Eckhard Lukas, Munir Selin, Wood David, Talbot Simon, Brighton Roger, Walter Bill, Baré Jonathan
Department of Orthopaedics and Traumatology, University Medical Center of the Johannes-Gutenberg University, Mainz, Germany.
Australian Institute of Musculoskeletal Research, Sydney, Australia.
Knee Surg Sports Traumatol Arthrosc. 2021 Feb;29(2):608-615. doi: 10.1007/s00167-020-05904-x. Epub 2020 Apr 16.
To investigate the validity, responsiveness and ceiling effect of the recently introduced KOOS-12 and compare its performance to the KOOS, OKS, WOMAC and UCLA activity scales.
Patients from an independent multicentre study examining a medially stabilized knee system prospectively completed the KOOS, OKS, WOMAC and UCLA preoperatively and at 1 year postoperatively. KOOS-12 scores were calculated from the full length KOOS data. Construct validity was assessed using Spearman's correlation analysis. The ceiling effect was evaluated by calculating the percentage of patients with a maximum score. If the percentage exceeded 15%, a ceiling effect was considered to be present. Responsiveness was evaluated by performing paired t tests on the changes in measures and calculation of Cohen's d.
A ceiling effect was present for the KOOS Pain, ADL and QoL subscales and the KOOS-JR at 1 year postoperatively. No ceiling effect was observed for the KOOS-12. Correlation of the KOOS-12 was low (0.3 < r < 0.5) with the UCLA, moderate (0.5 < r < 0.7) with the KOOS symptoms, sports and WOMAC stiffness subscales and high (r > 0.7) with all other scores and subscales. Effect size of the UCLA activity scale was moderate (Cohen's d 0.2-0.8) whereas effect sizes of all other outcome measures were large (d > 0.8).
The KOOS-12 does not exhibit a ceiling effect, has good convergent construct validity and is responsive to changes in pain, function, QoL and knee impact between preoperatively and 1 year postoperatively.
Diagnostic level III.
研究最近推出的膝关节损伤与骨关节炎疗效评分12项（KOOS-12）的有效性、反应度和天花板效应，并将其性能与膝关节损伤与骨关节炎疗效评分（KOOS）、牛津膝关节评分（OKS）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以及加州大学洛杉矶分校（UCLA）活动量表进行比较。
一项独立多中心研究中的患者前瞻性地完成了对内侧稳定膝关节系统的研究，在术前和术后1年完成了KOOS、OKS、WOMAC和UCLA量表的评估。KOOS-12评分由完整长度的KOOS数据计算得出。使用Spearman相关性分析评估结构效度。通过计算获得最高分的患者百分比来评估天花板效应。如果百分比超过15%，则认为存在天花板效应。通过对测量值的变化进行配对t检验并计算Cohen's d来评估反应度。
术后1年，KOOS疼痛、日常生活活动（ADL）和生活质量（QoL）子量表以及KOOS青少年版（KOOS-JR）存在天花板效应。KOOS-12未观察到天花板效应。KOOS-12与UCLA的相关性较低（0.3＜r＜0.5），与KOOS症状、运动和WOMAC僵硬子量表的相关性中等（0.5＜r＜0.7），与所有其他评分和子量表的相关性较高（r＞0.7）。UCLA活动量表效应量中等（Cohen's d为0.2 - 0.8），而所有其他结局指标的效应量较大（d＞0.8）。
KOOS-12不存在天花板效应，具有良好的聚合结构效度，并且对术前和术后1年之间疼痛、功能、生活质量和膝关节影响的变化有反应。
诊断性III级。
