膝关节损伤和骨关节炎结局评分（KOOS）：测量特性的系统评价和荟萃分析。
Knee Injury and Osteoarthritis Outcome Score (KOOS): systematic review and meta-analysis of measurement properties.
机构信息
School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia; Department of Mechanical Engineering, Melbourne School of Engineering, The University of Melbourne, Parkville, Victoria, Australia.
VU University Medical Center, Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, The Netherlands.
出版信息
Osteoarthritis Cartilage. 2016 Aug;24(8):1317-29. doi: 10.1016/j.joca.2016.03.010. Epub 2016 Mar 21.
OBJECTIVE
To conduct a systematic review and meta-analysis to synthesize evidence regarding measurement properties of the Knee injury and Osteoarthritis Outcome Score (KOOS).
DESIGN
A comprehensive literature search identified 37 eligible papers evaluating KOOS measurement properties in participants with knee injuries and/or osteoarthritis (OA). Methodological quality was evaluated using the COSMIN checklist. Where possible, meta-analysis of extracted data was conducted for all studies and stratified by age and knee condition; otherwise narrative synthesis was performed.
RESULTS
KOOS has adequate internal consistency, test-retest reliability and construct validity in young and old adults with knee injuries and/or OA. The ADL subscale has better content validity for older patients and Sport/Rec for younger patients with knee injuries, while the Pain subscale is more relevant for painful knee conditions. The five-factor structure of the original KOOS is unclear. There is some evidence that the KOOS subscales demonstrate sufficient unidimensionality, but this requires confirmation. Although measurement error requires further evaluation, the minimal detectable change for KOOS subscales ranges from 14.3 to 19.6 for younger individuals, and ≥20 for older individuals. Evidence of responsiveness comes from larger effect sizes following surgical (especially total knee replacement) than non-surgical interventions.
CONCLUSIONS
KOOS demonstrates adequate content validity, internal consistency, test-retest reliability, construct validity and responsiveness for age- and condition-relevant subscales. Structural validity, cross-cultural validity and measurement error require further evaluation, as well as construct validity of KOOS Physical function Short form. Suggested order of subscales for different knee conditions can be applied in hierarchical testing of endpoints in clinical trials.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO (CRD42011001603).
目的
系统回顾和荟萃分析，综合膝关节损伤和骨关节炎结局评分（KOOS）测量特性的证据。
设计
全面的文献检索确定了 37 项评估膝关节损伤和/或骨关节炎（OA）患者 KOOS 测量特性的合格论文。使用 COSMIN 清单评估方法学质量。在可能的情况下，对所有研究进行了提取数据的荟萃分析，并按年龄和膝关节状况进行分层；否则进行叙述性综合。
结果
KOOS 在膝关节损伤和/或 OA 的年轻和老年患者中具有足够的内部一致性、测试-重测可靠性和结构有效性。ADL 亚量表对老年患者具有更好的内容有效性，而运动/娱乐亚量表对年轻患者的膝关节损伤更相关，而疼痛亚量表对疼痛性膝关节状况更相关。KOOS 的五因素结构尚不清楚。有一些证据表明 KOOS 亚量表具有足够的单维性，但这需要进一步确认。虽然测量误差需要进一步评估，但 KOOS 亚量表的最小可检测变化范围为年轻个体 14.3 至 19.6，老年个体≥20。来自手术（尤其是全膝关节置换）而非非手术干预的更大效应量表明了反应性。
结论
KOOS 对年龄和条件相关亚量表具有足够的内容有效性、内部一致性、测试-重测可靠性、结构有效性和反应性。结构有效性、跨文化有效性和测量误差需要进一步评估，以及 KOOS 身体功能简表的结构有效性。不同膝关节状况的亚量表的建议顺序可应用于临床试验中终点的分层测试。
系统评价注册
PROSPERO（CRD42011001603）。
Zotero 插件