A systematic review of measurement properties of patient-reported outcome measures for use in patients with foot or ankle diseases

Abstract

Most PROMs on foot and ankle diseases have limited evidence for their psychometric properties. The MOXFQ, with the highest overall ratings, could be a useful PROM for evaluating patients with foot or ankle diseases, based on current available evidence. More research is needed to improve the quality of the standards used to assess PROMs and the studies making these assessments.

Patient reported outcomes in orthopaedics

“…Were the criteria appropriate (e.g., Refs. [30][31][32] )? Heterogeneity Did the authors account for differences between the primary studies evaluating the same instruments (e.g., study setting, sample characteristics, study methods)?…”

“…25,26 When performing systematic reviews of the psychometric evidence of PROMs one must be careful to assess both the methodological quality of each the primary studies and also assess the evidence for or against the psychometric property itself. 1,[29][30][31] For example, if a published study investigates the interrater reliability of an instrument, that study must have appropriate methods of doing so (e.g., a proper sample size calculation for the reliability statistic) and also the level of the reliability statistic must meet some cut-off (e.g, intraclass correlation coefficient/ weighted k ! 0.70 OR Pearson's r !…”

“…In fact, there is extensive evidence, which we review below, that PROMs used in many areas of orthopaedics are significantly flawed, or at least, lack data on their psychometric properties (e.g., Refs. [29][30][31] ). The use of poor quality instruments will result in biased or unreliable effect estimates and can potentially mislead decision makers relying this evidence as well as harm patients and waste resources.…”

“…56 There are many instruments available, many PROMs, that can be used in most areas of orthopaedics (e.g., Refs. [29][30][31][49][50][51][52][53][54][55] ). But, if an appropriate PROM does note exist, after an exhaustive literature search for said instrument, then one may embark on developing a new instrument specific to their needs.…”

“…PROMs have been used in clinical practice for many decades, whether it be a pain scale or some more elaborate measure such as a depression index. In orthopaedic surgery there is an array of PROMs that could potentially be used to manage individual patient care, some of which are cited above, [31][32][33][34][35][36][37][38][39] but many more exist and may be appropriate for a specific clinical focus. The two most comprehensive databases of individual PROMs are PROQOLID 87 and BIBLIOPRO, 88 the latter of which is a database of instruments in Spanish.…”