Aspetar, Orthopaedic and Sports Medicine Hospital, PO 29222, Doha, Qatar.
Hellenic Orthopaedic Manipulative Therapy Diploma (HOMTD), Athens, Greece.
Knee Surg Sports Traumatol Arthrosc. 2021 Sep;29(9):2749-2764. doi: 10.1007/s00167-021-06598-5. Epub 2021 May 21.
The Victorian Institute of Sport Assessment (Achilles tendon-VISA-A, greater trochanteric pain syndrome-VISA-G, proximal hamstring tendinopathy-VISA-H, patellar tendon-VISA-P) questionnaires are widely used in research and clinical practice; however, no systematic reviews have formally evaluated their content, structural, and cross-cultural validity evidence. The measurement properties referring to content, structural and cross-cultural validity of the VISA questionnaires were appraised and synthesized.
The systematic review was conducted according to Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) methodology. PubMed, Cochrane, CINAHL, EMBASE, Web of Science, SportsDiscus, grey literature, and reference lists were searched. Development studies and cross-cultural adaptations (12 languages) assessing content or structural validity of the VISA questionnaires were included and two reviewers assessed their methodological quality. Evidence for content (relevance, comprehensiveness, and comprehensibility), structural, and cross-cultural validity was synthesized. A modified Grading of Recommendations Assessment Development and Evaluation (GRADE) approach was applied to evidence synthesis.
The VISA-A presented very-low-quality evidence of sufficient relevance, insufficient comprehensiveness, and inconsistent comprehensibility. VISA-G displayed moderate-quality evidence for sufficient comprehensibility and very-low-quality evidence of sufficient relevance and comprehensiveness. The VISA-P presented very-low-quality evidence of sufficient relevance, insufficient comprehensiveness, and inconsistent comprehensibility, while VISA-H presented very-low evidence of insufficient content validity. VISA-A displayed low-quality evidence for structural validity concerning unidimensionality and internal structure, while VISA-H presented low-quality evidence of insufficient unidimensionality. The structural validity of VISA-G and VISA-P were indeterminate and inconsistent, respectively. Internal consistency for VISA-G, VISA-H, and VISA-P was indeterminate. No studies evaluated cross-cultural validity, while measurement invariance across sexes was assessed in one study.
Only very-low-quality evidence exists for the content and structural validity of VISA questionnaires when assessing the severity of symptoms and disability in patients with lower limb tendinopathies.
IV.
PROSPERO reference-CRD42019126595.
维多利亚运动研究所评估（跟腱-VISA-A、大转子疼痛综合征-VISA-G、近端腘绳肌腱病-VISA-H、髌腱-VISA-P）问卷广泛应用于研究和临床实践；然而，尚无系统评价正式评估其内容、结构和跨文化有效性证据。本研究旨在评估和综合 VISA 问卷的测量特性，包括内容、结构和跨文化有效性。
系统评价按照共识基础的健康测量仪器选择标准（COSMIN）方法进行。检索 PubMed、Cochrane、CINAHL、EMBASE、Web of Science、SportsDiscus、灰色文献和参考文献列表，纳入评估 VISA 问卷内容或结构有效性的开发研究和跨文化适应性研究（12 种语言），并由两名审查者评估其方法学质量。综合内容（相关性、全面性和可理解性）、结构和跨文化有效性的证据。应用改良的推荐评估、制定与评价（GRADE）方法对证据进行综合。
VISA-A 具有充分相关性、不充分全面性和不一致可理解性的极低质量证据。VISA-G 具有充分可理解性的中等质量证据和充分相关性和全面性的极低质量证据。VISA-P 具有充分相关性、不充分全面性和不一致可理解性的极低质量证据，而 VISA-H 则具有内容有效性不足的极低质量证据。VISA-A 具有结构有效性的一维性和内部结构的低质量证据，而 VISA-H 具有低质量证据表明一维性不足。VISA-G 和 VISA-P 的结构有效性不确定且不一致，VISA-G、VISA-H 和 VISA-P 的内部一致性不确定。没有研究评估跨文化有效性，而一项研究评估了性别间的测量不变性。
仅当评估下肢肌腱病患者的症状严重程度和残疾程度时，VISA 问卷在内容和结构有效性方面才有极低质量证据。
IV。
PROSPERO 参考-CRD42019126595。
