Warwick Orthopaedics, Division of Health Sciences, Warwick Medical School, Clinical Sciences Research Laboratories, University Hospital, Clifford Bridge Road, Coventry CV2 2DX, UK.
Health Qual Life Outcomes. 2012 Feb 29;10:24. doi: 10.1186/1477-7525-10-24.
The Achilles tendon Total Rupture Score was developed by a research group in 2007 in response to the need for a patient reported outcome measure for this patient population. Beyond this original development paper, no further validation studies have been published.Consequently the purpose of this study was to evaluate internal consistency, convergent validity and responsiveness of this newly developed patient reported outcome measure within patients who have sustained an isolated acute Achilles tendon rupture.
Sixty-four eligible patients with an acute rupture of their Achilles tendon completed the Achilles tendon Total Rupture Score alongside two further patient reported outcome measures (Disability Rating Index and EQ 5D). These were completed at baseline, six weeks, three months, six months and nine months post injury. The Achilles tendon Total Rupture Score was evaluated for internal consistency, using Cronbach's alpha, convergent validity, through correlation analysis and responsiveness, by analysing floor and ceiling effects and calculating its relative efficiency in comparison to the Disability Rating Index and EQ 5D scores.
The Achilles tendon Total Rupture Score demonstrated high internal consistency (Cronbachs alpha > 0.8) and correlated significantly (p < 0.001) with the Disability Rating Index at five time points (pre-injury, six weeks, three, six and nine months) with correlation coefficients between -0.5 and -0.9. However, the confidence intervals were wide. Furthermore, the ability of the new score to detect clinically important changes over time (responsiveness) was shown to be greater than the Disability Rating Index and EQ 5D.
A universally accepted outcome measure is imperative to allow comparisons to be made across practice. This is the first study to evaluate aspects of validity of this newly developed outcome measure, outside of the developing centre. The ATRS demonstrated high internal consistency and responsiveness, with limited convergent validity. This research provides further support for the use of this outcome measure, however further research is required to advocate its universal use in patients with acute Achilles tendon ruptures. Such areas include inter-rater reliability and research to determine the minimally clinically important difference between scores.All authors have read and concur with the content of this manuscript. The material presented has not been and will not be submitted for publication elsewhere, except as an abstract. All authors have made substantial contributions to all of the following: (1) the conception and design of the study, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content and (3) final approval of the submitted version. This research has been funded by Arthritis Research UK, no conflicts of interests have been declared by the authors.
跟腱完全断裂评分由研究小组于 2007 年开发，旨在为这一患者群体提供一种患者报告的结果衡量标准。除了最初的开发论文外，没有发表进一步的验证研究。因此，本研究的目的是评估新开发的患者报告结果衡量标准在急性跟腱完全断裂患者中的内部一致性、收敛有效性和反应能力。
64 名符合条件的急性跟腱断裂患者完成了跟腱完全断裂评分以及另外两项患者报告结果衡量标准（残疾评定指数和 EQ 5D）。这些在受伤前、6 周、3 个月、6 个月和 9 个月时完成。通过 Cronbach's alpha 评估跟腱完全断裂评分的内部一致性，通过相关分析评估收敛有效性，通过分析地板和天花板效应并与残疾评定指数和 EQ 5D 评分相比计算其相对效率来评估反应能力。
跟腱完全断裂评分显示出较高的内部一致性（Cronbach's alpha > 0.8），并在五个时间点与残疾评定指数显著相关（p < 0.001），相关系数在-0.5 到-0.9 之间。然而，置信区间较宽。此外，新评分在随时间检测临床重要变化（反应能力）的能力被证明大于残疾评定指数和 EQ 5D。
普遍接受的结果衡量标准对于允许在实践中进行比较至关重要。这是第一项评估新开发结果衡量标准在开发中心以外的有效性的研究。ATR 显示出较高的内部一致性和反应能力，收敛有效性有限。这项研究为使用这种结果衡量标准提供了进一步的支持，但是需要进一步的研究来提倡在急性跟腱断裂患者中普遍使用。这些领域包括评分的观察者间可靠性和研究以确定评分之间的最小临床重要差异。所有作者均已阅读并同意本文内容。所提交的材料以前未提交过，也不会提交给其他地方发表，除非是摘要。所有作者都对以下所有方面做出了实质性贡献：（1）研究的构思和设计，或数据的获取，或数据的分析和解释，（2）起草文章或批判性地修改以确保其重要的知识内容，以及（3）最终提交版本的批准。这项研究由关节炎研究英国资助，作者没有利益冲突。
