Validity of five foot and ankle specific electronic patient-reported outcome (ePRO) instruments in patients undergoing elective orthopedic foot or ankle surgery

Mikko M Uimonen; Ville T Ponkilainen; Alar Toom; Mikko Miettinen; Arja H Häkkinen; Henrik Sandelin; Antti O Latvala; Timo Sirola; Mika Sampo; Risto P Roine; Jan Lindahl; Outi Ilves; Anna Sandbacka; Jussi P Repo

doi:10.1016/j.fas.2020.02.003

Validity of five foot and ankle specific electronic patient-reported outcome (ePRO) instruments in patients undergoing elective orthopedic foot or ankle surgery

Mikko M Uimonen, Ville T Ponkilainen, Alar Toom, Mikko Miettinen, Arja H Häkkinen, Henrik Sandelin, Antti O Latvala, Timo Sirola, Mika Sampo, Risto P Roine, Jan Lindahl, Outi Ilves, Anna Sandbacka, Jussi P Repo

Research output: Contribution to journal › Article › Scientific › peer-review

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Abstract

BACKGROUND: Patient-reported outcomes (PROs) are widely accepted measures for evaluating outcomes of surgical interventions. As patient-reported information is stored in electronic health records, it is essential that there are valid electronic PRO (ePRO) instruments available for clinicians and researchers. The aim of this study was to evaluate the validity of electronic versions of five widely used foot and ankle specific PRO instruments.

METHODS: Altogether 111 consecutive elective foot/ankle surgery patients were invited face-to-face to participate in this study. Patients completed electronic versions of the Foot and Ankle Ability Measure (FAAM), the Foot and Ankle Outcome Score (FAOS), the modified Lower Extremity Function Scale (LEFS), the Manchester-Oxford Foot Questionnaire (MOXFQ), and the Visual Analogue Scale Foot and Ankle (VAS-FA) on the day of elective foot and/or ankle surgery. Construct validity, coverage, and targeting of the scales were assessed.

RESULTS: Based on general and predefined thresholds, construct validity, coverage, and targeting of the ePRO versions of the FAAM, the FAOS, the MOXFQ, and the VAS-FA were acceptable. Major issues arose with score distribution and convergent validity of the modified LEFS instrument.

CONCLUSIONS: The ePRO versions of the FAAM, the FAOS, the MOXFQ, and the VAS-FA provide valid scores for foot and ankle patients. However, our findings do not support the use of the modified LEFS as an electronic outcome measure for patients with orthopedic foot and/or ankle pathologies.

Original language	English
Pages (from-to)	52-59
Number of pages	8
Journal	Foot Ankle Surg
Volume	27
Issue number	1
DOIs	https://doi.org/10.1016/j.fas.2020.02.003
Publication status	Published - 2021
Externally published	Yes
Publication type	A1 Journal article-refereed

Keywords

Ankle Joint/surgery
Electronic Health Records/standards
Female
Humans
Male
Middle Aged
Patient Reported Outcome Measures
Reproducibility of Results
Surveys and Questionnaires
Visual Analog Scale

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.fas.2020.02.003

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Uimonen, M. M., Ponkilainen, V. T., Toom, A., Miettinen, M., Häkkinen, A. H., Sandelin, H., Latvala, A. O., Sirola, T., Sampo, M., Roine, R. P., Lindahl, J., Ilves, O., Sandbacka, A., & Repo, J. P. (2021). Validity of five foot and ankle specific electronic patient-reported outcome (ePRO) instruments in patients undergoing elective orthopedic foot or ankle surgery. Foot Ankle Surg, 27(1), 52-59. https://doi.org/10.1016/j.fas.2020.02.003

@article{77034edaed8f4cd097bda412177b1911,

title = "Validity of five foot and ankle specific electronic patient-reported outcome (ePRO) instruments in patients undergoing elective orthopedic foot or ankle surgery",

abstract = "BACKGROUND: Patient-reported outcomes (PROs) are widely accepted measures for evaluating outcomes of surgical interventions. As patient-reported information is stored in electronic health records, it is essential that there are valid electronic PRO (ePRO) instruments available for clinicians and researchers. The aim of this study was to evaluate the validity of electronic versions of five widely used foot and ankle specific PRO instruments.METHODS: Altogether 111 consecutive elective foot/ankle surgery patients were invited face-to-face to participate in this study. Patients completed electronic versions of the Foot and Ankle Ability Measure (FAAM), the Foot and Ankle Outcome Score (FAOS), the modified Lower Extremity Function Scale (LEFS), the Manchester-Oxford Foot Questionnaire (MOXFQ), and the Visual Analogue Scale Foot and Ankle (VAS-FA) on the day of elective foot and/or ankle surgery. Construct validity, coverage, and targeting of the scales were assessed.RESULTS: Based on general and predefined thresholds, construct validity, coverage, and targeting of the ePRO versions of the FAAM, the FAOS, the MOXFQ, and the VAS-FA were acceptable. Major issues arose with score distribution and convergent validity of the modified LEFS instrument.CONCLUSIONS: The ePRO versions of the FAAM, the FAOS, the MOXFQ, and the VAS-FA provide valid scores for foot and ankle patients. However, our findings do not support the use of the modified LEFS as an electronic outcome measure for patients with orthopedic foot and/or ankle pathologies.",

keywords = "Ankle Joint/surgery, Electronic Health Records/standards, Female, Humans, Male, Middle Aged, Patient Reported Outcome Measures, Reproducibility of Results, Surveys and Questionnaires, Visual Analog Scale",

author = "Uimonen, {Mikko M} and Ponkilainen, {Ville T} and Alar Toom and Mikko Miettinen and H{\"a}kkinen, {Arja H} and Henrik Sandelin and Latvala, {Antti O} and Timo Sirola and Mika Sampo and Roine, {Risto P} and Jan Lindahl and Outi Ilves and Anna Sandbacka and Repo, {Jussi P}",

year = "2021",

doi = "10.1016/j.fas.2020.02.003",

language = "English",

volume = "27",

pages = "52--59",

number = "1",

}

Uimonen, MM , Ponkilainen, VT, Toom, A, Miettinen, M, Häkkinen, AH, Sandelin, H, Latvala, AO, Sirola, T, Sampo, M, Roine, RP, Lindahl, J, Ilves, O, Sandbacka, A & Repo, JP 2021, 'Validity of five foot and ankle specific electronic patient-reported outcome (ePRO) instruments in patients undergoing elective orthopedic foot or ankle surgery', Foot Ankle Surg, vol. 27, no. 1, pp. 52-59. https://doi.org/10.1016/j.fas.2020.02.003

TY - JOUR

T1 - Validity of five foot and ankle specific electronic patient-reported outcome (ePRO) instruments in patients undergoing elective orthopedic foot or ankle surgery

AU - Uimonen, Mikko M

AU - Ponkilainen, Ville T

AU - Toom, Alar

AU - Miettinen, Mikko

AU - Häkkinen, Arja H

AU - Sandelin, Henrik

AU - Latvala, Antti O

AU - Sirola, Timo

AU - Sampo, Mika

AU - Roine, Risto P

AU - Lindahl, Jan

AU - Ilves, Outi

AU - Sandbacka, Anna

AU - Repo, Jussi P

PY - 2021

Y1 - 2021

N2 - BACKGROUND: Patient-reported outcomes (PROs) are widely accepted measures for evaluating outcomes of surgical interventions. As patient-reported information is stored in electronic health records, it is essential that there are valid electronic PRO (ePRO) instruments available for clinicians and researchers. The aim of this study was to evaluate the validity of electronic versions of five widely used foot and ankle specific PRO instruments.METHODS: Altogether 111 consecutive elective foot/ankle surgery patients were invited face-to-face to participate in this study. Patients completed electronic versions of the Foot and Ankle Ability Measure (FAAM), the Foot and Ankle Outcome Score (FAOS), the modified Lower Extremity Function Scale (LEFS), the Manchester-Oxford Foot Questionnaire (MOXFQ), and the Visual Analogue Scale Foot and Ankle (VAS-FA) on the day of elective foot and/or ankle surgery. Construct validity, coverage, and targeting of the scales were assessed.RESULTS: Based on general and predefined thresholds, construct validity, coverage, and targeting of the ePRO versions of the FAAM, the FAOS, the MOXFQ, and the VAS-FA were acceptable. Major issues arose with score distribution and convergent validity of the modified LEFS instrument.CONCLUSIONS: The ePRO versions of the FAAM, the FAOS, the MOXFQ, and the VAS-FA provide valid scores for foot and ankle patients. However, our findings do not support the use of the modified LEFS as an electronic outcome measure for patients with orthopedic foot and/or ankle pathologies.

AB - BACKGROUND: Patient-reported outcomes (PROs) are widely accepted measures for evaluating outcomes of surgical interventions. As patient-reported information is stored in electronic health records, it is essential that there are valid electronic PRO (ePRO) instruments available for clinicians and researchers. The aim of this study was to evaluate the validity of electronic versions of five widely used foot and ankle specific PRO instruments.METHODS: Altogether 111 consecutive elective foot/ankle surgery patients were invited face-to-face to participate in this study. Patients completed electronic versions of the Foot and Ankle Ability Measure (FAAM), the Foot and Ankle Outcome Score (FAOS), the modified Lower Extremity Function Scale (LEFS), the Manchester-Oxford Foot Questionnaire (MOXFQ), and the Visual Analogue Scale Foot and Ankle (VAS-FA) on the day of elective foot and/or ankle surgery. Construct validity, coverage, and targeting of the scales were assessed.RESULTS: Based on general and predefined thresholds, construct validity, coverage, and targeting of the ePRO versions of the FAAM, the FAOS, the MOXFQ, and the VAS-FA were acceptable. Major issues arose with score distribution and convergent validity of the modified LEFS instrument.CONCLUSIONS: The ePRO versions of the FAAM, the FAOS, the MOXFQ, and the VAS-FA provide valid scores for foot and ankle patients. However, our findings do not support the use of the modified LEFS as an electronic outcome measure for patients with orthopedic foot and/or ankle pathologies.

KW - Ankle Joint/surgery

KW - Electronic Health Records/standards

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Patient Reported Outcome Measures

KW - Reproducibility of Results

KW - Surveys and Questionnaires

KW - Visual Analog Scale

U2 - 10.1016/j.fas.2020.02.003

DO - 10.1016/j.fas.2020.02.003

M3 - Article

C2 - 32111516

SN - 1268-7731

VL - 27

SP - 52

EP - 59

JO - Foot Ankle Surg

JF - Foot Ankle Surg

IS - 1

ER -

Validity of five foot and ankle specific electronic patient-reported outcome (ePRO) instruments in patients undergoing elective orthopedic foot or ankle surgery

Abstract

Keywords

UN SDGs

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