Systematic review of the psychometric properties of the Victorian Institute of Sports Assessment – Achilles tendinopathy questionnaire

Ortega-Ávila, Ana Belén; Reina-Martín, Inmaculada; Cervera‐Garvi, Pablo; Lopezosa-Reca, Eva; Cabello-Manrique, David; Gijón-Noguerón, Gabriel

doi:10.1080/09638288.2019.1652701

Cited by 4 publications

(5 citation statements)

References 25 publications

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“…These results support the findings of the COSMIN review conducted by Ortega-Avila and colleagues [4], in that we could confirm significant flaws in the validity of VISA-A. As a PROM, VISA-A clearly lacks content validity, as patients were not included in the process of item generation or item reduction, the adequacy of the measurement properties of VISA-A was never confirmed using appropriate validation methods, and our own rigorous analyses using data from patents with Achilles tendinopathy revealed substantial problems.…”

Section: Discussionsupporting

confidence: 91%

“…Our results support the findings of Ortega-Avila and colleagues [4], in which which they used the COSMIN checklist and found significant flaws in the construct validity of VISA-A. We chose not to apply COSMIN for our analyses.…”

Section: Plos Onesupporting

confidence: 88%

“…However, a recent editorial questions the usefulness of VISA-A, and underscores the limited evidence of its "clinimetric properties" [3]. Furthermore, a recent COSMIN checklist review concluded that all 11 versions of VISA-A have flawed construct validity and weak responsiveness [4].…”

Section: Introductionmentioning

confidence: 99%

“…As mentioned, significant flaws in the validity of VISA-A were found using the COSMIN checklist [4]. Considering the harsh judgement passed by the COSMIN review, we believe it could be relevant to evaluate specifically which methods were used to generate and choose the items in VISA-A, and which methods were originally used to test its psychometric properties.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of content validity and psychometric properties of VISA-A for Achilles tendinopathy

et al. 2021

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A recent COSMIN review found that the Victorian Institute of Sports Assessment–Achilles tendinopathy questionnaire (VISA-A) has flawed construct validity. The objective of the current study was to assess specifically the process of how VISA-A was constructed and validated, and whether the Danish version of VISA-A is a valid patient-reported outcome measure (PROM) for measuring the perceived impact of Achilles tendinopathy. The original item generation strategy for content validity and the process for confirming the scaling properties (construct validity) were examined. In addition, construct validity was evaluated directly using several psychometric methods (Rasch analysis, confirmatory factor analysis (CFA), and multivariable linear regression) in a cohort of 318 persons with Achilles tendinopathy with symptom duration groups ranging from less than 3 months to more than 1 year of chronicity, and a group of 120 healthy persons. We found that the item generation and item reduction in the original construction of VISA-A was based on literature review and clinician consensus with little or no patient involvement. We determined that 1) VISA-A consists of ambiguous conceptual item themes and thus lacks content validity, 2) there was no thorough investigation of the psychometric properties of the original version of VISA-A, which thus lacks construct validity, and 3) rigorous direct assessment of the psychometric properties of the Danish VISA-A revealed inadequate psychometric properties. In agreement with the COSMIN study, we conclude that when used as a single score, VISA-A is not an adequate scale for measuring self-reported impact of Achilles tendinopathy.

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Section: Discussionsupporting

confidence: 91%

Section: Plos Onesupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessment of content validity and psychometric properties of VISA-A for Achilles tendinopathy

et al. 2021

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“…Since PROMs measure constructs that can only be reported by patients themselves, no gold standard exists for these measures 21. The VISA-A is one of the most widely used PROMs in AT studies, but recent publications have questioned its validity and responsiveness 22 23. It is felt that internal validity of the VISA-A was not adequately investigated in the original study,9 likely due to the fact that it was developed before the COSMIN guidelines were published.…”

Section: Discussionmentioning

confidence: 99%

The VISA-A (sedentary) should be used for sedentary patients with Achilles tendinopathy: a modified version of the VISA-A developed and evaluated in accordance with the COSMIN checklist

et al. 2023

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ObjectiveTo develop and evaluate a modified version of the Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire, for use in sedentary patients with Achilles tendinopathy, using the Consensus-based Standards for the selection of health Measurement Instruments recommendations.MethodsTwenty-two sedentary patients with Achilles tendinopathy completed the VISA-A and provided feedback regarding the relevance, comprehensiveness and comprehensibility of each item, response options and instructions. Patient and professional feedback was used to develop the VISA-A (sedentary) questionnaire. Reliability, validity and responsiveness of the VISA-A (sedentary) was evaluated in 51 sedentary patients with Achilles tendinopathy: 47.1% women, mean age 64.8 (SD 11.24).ResultsFactor analysis identified two dimensions (symptoms and activity) for the VISA-A (sedentary). Test–retest reliability was excellent for symptoms (intraclass correlation coefficient, ICC=0.991) and activity (ICC=0.999). Repeatability was 1.647 for symptoms and 0.549 for activity. There was a significant difference between the VISA-A and VISA-A (sedentary) scores both pretreatment and post-treatment. There was stronger correlation between the pretreatment to post-treatment change in the VISA-A (sedentary) scores (r=0.420 for symptoms, r=0.407 for activity) and the global rating of change than the VISA-A scores (r=0.253 for symptoms, r=0.186 for activity).ConclusionThe VISA-A (sedentary) demonstrates adequate reliability, validity and responsiveness in sedentary patients with Achilles tendinopathy. The VISA-A (sedentary) is a more appropriate measure than the VISA-A for this cohort and is recommended for clinical and research purposes.

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Outcome measurement instruments in Rett syndrome: A systematic review

Romero-Galisteo

Gónzalez-Sánchez

Silva

et al. 2022

European Journal of Paediatric Neurology

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Systematic review of the psychometric properties of the Victorian Institute of Sports Assessment – Achilles tendinopathy questionnaire

Cited by 4 publications

References 25 publications

Assessment of content validity and psychometric properties of VISA-A for Achilles tendinopathy

Assessment of content validity and psychometric properties of VISA-A for Achilles tendinopathy

The VISA-A (sedentary) should be used for sedentary patients with Achilles tendinopathy: a modified version of the VISA-A developed and evaluated in accordance with the COSMIN checklist

Outcome measurement instruments in Rett syndrome: A systematic review

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