Letchford Robert, Sparkes Valerie, van Deursen Robert W M
School of Healthcare Sciences, Cardiff University, Second Floor, Cardigan House, Heath Park Campus, Cardiff CF14 4XN, United Kingdom; Aneurin Bevan Health Board, Physiotherapy Department, Royal Gwent Hospital, Cardiff Road, Newport NP20 2UB, Gwent, United Kingdom.
School of Healthcare Sciences, Cardiff University, Second Floor, Cardigan House, Heath Park Campus, Cardiff CF14 4XN, United Kingdom; Arthritis Research UK Biomechanics and Bioengineering Centre, Cardiff University, Cardiff, United Kingdom.
Knee. 2015 Jun;22(3):262-9. doi: 10.1016/j.knee.2015.01.010. Epub 2015 Mar 21.
BACKGROUND/AIM: A return to pre injury activity participation remains a common but often elusive goal following ACL injury. Investigations to improve our understanding of participation restrictions are limited by inconsistent use of insufficiently investigated measurement tools. The aim of this study was to follow the consensus based standards for the selection of health measurement instruments (COSMIN) guideline to provide a comparative evaluation of four patient reported outcomes (PROMs) on the basis of measurement properties. This will inform recommendations for measuring participation of ACL injured subjects, particularly in the United Kingdom (UK) National Health Service (NHS).
Thirteen criteria were compiled from the COSMIN guideline. These included reliability, measurement error, content validity, construct validity, responsiveness and interpretability. Data from 51 subjects collected as part of a longitudinal observational study of recovery over the first year following ACLR was used in the analysis.
Of the thirteen criteria, the required standard was met in 11 for Tegner, 11 for International Knee Documentation Committee (IKDC), 6 for Cincinnati Sports Activity Scale (CSAS) and 6 for Marx. The two weaknesses identified for the Tegner are more easily compensated for during interpretation than those in the IKDC; for this reason the Tegner is the recommended PROM.
The Tegner activity rating scale performed consistently well in respect of all measurement properties in this sample, with clear benefits over the other PROMs. The measurement properties presented should be used to inform implementation and interpretation of this outcome measure in clinical practice and research.
Level II prospective study.
背景/目的：前交叉韧带（ACL）损伤后恢复到伤前的活动参与水平仍是一个常见但往往难以实现的目标。由于对研究不足的测量工具使用不一致，旨在增进我们对参与限制理解的调查受到了限制。本研究的目的是遵循基于共识的健康测量工具选择标准（COSMIN）指南，基于测量属性对四种患者报告结局（PROMs）进行比较评估。这将为测量ACL损伤患者的活动参与情况提供建议，尤其是在英国国家医疗服务体系（NHS）中。
从COSMIN指南中整理出13条标准。这些标准包括信度、测量误差、内容效度、结构效度、反应度和可解释性。分析使用了作为ACL重建术后第一年恢复情况纵向观察性研究一部分收集的51名受试者的数据。
在这13条标准中，Tegner量表满足11条，国际膝关节文献委员会（IKDC）满足11条，辛辛那提体育活动量表（CSAS）满足6条，马克思量表满足6条。Tegner量表确定的两个弱点在解释过程中比IKDC量表的更容易弥补；因此，Tegner量表是推荐的PROM。
在本样本中，Tegner活动评分量表在所有测量属性方面均表现良好，明显优于其他PROMs。所呈现的测量属性应用于指导该结局指标在临床实践和研究中的实施与解释。
二级前瞻性研究。
