Patient reported outcome measures for ankle instability. An analysis of 17 existing questionnaires

Christian Fugl Hansen; Kenneth Chukwuemeka Obionu; Jonathan David Comins; Michael Rindom Krogsgaard

doi:10.1016/j.fas.2021.04.009

Patient reported outcome measures for ankle instability. An analysis of 17 existing questionnaires

Foot Ankle Surg. 2022 Apr;28(3):288-293. doi: 10.1016/j.fas.2021.04.009. Epub 2021 May 1.

Authors

Christian Fugl Hansen¹, Kenneth Chukwuemeka Obionu², Jonathan David Comins³, Michael Rindom Krogsgaard³

Affiliations

¹ Section for Sports Traumatology M51, Department of Orthopedic Surgery M, Bispebjerg and Frederiksberg Copenhagen University Hospitals, Denmark. Electronic address: christian.fugl.hansen@regionh.dk.
² Section for Foot and Ankle Surgery, Department of Orthopedic Surgery M, Bispebjerg and Frederiksberg Copenhagen University Hospitals, Denmark.
³ Section for Sports Traumatology M51, Department of Orthopedic Surgery M, Bispebjerg and Frederiksberg Copenhagen University Hospitals, Denmark.

PMID: 34001448
DOI: 10.1016/j.fas.2021.04.009

Abstract

Background: Patient reported outcome measures (PROMs) are essential for evaluating treatment of ankle instability (AI). The aim was to assess the content validity and the measurement properties of all relevant PROMs for AI.

Methods: Relevant PROMs were identified from PubMed and SCOPUS. The development and validation quality of the PROMs was assessed according to established scientific standards.

Results: Seventeen PROMs and 56 validation studies were analyzed. Content validity, which ensures the PROM measures what is relevant, is obtained by involving target patients in the development process. Only three PROMs identified had some degree of patient involvement (Cumberland Ankle Instability Tool (CAIT), Lower Extremity Function Scale (LEFS), and the Foot and Ankle Ability Measure (FAAM)). Of these, only FAAM was somewhat rigorously validated using modern psychometric validation methods, and exhibited superior measurement properties (construct validity).

Conclusion: No existing PROM is completely adequate to evaluate AI. However, FAAM is the best choice.

Keywords: Chronic ankle instability; Construct validity; Content validity; Measurement properties; Patient reported outcome measures.

Publication types

Review

MeSH terms

Ankle*
Humans
Joint Instability* / diagnosis
Joint Instability* / therapy
Patient Reported Outcome Measures
Reproducibility of Results
Surveys and Questionnaires