Outcome Measures to Evaluate Upper and Lower Extremity: Which Scores are Valid?

Area of Science:

• Orthopaedic surgery
• Trauma surgery
• Health outcomes research

Background:

• Scores are crucial for assessing treatment outcomes in orthopaedics and trauma surgery.
• A systematic review is needed to evaluate the validity of commonly used extremity scores.

Purpose of the Study:

• To provide an overview of the content validity of frequently used scores for the upper and lower extremities.
• To analyze the methodological quality of validation studies for these scores.

Main Methods:

• Included 19 upper and 22 lower extremity outcome measures.
• Conducted comprehensive literature searches in Medline, PubMed, and Google Scholar for validation studies.
• Utilized the COSMIN Checklist (Consensus-based Standards for the selection of health Measurement Instruments) to assess methodological quality.

Main Results:

• Validity, objectivity, and reliability were not consistently addressed in validation studies.
• Six upper extremity and four lower extremity scores were inadequately validated.
• The Oxford Shoulder Score (OSS) for the upper extremity and the Hip Disabilities and Osteoarthritis Outcome Score (HOOS) and WOMAC for the lower extremity were best validated.

Conclusions:

• No gold standard exists for validating orthopaedic outcome measures.
• More comprehensive validation leads to more informative outcome measures.
• Some inadequately validated scores are still widely used in research and practice.