Clinica Ortopedica E Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, BO, Italy.
Dipartimento Di Medicina Clinica E Sperimentale, Università Degli Studi Di Foggia, Foggia, FG, Italy.
Knee Surg Sports Traumatol Arthrosc. 2022 Oct;30(10):3361-3366. doi: 10.1007/s00167-022-06922-7. Epub 2022 Feb 26.
The increasing incidence of knee injuries among children is well known by sports physicians. Papers dealing with this topic have often collected patient-reported outcomes measures (PROMs) in a retrospective manner; this limitation could lead to a misinterpretation of the results, because pediatric patients might not remember their preoperative conditions adequately. This study aims to evaluate the reliability and the reproducibility of the IKDC pediatric score when administered retrospectively at a 12-month follow-up.
From September 2018 and June 2019, all patients aged 7-18 scheduled for surgery due to different knee pathologies in a single center were considered eligible. Parents were contacted by phone for consent. An open-source platform was implemented to collect the responses: two surveys were created (Q1, Q2). They included general information and the Pedi-IKDC score. Q1 was completed prospectively, while Q2 was completed 12 months after surgery. The two questionnaires were identical, and patients were carefully advised to complete Q2 recalling their health status before surgery. ICC and the concordance correlation coefficient (ρ) were used to assess the reproducibility between the prospective and recalled scores.
Sixty-six patients responded to Q1 and Q2, and the mean age was 12.9 ± 2.2 years at Q1 and 14.1 ± 2.2 years at Q2. The mean time between Q1 and Q2 was 14.1 ± 2.1 months. Between prospective-IKDC and recall-IKDC, the ICC coefficient was "poor" at 0.32 (CI 0.09 to 0.5) and the ρ was "poor" at 0.4 (CI 0.29 to 0.51). Mean prospective-IKDC was 76.8 ± 23.52 mean recalled-IKDC was 60.4 ± 11.5 (P < 0.0001), while mean difference was -16.3 ± 2.09. Simple linear regression models showed that Δ-IKDC is independently associated with age at Q1 (R = 0.2676; P0.0001) and prospective-IKDC (R = 0.653; P < 0.0001).
Retrospective collection of the Pedi-IKDC score is not reliable and has high recall bias. This should be avoided in children with knee conditions.
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运动医学医生熟知儿童膝关节损伤发病率不断上升的情况。涉及该主题的论文通常以回顾性的方式收集患者报告的结局测量（PROMs）；这种局限性可能导致对结果的误解，因为儿科患者可能无法充分回忆术前的情况。本研究旨在评估在 12 个月随访时回顾性使用 IKDC 小儿评分的可靠性和可重复性。
2018 年 9 月至 2019 年 6 月，单中心因不同膝关节疾病接受手术的所有 7-18 岁患者均符合入选标准。通过电话联系家长获得同意。实施了一个开源平台来收集回复：创建了两个调查（Q1，Q2）。它们包括一般信息和 Pedi-IKDC 评分。Q1 是前瞻性完成的，而 Q2 是在手术后 12 个月完成的。两个问卷完全相同，患者在完成 Q2 时被仔细告知要回忆起手术前的健康状况。ICC 和一致性相关系数（ρ）用于评估前瞻性和回顾性评分之间的可重复性。
66 名患者对 Q1 和 Q2 做出了回应，Q1 的平均年龄为 12.9±2.2 岁，Q2 的平均年龄为 14.1±2.2 岁。Q1 和 Q2 之间的平均时间为 14.1±2.1 个月。前瞻性 IKDC 和回忆性 IKDC 之间的 ICC 系数为“差”，为 0.32（CI 0.09 至 0.5），ρ为“差”，为 0.4（CI 0.29 至 0.51）。前瞻性 IKDC 的平均得分为 76.8±23.52，回忆性 IKDC 的平均得分为 60.4±11.5（P<0.0001），平均差值为-16.3±2.09。简单线性回归模型显示，Δ-IKDC 与 Q1 时的年龄（R=0.2676；P<0.0001）和前瞻性 IKDC（R=0.653；P<0.0001）独立相关。
回顾性收集 Pedi-IKDC 评分不可靠，且存在较高的回忆偏倚。在膝关节疾病的儿童中应避免这种情况。
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