), MOLI Trial Manager, 220 East 42nd Street, New York, NY, 10017, USA
| | - Beverly Winikoff
- Gynuity Health Projects (GHP), MOLI Trial Manager, 220 East 42nd Street, New York, NY, 10017, USA
| | - Andrew Weeks
- Sanyu Research Department, University of Liverpool, Liverpool Women's Hospital, Crown Street, Liverpool, L8 7SS, UK
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Moons P, Norekvål TM, Arbelo E, Borregaard B, Casadei B, Cosyns B, Cowie MR, Fitzsimons D, Fraser AG, Jaarsma T, Kirchhof P, Mauri J, Mindham R, Sanders J, Schiele F, Torbica A, Zwisler AD. Placing patient-reported outcomes at the centre of cardiovascular clinical practice: implications for quality of care and management. Eur Heart J 2023; 44:3405-3422. [PMID: 37606064 DOI: 10.1093/eurheartj/ehad514] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 05/01/2023] [Accepted: 07/25/2023] [Indexed: 08/23/2023] Open
Abstract
Patient-reported outcomes (PROs) provide important insights into patients' own perspectives about their health and medical condition, and there is evidence that their use can lead to improvements in the quality of care and to better-informed clinical decisions. Their application in cardiovascular populations has grown over the past decades. This statement describes what PROs are, and it provides an inventory of disease-specific and domain-specific PROs that have been developed for cardiovascular populations. International standards and quality indices have been published, which can guide the selection of PROs for clinical practice and in clinical trials and research; patients as well as experts in psychometrics should be involved in choosing which are most appropriate. Collaborations are needed to define criteria for using PROs to guide regulatory decisions, and the utility of PROs for comparing and monitoring the quality of care and for allocating resources should be evaluated. New sources for recording PROs include wearable digital health devices, medical registries, and electronic health record. Advice is given for the optimal use of PROs in shared clinical decision-making in cardiovascular medicine, and concerning future directions for their wider application.
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Affiliation(s)
- Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Kapucijnenvoer 35 PB7001, 3000 Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Arvid Wallgrens backe 1, 413 46 Gothenburg, Sweden
- Department of Paediatrics and Child Health, University of Cape Town, Klipfontein Rd, Rondebosch, 7700 Cape Town, South Africa
| | - Tone M Norekvål
- Department of Heart Disease, Haukeland University Hospital, Haukelandsveien 22, 5009 Bergen, Norway
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Jonas Lies veg, 875021 Bergen, Norway
| | - Elena Arbelo
- Cardiology Department, Hospital Clínic, Universitat de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain
- Institut d'Investigació August Pi i Sunyer (IDIBAPS). Rosselló 149-153, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - Britt Borregaard
- Department of Cardiology, Odense University Hospital, J.B. Winsløws Vej 4, 5000 Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 19, 5000 Odense, Denmark
| | - Barbara Casadei
- Division of Cardiovascular Medicine, RDM, University of Oxford; Headley Way, Headington Oxford OX3 9DU, UK
- NIHR Biomedical Research Centre, Headley Way, Headington Oxford OX3 9DU, UK
| | - Bernard Cosyns
- Department of Cardiology, University Hospital Brussels, Laarbeeklaan 101, 1090 Jette, Belgium
| | - Martin R Cowie
- Royal Brompton Hospital & School of Cardiovascular Medicine, Faculty of Medicine & Lifesciences, King's College London, Sydney St, London SW3 6NP, UK
| | - Donna Fitzsimons
- School of Nursing & Midwifery, Queens University Belfast, 97 Lisburn Road, Belfast | BT9 7BL, Northern Ireland
| | - Alan G Fraser
- School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XW, UK
| | - Tiny Jaarsma
- Department of Medicine, Health and Caring Sciences, Linköping University, Campus Norrköping, 601 74 Norrköping, Sweden
- Nursing Science, Julius Center, University Medical Centre Utrecht, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands
| | - Paulus Kirchhof
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, D-20246 Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Martinistrasse 52, D-20246 Hamburg, Germany
- Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston Birmingham B15 2TT, UK
| | - Josepa Mauri
- Department of Cardiology, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet, s/n, 08916 Badalona, Barcelona, Spain
| | - Richard Mindham
- European Society of Cardiology (ESC) Patient Forum, 2035 route des colles, CS 80179 Biot, 06903 Sophia Antipolis Cedex, France
| | - Julie Sanders
- St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK
- William Harvey Research Institute, Charterhouse Square, Queen Mary University of London, London EC1M 6BQ, UK
| | - Francois Schiele
- Department of Cardiology, University Hospital Besancon, 3 Bd Alexandre Fleming, 25030 Besançon, France
| | - Aleksandra Torbica
- Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Via Sarfatti, 10 20136 Milan, Italy
| | - Ann Dorthe Zwisler
- Department of Cardiology, Odense University Hospital, J.B. Winsløws Vej 4, 5000 Odense, Denmark
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Vestergade 17, 5800 Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Campusvej 55, DK-5230 Odense, Denmark
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Hansen CF, Madsen MØ, Warming S, Lind M, Faunø P, Rathcke MW, Krogsgaard MR, Christensen KB. Pedi-IKDC exhibits questionable measurement properties in a cohort of pediatric patients with ACL rupture. Scand J Med Sci Sports 2023; 33:1831-1840. [PMID: 37248641 DOI: 10.1111/sms.14413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 04/15/2023] [Accepted: 05/18/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND Pedi-IKDC is commonly used to evaluate anterior cruciate ligament (ACL) deficiency in children. However, its construct validity has not been thoroughly assessed. The aim was to examine the measurement properties of the Pediatric International Knee Documentation Committee (Pedi-IKDC) by modern test theory (MTT) models, confirmatory factor analysis (CFA), and item response theory (IRT). METHODS The cohort consisted of all children and adolescents in Denmark (n = 535, age 9-16) treated with physeal-sparing ACL reconstruction 2011-2020. Patient-reported outcome measure (PROM) data were collected before surgery and at 1 year follow-up. Structural validity of Pedi-IKDC was assessed with MTT models. Reliability was reported as McDonalds coefficient omega. Responsiveness was evaluated with standardized response means. RESULTS Sufficient PROM data were available for 372 patients. The original unidimensional construct did not fit CFA model expectations neither before surgery (χ2 = 462.0, df = 163, p < 0.0001; RMSEA: 0.109, CFI: 0.910, TFI: 0.895) nor at follow-up. Neither did a two-factor CFA model with "Symptoms" and "Sports activities" as individual subscales (χ2 = 455.6, df = 162, p < 0.0001) nor a bifactor model (χ2 = 338.9, df = 143, p < 0.0001), although fit indices improved with the latter (RMSEA: 0.094, CFI: 0.941, TFI: 0.922). The IRT models confirmed this pattern. The scale was responsive (SRM 1.66 (95% CI: 1.46-1.88)). Coefficient omega values were 0.866 before surgery and 0.919 at follow-up. CONCLUSIONS The Pedi-IKDC exhibited inadequate structural validity. Neither the original construct, a two-factor model, nor bifactor models fitted data well. We advise that data obtained by Pedi-IKDC are interpreted with caution.
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Affiliation(s)
- Christian Fugl Hansen
- Section of Sports Traumatology M51, Bispebjerg and Frederiksberg Copenhagen University Hospital, Copenhagen, Denmark
| | - Maria Østergaard Madsen
- Section of Sports Traumatology M51, Bispebjerg and Frederiksberg Copenhagen University Hospital, Copenhagen, Denmark
| | - Susan Warming
- Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg Copenhagen University Hospital, Copenhagen, Denmark
| | - Martin Lind
- Sector for Sports Traumatology, Aarhus University Hospital Skejby, Aarhus, Denmark
| | - Peter Faunø
- Sector for Sports Traumatology, Aarhus University Hospital Skejby, Aarhus, Denmark
| | - Martin Wyman Rathcke
- Section of Sports Traumatology M51, Bispebjerg and Frederiksberg Copenhagen University Hospital, Copenhagen, Denmark
| | - Michael Rindom Krogsgaard
- Section of Sports Traumatology M51, Bispebjerg and Frederiksberg Copenhagen University Hospital, Copenhagen, Denmark
| | - Karl Bang Christensen
- Section of Biostatistics Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Agergaard AS, Comins JD, Siersma V, Malmgaard-Clausen NM, Couppe C, Hjortshoej MH, Olesen JL, Magnusson SP. Assessment of the Psychometric Properties of the Danish VISA-P. TRANSLATIONAL SPORTS MEDICINE 2023; 2023:5291949. [PMID: 38654908 PMCID: PMC11022774 DOI: 10.1155/2023/5291949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/15/2023] [Accepted: 04/06/2023] [Indexed: 04/26/2024]
Abstract
Purpose The objective of the current study was to conduct a rigorous assessment of the psychometric properties of the Victorian Institute of Sports Assessment-patellar tendinopathy (VISA-P). Methods Rasch analysis, confirmatory factor analysis (CFA), and multivariable linear regression were used to assess the psychometric properties of the VISA-P questionnaire in 184 Danish patients with patellar tendinopathy who had symptoms ranging from under 3 months to over 1 year. A group of 100 healthy Danish persons was included as a reference for known-group validation. Results The analyses revealed that the 8-item VISA-P did not fit a unidimensional model, yielded at best a 3-factor model, and exhibited differential item functioning (DIF) across healthy subjects versus people with patellar tendinopathy. Conclusion VISA-P in its present form does not satisfy a measurement model and is not a robust scale for measuring patellar tendinopathy. A new PROM for patellar tendinopathy should be developed and appropriately validated, and meanwhile, simple pain scoring (e.g., numeric rating scales) and functional tests are suggested as more appropriate outcome measures for studies of patellar tendinopathy.
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Affiliation(s)
- Anne-Sofie Agergaard
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg and Frederiksberg, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
| | - Jonathan D. Comins
- Section for Sports Traumatology M51, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
- Novo Nordisk A/S, Søborg, Denmark
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Nikolaj M. Malmgaard-Clausen
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg and Frederiksberg, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christian Couppe
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg and Frederiksberg, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
| | - Mikkel H. Hjortshoej
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg and Frederiksberg, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
| | - Jens L. Olesen
- Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - S. Peter Magnusson
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg and Frederiksberg, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
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Slayter J, Casey L, O’Connell C. Patient Reported Outcome Measures in Adult Spinal Muscular Atrophy: A Scoping Review and Graphical Visualization of the Evidence. J Neuromuscul Dis 2023; 10:239-250. [PMID: 36530090 PMCID: PMC10041426 DOI: 10.3233/jnd-221595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Spinal Muscular Atrophy (SMA) is a hereditary neuromuscular disease with an estimated prevalence of 1/10 000 births. SMA is increasingly recognized as a multi-system disease with a need to study additional under-recognized health domains such as quality of life, fatigue, bulbar function, respiratory function, and independence. OBJECTIVE Identify and assess reported evidence from the literature investigating Patient Reported Outcome Measures (PROMs) in adults with SMA. Develop a novel method drawing from network theory to graphically depict the literature, PROMs, and supporting psychometric evidence. METHODS A scoping review was completed following PRISM-ScR, COSMIN and JBI scoping review guidelines. Literature investigating PROMs in adult SMA or neuromuscular disease was identified from peer-reviewed and grey databases. A network graph was derived from extracted data. RESULTS 5292 articles were retrieved, 81 articles met inclusion criteria; corresponding to 31 unique PROMs. Only two PROMs were developed specifically for SMA. Few PROMs covered multiple domains of health. Most PROMs were incompletely validated, focusing on concurrent validity, and few assessed responsiveness or internal consistency. CONCLUSIONS PROMs are emerging tools for monitoring and assessing adults with SMA. Despite their potential benefits, additional validation studies should be completed prior to their use for clinical decision-making. Network graphics may represent a technique to aid in the visualization of evidence supporting a scoping review.
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Affiliation(s)
- Jeremy Slayter
- Dalhousie Medicine New Brunswick, Faculty of Medicine, Dalhousie University, Saint John, NB, Canada
- Stan Cassidy Centre for Rehabilitation, Horizon Health Network, Fredericton, NB, Canada
| | - Lauren Casey
- Stan Cassidy Centre for Rehabilitation, Horizon Health Network, Fredericton, NB, Canada
| | - Colleen O’Connell
- Dalhousie Medicine New Brunswick, Faculty of Medicine, Dalhousie University, Saint John, NB, Canada
- Stan Cassidy Centre for Rehabilitation, Horizon Health Network, Fredericton, NB, Canada
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Khalilian-Ekrami N, Amirshakeri B, Ghanavati T, Mokhtarinia HR, Gabel CP. Cross-cultural adaptation, reliability, and validity of the Persian version of the Lower Limb Functional Index. Musculoskelet Sci Pract 2022; 62:102626. [PMID: 35849957 DOI: 10.1016/j.msksp.2022.102626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/27/2022] [Accepted: 07/11/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND the Lower Limb Functional Index (LLFI) is a regional patient reported outcome measure (PROM) for evaluation of lower limb musculoskeletal functional status. No Persian-language (LLFI-Pr) version is available. OBJECTIVES LLFI translation and cross-cultural adaptation to Persian and psychometric property evaluation. STUDY DESIGN prospective diagnostic assessment. METHODS to establish the LLFI-Pr face and content validity, double forward-backward translation protocols were used plus cognitive interviews and the 'content validity index'(CVI). Psychometric properties were determined from a convenience sample (n = 307, age 47.18 ± 11.52 years, female = 58.3%) that concurrently completed the LLFI-Pr and Persian Lower Extremity Functional Scale (LEFS-Pr). Test-retest reliability (ICC2,1, sub-sample, n = 64) was determined during a non-intervention period of 3-7 days. Internal consistency used Cronbach's Alpha (α), error used MDC90/95 from the SEM, and construct validity used Pearson's r between the LLFI-Pr and LEFS-Pr. Construct validity used exploratory factor analysis (EFA, suppression = 0.30) with non-Gaussian distribution protocols. RESULTS psychometric properties were high for test-retest reliability (ICC2,1 = 0.90) and internal consistency (α = 0.77), moderate for construct validity (r = 0.63), with no floor or ceiling effects, error found SEM = 1.60, MDC90 = 3.7% and MDC95 = 4.42%. A two-factor (EFA) structure (total-variance = 22.01%), that consequently cannot be summated, was determined where five-items failed consistent factor-loading leaving a 20-item version with a high original-LLFI total-equivalency (r = 0.97). However, the general/region-specific item-ratio reduced from the recognized 60/40 ratio to 50/50. CONCLUSION the 20-item LLFI-Pr is a valid two-factor solution with sound psychometric properties for research and clinical Persian-language populations with lower limb disorders.
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Affiliation(s)
- Noushin Khalilian-Ekrami
- Department of Physiotherapy, Faculty of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Bahram Amirshakeri
- Department of Physiotherapy, Faculty of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Tabassom Ghanavati
- Department of Physiotherapy, Faculty of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Hamid Reza Mokhtarinia
- Department of Ergonomics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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10
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Hansen CF, Jensen J, Odgaard A, Siersma V, Comins JD, Brodersen J, Krogsgaard MR. Four of five frequently used orthopedic PROMs possess inadequate content validity: a COSMIN evaluation of the mHHS, HAGOS, IKDC-SKF, KOOS and KNEES-ACL. Knee Surg Sports Traumatol Arthrosc 2022; 30:3602-3615. [PMID: 34618175 DOI: 10.1007/s00167-021-06761-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/27/2021] [Indexed: 01/15/2023]
Abstract
PURPOSE Content validity is the most important property of PROMs. The COSMIN initiative has published guidelines for evaluating the content validity of PROMs, but they have only sparsely been applied to relevant PROMs for musculoskeletal conditions. The aim of this study was to use the COSMIN Risk of Bias checklist to evaluate the content validity of five PROMs, that are highly relevant in musculoskeletal research and used by the arthroscopic surgery community: the modified Harris' Hip Score (mHHS), the Copenhagen Hip and Groin Outcome Score (HAGOS), the International Knee Documentation Committee Subjective Knee evaluation Form (IKDC-SKF), the Knee injury and Osteoarthritis Outcome Score (KOOS) and the Knee Numeric-Entity Evaluation Score ACL (KNEES-ACL). METHODS The development articles for the five PROMs were identified through searches in PubMed and SCOPUS. A literature search was performed to identify additional studies assessing content validity of the PROMs. Additional information, necessary for the assessments, was obtained from the PROM developers after direct request. To evaluate the quality of the development studies and rate the content validity, the COSMIN Risk of Bias checklist was applied to all studies. RESULTS All five development studies were identified. Three subsequent content validity studies were identified, all evaluating KOOS and one also IKDC. One content validity study was of inadequate quality and excluded from further analysis. The development of mHHS, IKDC-SKF, and KOOS was rated inadequate and possess insufficient content validity for their target populations. Due to the irrelevance of multiple items, KOOS was in particular inappropriate to evaluate patients with an ACL injury. The development of HAGOS was also rated inadequate, although the insufficiency aspects can be regarded as minor. KNEES-ACL possessed sufficient content validity. CONCLUSION Out of five PROMs, only KNEES-ACL possessed sufficient content validity. Particularly, KOOS should not be used as an outcome for patients with an ACL injury. There is an urgent need for condition-specific PROMs for musculoskeletal conditions, developed with adequate methods. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Christian Fugl Hansen
- Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Copenhagen University Hospitals, Copenhagen, Denmark.
| | - Jonas Jensen
- Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Copenhagen University Hospitals, Copenhagen, Denmark
| | - Anders Odgaard
- Department of Orthopaedic Surgery, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jonathan David Comins
- Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Copenhagen University Hospitals, Copenhagen, Denmark.,The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - John Brodersen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Primary Health Care Research Unit, Region Zealand, Denmark
| | - Michael Rindom Krogsgaard
- Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Copenhagen University Hospitals, Copenhagen, Denmark
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11
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Krogsgaard MR, Hansen CF. Patient-reported outcome measures: it is time for authors, reviewers, journal editors and health care strategists to take sufficient responsibility. Knee Surg Sports Traumatol Arthrosc 2022; 30:3589-3593. [PMID: 36048201 DOI: 10.1007/s00167-022-07138-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/19/2022] [Indexed: 10/14/2022]
Affiliation(s)
- Michael Rindom Krogsgaard
- Section for Sports Traumatology M51 (a part of IOC Research Center Copenhagen), Bispebjerg and Frederiksberg University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark.
| | - Christian Fugl Hansen
- Section for Sports Traumatology M51 (a part of IOC Research Center Copenhagen), Bispebjerg and Frederiksberg University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark
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12
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Ralphsmith M, Ahern S, Dean J, Ruseckaite R. Patient-reported outcome measures for pain in women with pelvic floor disorders: a systematic review. Int Urogynecol J 2022; 33:2325-2334. [PMID: 35233681 PMCID: PMC9427903 DOI: 10.1007/s00192-022-05126-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/07/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Patient-reported outcome measures (PROMs) are helpful instruments when measuring and reporting changes in patient health status (Al Sayah et al. J Patient Rep Outcomes 5 (Suppl 2):99, 2021) such as the health-related quality of life (HrQoL) of women with pelvic organ prolapse (POP) and stress urinary incontinence (SUI). The Australasian Pelvic Floor Procedure Registry (APFPR) aims to increase capacity for women to report surgical outcomes through the collection of HrQoL data (Ruseckaite et al. Qual Life Res. 2021) but currently lacks a pain-specific PROM for women with pelvic floor disorders (PFDs), particularly POP and SUI. This review aims to systematically review the existing literature and identify instruments that measure pain in women with POP and SUI for inclusion within the APFPR, which reports on complications from these conditions. METHODS We conducted a literature search on OVID MEDLINE, Embase, CINAHL, PsycINFO and EMCARE databases in addition to Google Scholar and grey literature to identify studies from inception to April 2021. Full-text studies were included if they used PROMs to measure pain in women with POP and SUI. Two authors independently screened articles, extracted data and assessed methodological quality. RESULTS From 2001 studies, 23 publications describing 19 different PROMs were included for analysis. Eight of these instruments were specific to the pelvic floor; four were only specific to pain and used across multiple disorders; three were generic quality of life instruments and four were other non-validated instruments such as focus group interviews. These instruments were not specific to pain in women with POP or SUI, as they did not identify all relevant domains such as the sensation, region and duration of pain, or incidents where onset of pain occurs. CONCLUSIONS The findings of this review suggest there are no current PROMs that are suitable pain-specific instruments for women with POP or SUI. This knowledge may inform and assist in the development of a new PROM to be implemented into the APFPR.
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Affiliation(s)
- Maisie Ralphsmith
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Joanne Dean
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia.
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13
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Kuiper SZ, Kimman ML, Van Tol RR, Waardenburg SF, Van Kuijk SMJ, Dirksen CD, Breukink SO. Patient reported outcome measure-haemorrhoidal impact and satisfaction score (PROM-HISS): Development, reliability and construct validity. Colorectal Dis 2022; 24:992-999. [PMID: 35119715 PMCID: PMC9544465 DOI: 10.1111/codi.16079] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 12/29/2022]
Abstract
AIM Haemorrhoidal disease (HD) is a frequently occurring disorder with a significant negative impact on a patient's quality of life. Here, we describe the development and validation of the Dutch patient reported outcome measure-haemorrhoidal impact and satisfaction score (PROM-HISS). METHODS The development of the PROM-HISS followed recommended guidelines. Face and content validity, structural properties, reliability and construct validity were evaluated in a HD population. Reliability was tested by assessing the test-retest reliability, defined by the intraclass correlation coefficient (ICC), and internal consistency measured with Cronbach's alpha. Construct validity was evaluated using confirmatory factor analysis (CFA) and hypotheses testing. RESULTS The PROM-HISS consists of three domains: (1) HD symptoms (blood loss; pain; prolapse; soiling; itching), (2) impact of symptoms on daily activities, and (3) satisfaction with treatment. The PROM-HISS showed good face and content validity. The PROM-HISS was completed by 102 patients (65% male), with a mean age of 58 years (23-81 years). The ICCs of the different items in the domain HD symptoms ranged between 0.56 and 0.79 and were interpreted as good. The Cronbach's alpha value was 0.80 and considered satisfactory. The CFA provided further evidence for construct validity with a good model fit. A high score on the symptoms of HD correlated with a high impact of HD on daily activities (Pearson's r = 0.632, p < 0.01) and a low degree of satisfaction (Pearson's r = 0.378, p < 0.01). CONCLUSION The PROM-HISS is a reliable and valid instrument to evaluate symptoms of HD, impact on daily activities and satisfaction with treatment.
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Affiliation(s)
- Sara Z. Kuiper
- Department of SurgerySchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht UniversityMaastrichtThe Netherlands
| | - Merel L. Kimman
- Department of Clinical Epidemiology and Medical Technology Assessment, Care and Public Health Research Institute (CAPHRI)Maastricht University Medical CentreMaastrichtThe Netherlands
| | - Robin R. Van Tol
- Department of SurgeryDiakonessenhuis Medical CentreUtrechtThe Netherlands
| | - Sophie F. Waardenburg
- Department of Clinical Epidemiology and Medical Technology Assessment, Care and Public Health Research Institute (CAPHRI)Maastricht University Medical CentreMaastrichtThe Netherlands,Department of Anaesthesiology and Pain MedicineMaastricht University Medical CentreMaastrichtThe Netherlands
| | - Sander M. J. Van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Care and Public Health Research Institute (CAPHRI)Maastricht University Medical CentreMaastrichtThe Netherlands
| | - Carmen D. Dirksen
- Department of Clinical Epidemiology and Medical Technology Assessment, Care and Public Health Research Institute (CAPHRI)Maastricht University Medical CentreMaastrichtThe Netherlands
| | - Stéphanie O. Breukink
- Department of SurgerySchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht UniversityMaastrichtThe Netherlands,Department of SurgerySchool for Oncology and Developmental Biology (GROW)Maastricht UniversityMaastrichtThe Netherlands,Department of SurgeryMaastricht University Medical CentreMaastrichtThe Netherlands
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14
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Obionu KC, Krogsgaard MR, Hansen CF, Comins JD. Dual-panel translation to Danish and Rasch validation of the Foot and Ankle Ability Measure (FAAM-DK). Foot Ankle Surg 2022; 28:588-594. [PMID: 34247919 DOI: 10.1016/j.fas.2021.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/17/2021] [Accepted: 06/25/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND The Foot and Ankle Ability Measure (FAAM) was developed by involvement of patients with chronic ankle instability (CAI) and has acceptable measurement properties, but is not available in Danish. METHODS FAAM was translated and culturally adapted into Danish, and its measurement properties were assessed using Rasch analyses. RESULTS A Danish version was produced with small adaptations, and content relevance was confirmed by Danish patients. The 21-item ADL domain showed misfit to the Rasch model, but after removing six items, the resulting 15-item scale displayed adequate fit. The Sports domain also exhibited misfit, but after removing one item and adjusting due to differential item functioning related to age for another item, a 7-item scale showed good fit. This resulted in a 22-item 2-dimensional Danish version of FAAM. CONCLUSION The 22-item Danish FAAM exhibits robust measurement properties for patients with various conditions of the lower leg, ankle, and foot, including CAI.
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Affiliation(s)
- Kenneth Chukwuemeka Obionu
- Section for Foot and Ankle Surgery, Department of Orthopedic Surgery M, Bispebjerg and Frederiksberg Hospital, Copenhagen University, Denmark.
| | - Michael Rindom Krogsgaard
- Section for Sports Traumatology M51, Department of Orthopedic Surgery M, Bispebjerg and Frederiksberg Hospital, Copenhagen University, Denmark
| | - Christian Fugl Hansen
- Section for Sports Traumatology M51, Department of Orthopedic Surgery M, Bispebjerg and Frederiksberg Hospital, Copenhagen University, Denmark
| | - Jonathan David Comins
- Section for Sports Traumatology M51, Department of Orthopedic Surgery M, Bispebjerg and Frederiksberg Hospital, Copenhagen University, Denmark
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15
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Torres-Ronda L, Beanland E, Whitehead S, Sweeting A, Clubb J. Tracking Systems in Team Sports: A Narrative Review of Applications of the Data and Sport Specific Analysis. SPORTS MEDICINE - OPEN 2022; 8:15. [PMID: 35076796 PMCID: PMC8789973 DOI: 10.1186/s40798-022-00408-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 01/02/2022] [Indexed: 01/26/2023]
Abstract
Seeking to obtain a competitive advantage and manage the risk of injury, team sport organisations are investing in tracking systems that can quantify training and competition characteristics. It is expected that such information can support objective decision-making for the prescription and manipulation of training load. This narrative review aims to summarise, and critically evaluate, different tracking systems and their use within team sports. The selection of systems should be dependent upon the context of the sport and needs careful consideration by practitioners. The selection of metrics requires a critical process to be able to describe, plan, monitor and evaluate training and competition characteristics of each sport. An emerging consideration for tracking systems data is the selection of suitable time analysis, such as temporal durations, peak demands or time series segmentation, whose best use depends on the temporal characteristics of the sport. Finally, examples of characteristics and the application of tracking data across seven popular team sports are presented. Practitioners working in specific team sports are advised to follow a critical thinking process, with a healthy dose of scepticism and awareness of appropriate theoretical frameworks, where possible, when creating new or selecting an existing metric to profile team sport athletes.
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Affiliation(s)
- Lorena Torres-Ronda
- Institute for Health and Sport, Victoria University, Melbourne, Australia.
- Spanish Basketball Federation, Madrid, Spain.
| | | | - Sarah Whitehead
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Leeds Rhinos Netball, Leeds, UK
| | - Alice Sweeting
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Jo Clubb
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, Australia
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16
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Hansen CF, Jensen J, Siersma V, Brodersen J, Comins JD, Krogsgaard MR. A catalogue of PROMs in sports science: Quality assessment of PROM development and validation. Scand J Med Sci Sports 2021; 31:991-998. [PMID: 33464661 PMCID: PMC8251933 DOI: 10.1111/sms.13923] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 12/11/2020] [Accepted: 01/04/2021] [Indexed: 02/02/2023]
Abstract
Choosing the most adequate PROM for a study is a non-trivial process. The aim of this study was to provide a catalogue with analyses of content and construct validity of PROMs relevant to research in sports science, including all published local translations. The most commonly used PROMs in sports research were selected from a PubMed search "patient reported outcome measures sports", identifying 439 articles and 194 different PROMs. Articles describing development of the 61 selected PROMs were assessed for content validity, and all articles regarding construct validity of each PROM and all published translations (in total 622 articles) were analyzed. A catalogue with assessments of the 61 PROMs was produced. The majority were of inferior validity, with few exceptions. The most common reason for this was that the PROM had not been developed by methods that ensure high content validity. Another major reason for inferior validity was that construct validity had not been secured by adequate statistical methods. In conclusion, this catalogue provides a tool for researchers to facilitate choosing the most valid PROM for studies in sports research. Furthermore, it shows for popular PROMs where further validation is needed, and for fields in musculoskeletal medicine where valid PROMs are lacking. It is suggested that a targeted effort is made to develop valid PROMs for major conditions in musculoskeletal research. The current method is easier to practice compared with assessment after COSMIN guidelines.
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Affiliation(s)
- Christian F. Hansen
- Section for Sports Traumatology M51Bispebjerg and Frederiksberg HospitalCopenhagenDenmark
| | - Jonas Jensen
- Section for Sports Traumatology M51Bispebjerg and Frederiksberg HospitalCopenhagenDenmark
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General PracticeDepartment of Public HealthUniversity of CopenhagenCopenhagenDenmark
| | - John Brodersen
- The Research Unit for General Practice and Section of General PracticeDepartment of Public HealthUniversity of CopenhagenCopenhagenDenmark
- Primary Health Care Research UnitRegion ZealandSorøDenmark
| | - Jonathan D. Comins
- Section for Sports Traumatology M51Bispebjerg and Frederiksberg HospitalCopenhagenDenmark
- The Research Unit for General Practice and Section of General PracticeDepartment of Public HealthUniversity of CopenhagenCopenhagenDenmark
| | - Michael R. Krogsgaard
- Section for Sports Traumatology M51Bispebjerg and Frederiksberg HospitalCopenhagenDenmark
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17
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Hansen CF, Jensen J, Brodersen J, Siersma V, Comins JD, Krogsgaard MR. Are adequate PROMs used as outcomes in randomized controlled trials? an analysis of 54 trials. Scand J Med Sci Sports 2021; 31:972-981. [DOI: 10.1111/sms.13896] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 10/06/2020] [Accepted: 11/24/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Christian Fugl Hansen
- Section for Sports Traumatology M51 Bispebjerg and Frederiksberg Hospital Copenhagen Denmark
| | - Jonas Jensen
- Section for Sports Traumatology M51 Bispebjerg and Frederiksberg Hospital Copenhagen Denmark
| | - John Brodersen
- The Research Unit for General Practice and Section of General Practice Department of Public Health University of Copenhagen Copenhagen Denmark
- Primary Health Care Research Unit Region Zealand Denmark
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice Department of Public Health University of Copenhagen Copenhagen Denmark
| | - Jonathan D. Comins
- Section for Sports Traumatology M51 Bispebjerg and Frederiksberg Hospital Copenhagen Denmark
- The Research Unit for General Practice and Section of General Practice Department of Public Health University of Copenhagen Copenhagen Denmark
| | - Michael R. Krogsgaard
- Section for Sports Traumatology M51 Bispebjerg and Frederiksberg Hospital Copenhagen Denmark
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18
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Comins JD, Brodersen J, Siersma V, Jensen J, Hansen CF, Krogsgaard MR. Choosing the most appropriate PROM for clinical studies in sports medicine. Scand J Med Sci Sports 2020; 31:1209-1215. [PMID: 33342023 DOI: 10.1111/sms.13906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/20/2020] [Accepted: 12/14/2020] [Indexed: 12/16/2022]
Abstract
Choosing the most appropriate patient-reported outcome measure (PROM) for a clinical study is essential in order to achieve trustworthy results. This choice will depend on (a) the objective of the study and hence the research question; (b) the choice of a theoretical framework, such as the World Health Organization's International Classification of Functioning, Disability, and Health (ICF); (c) whether there currently is a PROM that possesses high content validity and high construct validity for the specific patient group and objective, and if not; (d) the decision on whether to use a suboptimal PROM or develop and validate a new PROM. This paper presents the steps that should be followed in order to assess the relevance of PROMs and suggests ways to enhance the choice depending on the goal of the study.
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Affiliation(s)
- Jonathan D Comins
- Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.,The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - John Brodersen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Primary Health Care Research Unit, Region Zealand, Sorø, Denmark
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jonas Jensen
- Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Christian Fugl Hansen
- Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Michael R Krogsgaard
- Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
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19
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Krogsgaard MR, Brodersen J, Jensen J, Hansen CF, Comins JD. Potential problems in the use of patient reported outcome measures (PROMs) and reporting of PROM data in sports science. Scand J Med Sci Sports 2020; 31:1249-1258. [PMID: 33231328 DOI: 10.1111/sms.13888] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 10/06/2020] [Accepted: 11/12/2020] [Indexed: 12/13/2022]
Abstract
To use an inadequate patient reported outcome measure (PROM) or use a PROM in an inappropriate way potentially influences the quality of measurement. The objectives of this study were to define potential inadequate uses of PROMs in sports research studies and estimate how often they occur. A consensus group consisting of medical researchers, statisticians, and psychometricians identified and defined potentially irregular applications of PROMs. Occurrence of these in 349 consecutive articles in sports medicine in which PROMs were used as primary outcomes was reviewed. In all, 14 different potential problems were defined, and one or several occurred in 172 of the articles (49%). These were as follows: using a PROM that was developed for a different patient group (100 cases), using two or more PROMs with identical questions (94), aggregation of domain sum scores (82), combinations of subjective and objective measures (27), using a PROM to diagnose or evaluate the individual patient (7), using a PROM for a single limb (3), recall bias (3), exclusion of domains or items (3), construction of a PROM for a specific occasion (2), categorization of the scale (2), and mixing different versions of a PROM (1). Adaption of scale scores (e. g., to percentage) when results are reported (144) carries a risk of miscalculation and distorted impression of results. Data related to uncertainty about completing the PROM and the handling of missing data were not provided in the manuscripts. In conclusion, potential problems in the use and reporting of PROMs are common in sports research, and this can influence the validity of reported results.
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Affiliation(s)
- Michael R Krogsgaard
- Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - John Brodersen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Primary Health Care Research Unit, Region Zealand, Denmark
| | - Jonas Jensen
- Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Christian Fugl Hansen
- Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Jonathan D Comins
- Section for Sports Traumatology M51, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.,The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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