Martinus Richter1, Per-Henrik Agren2, Jean-Luc Besse3, Maria Cöster4, Hakon Kofoed5, Nicola Maffulli6, Dieter Rosenbaum7, Martijn Steultjens8, Fernando Alvarez9, Andrzej Boszczyk10, Kris Buedts11, Marco Guelfi12, Henryk Liszka13, Jan-Willem Louwerens14, Jussi P Repo15, Elena Samaila16, Michael Stephens17, Angelique G H Witteveen14. 1. Department for Foot and Ankle Surgery Rummelsberg and Nuremberg, Schwarzenbruck, Germany. 2. Stockholms Fotkirurgklinik, Sophiahemmet University, Stockholm, Sweden. 3. Université Lyon 1, IFSTTAR, LBMC UMR-T 9406 - Laboratoire de Biomécanique et Mécanique des Chocs, Bron Cedex, France; Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Service de Chirurgie Orthopédique et Traumatologique, Pierre-Bénite Cedex, France. 4. Department of Clinical Sciences and Orthopedics, Skåne University Hospital, Malmö, Sweden; Department of Foot and Ankle Surgery, Capio Movement, Halmstad, Sweden. 5. Private praxis, Charlottenlund, Denmark. 6. Queen Mary University of London, Barts and The London School of Medicine and Dentistry, London, UK. 7. Movement Analysis Lab, Institute for Experimental Musculoskeletal Medicine University Hospital Muenster, Muenster, Germany. 8. School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK. 9. Orthopaedic Surgery Department, Sant Rafael Hospital, Barcelona, Spain. 10. Department of Traumatology and Orthopaedics, Centre of Postgraduate Medical Education, Otwock, Poland. 11. Foot and Ankle Surgery Unit, Orthopaedic Department ZNA Middelheim, Antwerpen, Belgium. 12. Orthopaedic Department, Montallegro Clinic, Genoa, Italy; Foot & Ankle Department, "Policlinico di Monza" Salus Clinic, Alessandria, Italy; Orthopaedic & Traumatology specialization school, "D'Annunzio University", Chieti-Pescara, Italy. 13. Department of Orthopaedics and Rehabilitation, University Hospital in Krakow, Poland. 14. Foot and Ankle Reconstruction Unit, Sint Maartenskliniek, Nijmegen, The Netherlands. 15. Department of Orthopedics and Traumatology, Central Finland Health Care District, Jyväskylä, Finland. 16. Orthopedic and Traumatology, University of Verona, Verona, Italy. 17. Mater Private Hospital, Dublin, Ireland.
Abstract
BACKGROUND: A scientifically sound validated foot and ankle specific score validated ab initio for different languages is missing. The aim of a project of the European Foot and Ankle Society (EFAS) was to develop, validate, and publish a new score(the EFAS-Score) for different European languages. METHODS: The EFAS Score was developed and validated in three stages: (1) item (question) identification, (2) item reduction and scale exploration, (3) confirmatory analyses and responsiveness. The following score specifications were chosen: scale/subscale (Likert 0-4), questionnaire based, outcome measure, patient related outcome measurement. For stage 3, data were collected pre-operatively and at a minimum follow-up of 3 months and mean follow-up of 6 months. Item reduction, scale exploration, confirmatory analyses and responsiveness were executed using analyses from classical test theory and item response theory. RESULTS: Stage 1 resulted in 31 general and 7 sports related questions. In stage 2, a 6-item general EFAS Score was constructed using English, German, French and Swedish language data. In stage 3, internal consistency of the scale was confirmed in seven languages: the original four languages, plus Dutch, Italian and Polish (Cronbach's Alpha >0.86 in all language versions). Responsiveness was good, with moderate to large effect sizes in all languages, and significant positive association between the EFAS Score and patient-reported improvement. No sound EFAS Sports Score could be constructed. CONCLUSIONS: The multi-language EFAS Score was successfully validated in the orthopaedic ankle and foot surgery patient population, including a wide variety of foot and ankle pathologies. All score versions are freely available at www.efas.co.
BACKGROUND: A scientifically sound validated foot and ankle specific score validated ab initio for different languages is missing. The aim of a project of the European Foot and Ankle Society (EFAS) was to develop, validate, and publish a new score(the EFAS-Score) for different European languages. METHODS: The EFAS Score was developed and validated in three stages: (1) item (question) identification, (2) item reduction and scale exploration, (3) confirmatory analyses and responsiveness. The following score specifications were chosen: scale/subscale (Likert 0-4), questionnaire based, outcome measure, patient related outcome measurement. For stage 3, data were collected pre-operatively and at a minimum follow-up of 3 months and mean follow-up of 6 months. Item reduction, scale exploration, confirmatory analyses and responsiveness were executed using analyses from classical test theory and item response theory. RESULTS: Stage 1 resulted in 31 general and 7 sports related questions. In stage 2, a 6-item general EFAS Score was constructed using English, German, French and Swedish language data. In stage 3, internal consistency of the scale was confirmed in seven languages: the original four languages, plus Dutch, Italian and Polish (Cronbach's Alpha >0.86 in all language versions). Responsiveness was good, with moderate to large effect sizes in all languages, and significant positive association between the EFAS Score and patient-reported improvement. No sound EFAS Sports Score could be constructed. CONCLUSIONS: The multi-language EFAS Score was successfully validated in the orthopaedic ankle and foot surgery patient population, including a wide variety of foot and ankle pathologies. All score versions are freely available at www.efas.co.
Authors: Kathrin Pfahl; Anke Röser; Julia Eder; Oliver Gottschalk; Hubert Hörterer; Alexander Mehlhorn; Markus Walther Journal: Arch Orthop Trauma Surg Date: 2022-10-21 Impact factor: 2.928