KOOS-Child exhibits inadequate structural validity in a cohort of paediatric patients with ACL deficiency

Hansen, Christian Fugl; Madsen, Maria Østergaard; Warming, Susan; Rathcke, Martin Wyman; Krogsgaard, Michael

doi:10.1136/bjsports-2021-105311

Cited by 8 publications

(11 citation statements)

References 23 publications

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“…Structural validity : The structural validity was evaluated for six PROMs. 22 , 29 , 33 , 44 , 51 , 52 Three studies reported on the structural validity of a cultural adaption of the original PROMs. 29 , 44 , 52 All studies 22 , 29 , 33 , 44 , 51 , 52 failed to report on the important aspects of the item-related theory or Rasch analyses and did not describe the model fit.…”

Section: Resultsmentioning

confidence: 99%

“… 22 , 29 , 33 , 44 , 51 , 52 Three studies reported on the structural validity of a cultural adaption of the original PROMs. 29 , 44 , 52 All studies 22 , 29 , 33 , 44 , 51 , 52 failed to report on the important aspects of the item-related theory or Rasch analyses and did not describe the model fit. The results of the PROMs did not meet the COSMIN criteria for good measurement properties.…”

Section: Resultsmentioning

confidence: 99%

“…Reliability : Twenty-one studies 21 – 23 , 26 , 27 , 29 , 31 – 33 , 36 , 38 , 39 , 41 , 45 , 46 , 48 , 49 – 51 , 53 reported on the test–retest reliability of the instrument. Four studies reported no intraclass correlation coefficient (ICC) values or ICC values ranging below <0.7, thus demonstrating insufficient evidence on the quality of the test–retest reliability of the instrument.…”

Section: Resultsmentioning

confidence: 99%

“…29,41,45,46 Measurement error: Eleven studies reported the measurement error of their respective PROM. 21,27,31,33,36,39,45,49,50,53 None of the PROMs included in these analyses had previously published information on the minimal important change. Therefore, all included data on measurement error were rated as "indeterminate.…”

Section: General Characteristics Of Included Studies and Instrumentsmentioning

confidence: 99%

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Quality of patient- and proxy-reported outcomes for children with impairment of the lower extremity: A systematic review using the COnsensus-based Standards for selection of health Measurement INstruments methodology

Saris,

Kalle,

Sierevelt

et al. 2023

Journal of Children's Orthopaedics

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Background: Patient-reported outcome measures have become crucial in the clinical evaluation of patients. Appropriate selection, in a young population, of the instrument is vital to providing evidence-based patient-centered healthcare. This systematic review applies the COnsensus-based Standards for selection of health Measurement INstruments methodology to provide a critically appraised overview of patient-reported outcome measures targeted at pediatric orthopedic patients with lower limb impairment. Method: A systematic search of electronic databases was performed to identify original studies reporting the development and/or validation of patient-reported outcome measures evaluating children with impairment of the lower extremity. Data extraction, quality assessment, and risk of bias evaluation were performed following the COnsensus-based Standards for selection of health Measurement INstruments guidelines and Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. Results: A total of 6919 articles were screened. Thirty-three studies were included, reporting evidence on the measurement properties of 13 different patient-reported outcome measures and 20 translations. Four studies reported on content validity and patient-reported outcome measure development. The methodological quality of studies on structural validity, content validity, or patient-reported outcome measure development was mostly rated as “doubtful” or “very good.” The quality of evidence on measurement properties varied noticeably, with most studies needing to perform improve their methodological quality to justify their results. Conclusion: This review provides an extensive overview of all available patient-reported outcome measures for patients with lower extremity impairment within pediatric orthopedics. We cautiously advise the use of four patient-reported outcome measures. However, the scarce availability of research on content validity and patient-reported outcome measure development highlights an area for future research endeavors to improve our knowledge on the currently available patient-reported outcome measures. Level of evidence: Diagnostic level 1

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: General Characteristics Of Included Studies and Instrumentsmentioning

confidence: 99%

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Quality of patient- and proxy-reported outcomes for children with impairment of the lower extremity: A systematic review using the COnsensus-based Standards for selection of health Measurement INstruments methodology

Saris,

Kalle,

Sierevelt

et al. 2023

Journal of Children's Orthopaedics

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“…IKDC-SKF has inadequate construct validity for adults [ 9 ], and there is no certainty that Pedi-IKDC has content validity for children. Construct validation of Pedi-IKDC has shown that for children with ACL injury, the unidimensional questionnaire does not exhibit adequate fit, meaning that measurement properties are inadequate, and it is recommended that data obtained by Pedi-IKDC are interpreted with caution [ 10 ]. The Danish version was translated by the forward-backward method, culturally adapted through interviews with 45 children, and validated by classical test method analyses [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

Similar outcomes after anterior cruciate ligament reconstruction in paediatric and adult populations: a 1‐year follow‐up of 506 paediatric operations in Denmark

Madsen,

Warming,

Rathcke

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose To present 1-year results after all paediatric anterior cruciate ligament (ACL) reconstructions in Denmark (5.9 M inhabitants) for the 10½ year period, 1 July 2011 to 31 December 2021. Methods All children who had an ACL reconstruction were enrolled. They were asked to complete Pedi-IKDC preoperatively and at 1-year follow-up. Independent observers performed pivot shift test and instrumented laxity assessment preoperatively and at 1-year follow-up. Results The median age of the 506 children (47.2% girls) was 14.3 years (9.3–15.9). The Pedi-IKDC score increased from preoperatively 61.6 ± 15.8 (mean ± SD) to 85.9 ± 13.0 at 1-year follow-up (p < 0.0001). There were concomitant injuries (to meniscus and/or cartilage) in 49.9%, but these children had preoperative and follow-up Pedi-IKDC scores similar to the scores for children with isolated injury to ACL (n. s.). Instrumented anterior laxity was 4.3 ± 1.4 (mean ± SD) mm preoperatively and 1.4 ± 1.4 mm at follow-up (p < 0.0001). Preoperatively, 3% had no pivot shift whilst this was the case for 68% postoperatively (p < 0.0001). Twenty-five children (5.6%) had 4 mm instrumented laxity or more relative to the unoperated knee at follow-up. Two patients (0.4%) had an operatively treated deep infection, three (0.5%) were operated on for reduced range of motion and two (0.4%) had a revision ACL reconstruction. Conclusion ACL reconstruction resulted in a clinically meaningful increase in Pedi-IKDC, an improved instrumented stability, a reduction in the grade of pivot shift and the complication rate was low at 1-year follow-up. The risk of graft insufficiency at 1-year follow-up was the same as in an adult population. Level of Evidence II.

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Good physical function but reduced quality of life in children 3 years after ACL reconstruction

Lundgaard‐Nielsen,

Herzog,

Warming

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeTo assess children's physical function and subjective knee status 1 and 3 years after anterior cruciate ligament (ACL) reconstruction. It was hypothesised that there was no difference between the operated and normal legs in relation to physical strength and function, that there was <‐2 mm side‐to‐side difference in knee laxity, and that the subjective knee function was better 3 years after ACL reconstruction compared to 1 year after.MethodsChildren (<16 years of age) who had an ACL reconstruction had follow‐up with physical function tests (four hop tests and strength measurement in a power rig [PR]), anterior knee laxity (measured using a Rolimeter) and patient‐reported outcome measures (Pedi‐International Knee Documentation Committee [IKDC] and Knee injury and Osteoarthritis Outcome Score [KOOS]‐Child) 1 and 3 years postoperatively. Changes from 1‐ to 3‐year follow‐up were evaluated with a paired t test.ResultsOut of 148 ACL reconstructed children, 60 had all measures. The four hop tests and the PR all yielded a Limb Symmetry Index >90% at both follow‐ups. There was a significant improvement from 1‐ to 3‐year follow‐up in two‐hop tests (6 m on time and crossover hop). Side‐to‐side knee laxity was >2 mm in four children at 1‐ and 3‐year tests. Pedi‐IKDC scores increased, and KOOS‐Child improved significantly from 1 to 3 years in two of the five domains: ‘Sport’ and ‘Quality of life’, but scores were lower than in a cohort of normal children.ConclusionThe children had good objective physical function 1 and 3 years after ACL reconstruction. However, scores from the KOOS‐Child sport‐specific function and quality of life domains were lower than in normal children.Level of evidenceLevel II.

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KOOS-Child exhibits inadequate structural validity in a cohort of paediatric patients with ACL deficiency

Cited by 8 publications

References 23 publications

Quality of patient- and proxy-reported outcomes for children with impairment of the lower extremity: A systematic review using the COnsensus-based Standards for selection of health Measurement INstruments methodology

Quality of patient- and proxy-reported outcomes for children with impairment of the lower extremity: A systematic review using the COnsensus-based Standards for selection of health Measurement INstruments methodology

Similar outcomes after anterior cruciate ligament reconstruction in paediatric and adult populations: a 1‐year follow‐up of 506 paediatric operations in Denmark

Good physical function but reduced quality of life in children 3 years after ACL reconstruction

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