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Foot and Ankle Outcome Instruments: Missing the Target
Omar A Al-Mohrej1, Bradley Petrisor2
1Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, L8L 2X2, Canada. mohrejo@mcmaster.ca.
Current Reviews in Musculoskeletal Medicine
|April 4, 2023
Summary
Limited evidence supports most foot and ankle patient-reported outcome measures (PROMs). The most common tool, the AOFAS Clinical Rating System, lacks supporting evidence, necessitating further research for reliable outcome assessment.
Area of Science:
- Orthopedic surgery
- Clinical outcomes assessment
Background:
- The number of patient-reported outcome measures (PROMs) for foot and ankle conditions has significantly increased.
- The psychometric properties of these PROMs vary widely, leading to inconsistent use in research.
Purpose of the Study:
- To review the most frequently utilized PROMs in foot and ankle literature.
- To evaluate the existing evidence supporting the psychometric validity of these commonly used PROMs.
Main Methods:
- Systematic review of foot and ankle literature focusing on PROMs.
- Assessment of the quality of studies examining PROM psychometric properties.
Main Results:
- Very limited evidence supports the use of most commonly used foot and ankle PROMs.
- No evidence supports the use of the American Orthopaedic Foot & Ankle Society (AOFAS) Clinical Rating System.
- The quality of studies evaluating PROMs was found to be questionable.
Conclusions:
- Further research is required to conclusively determine the validity of individual foot and ankle PROMs.
- The heterogeneity of foot and ankle studies hinders high-quality meta-analyses.
- There is a need for validated PROMs specifically designed for trauma, elective procedures, and pediatric foot and ankle conditions.
