Published online Feb 18, 2021. doi: 10.5312/wjo.v12.i2.69
Peer-review started: September 16, 2020
First decision: December 1, 2020
Revised: December 14, 2020
Accepted: January 21, 2021
Article in press: January 21, 2021
Published online: February 18, 2021
Patient-reported outcome (PRO) measurement is gaining more and more importance in clinical decision-making. Evaluation of psychometric properties of PRO tools is essential to assure validity.
A fracture of the acetabulum is an uncommon but serious injury. Outcome evaluation tools in patients after acetabular fractures are outdated. However, research based on large registries are dependent on valid outcome tools to allow the comparability.
Aim of the study was to validate the Forgotten Joint Score (FJS) according the COSMIN checklist. The FJS is a novel PRO tool to disease-specific quality of life in musculo-skeletal disorders.
The COSMIN checklist is a standard protocol to assure methodical quality of validation studies. The COSMIN checklist consists of ten items giving recommendations for design, conduction and interpretation of medical validation studies. Relevant characteristics are study design, content validity, structural validity, internal consistency, cross-cultural validity/measurement invariance, reliability, measurement error, criterion validity, hypotheses testing for construct validity, and responsiveness.
We found the FJS to be a valid and reliable tool for evaluation of PRO in posttraumatic condition after an acetabular fracture. With a Cronbach’s alpha of 0.95, internal consistency of the questionnaire was good. Test-retest reliability was excellent with an ICC of 0.99. Based on the anchor variable, the smallest detectable change indicating a real clinical improvement was 8.8 points in the FJS. We could confirm responsiveness of the FJS and found no relevant floor- or ceiling effects.
Clinicians are suggested to use the FJS for evaluation of PRO after fractures of the acetabulum.
Further studies are needed to confirm the study results, especially concerning longitudinal data. Based on the study results, the FJS can now be used for further clinical studies on post-traumatic conditions after fractures of the acetabulum.