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‘The Forgotten Joint Score’ Construct Validity and Test-Retest Reliability Justin Roe, Justin Webb, Lucy Salmon North Sydney Orthopaedic & Sports Medicine.

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Presentation on theme: "‘The Forgotten Joint Score’ Construct Validity and Test-Retest Reliability Justin Roe, Justin Webb, Lucy Salmon North Sydney Orthopaedic & Sports Medicine."— Presentation transcript:

1 ‘The Forgotten Joint Score’ Construct Validity and Test-Retest Reliability Justin Roe, Justin Webb, Lucy Salmon North Sydney Orthopaedic & Sports Medicine Centre Mater Hospital, Sydney, Australia

2 Disclosures Educational support from Smith and Nephew Stryker Funding for this study was received from Stryker Inc. Associate Professor Justin Roe

3 Introduction 51,212 Total Knee Replacements in Australia 2013* Results generally good – 10-15% patients dissatisfied ** Review of outcomes is important Patient reported outcome measures (PROMS) * ANJRR 2014 ** Becker Knee Surg Sports Traumatol Arthrosc 2011, Kim J Arthroplasty 2009

4 What makes a good outcome score? Measure the outcome in question Reliable Reproducible Responsive Validated Easy to administer Associate Professor Justin Roe

5 Why a new score? Many validated scores currently available – KOOS, WOMAC, IKS, Oxford Pain, function and symptoms variables – Excellent improvement in scores The Ceiling Effect – Large percentage responses near perfect – Inability to detect further improvement – Up to 20% in WOMAC Associate Professor Justin Roe

6 The Forgotten Joint Score Newly developed and Validated in German Language Patient awareness of TKR The ‘Forgotten Joint’ is a successful TKR Associate Professor Justin Roe

7 The Forgotten Joint Score (FJS-12)

8 Methods 240 Consecutive TKR patients enrolled Patients completed KOOS and FJS-12 FJS-12 repeated at 4 weeks Test-retest reliability was analysed calculating a Intraclass Correlation Coefficient Convergent construct validity was assessed with a Spearman’s coefficient between the FJS-12 score and a normalised WOMAC and KOOS score Associate Professor Justin Roe

9 Results 147 patients returned all questionnaires 68 females and 79 males Mean age 67 years (range 32-89) Mean time from surgery to completion of first questionnaire 39 months (range 18-72) Mean time between questionnaires 6 weeks (3-15) Associate Professor Justin Roe

10 Results MeanSDRange FJS-12Initial Follow-up Normalised WOMACPain Stiffness Function Total KOOSQuality of Life Symptom Pain ADL

11 Test Re-test Reliability Intra Class Correlation95% Confidence Interval Landis & Koch Classification Overall Score Almost Perfect Individual Questions Night Symptoms Almost Perfect Sitting Almost Perfect Walking Almost Perfect Bathing Almost Perfect Travelling Almost Perfect Stairs Almost Perfect Walking uneven ground Almost Perfect Rising Almost Perfect Associate Professor Justin Roe

12 Correlation of FJS-12 with Normalised WOMAC The FJS and the WOMAC demonstrate a positive correlation The FJS scores have a larger range than the WOMAC scores Associate Professor Justin Roe

13 Correlation of FJS-12 with Normalised WOMAC and KOOS Forgotten Joint Score Spearman’sSignificance Normalised WOMAC Pain Stiffness Function Total KOOSQuality of Life Symptom Pain ADL Associate Professor Justin Roe

14 Distribution of Scores broad distribution similar distribution, clustered lower FJS 15% > 95 WOMAC 26% > 95 30% perfect scores

15 Ceiling effect WOMAC and KOOS Pain scores demonstrate ceiling effect – Reflects excellent pain relief with TKR FJS-12 has much wider score distribution Associate Professor Justin Roe

16 Discussion FJS-12 similar score distribution to KOOS Symptom score FJS KOOS Symptom -65 May reflect ongoing symptoms in well functioning pain free TKR Associate Professor Justin Roe

17 Summary Forgotten Joint Score has near perfect test-retest reliability Valid when compared to WOMAC and KOOS No Ceiling effect 12 question format is quick and easy Useful adjunct Associate Professor Justin Roe

18 Thank-you for your attention. See you in Sydney Associate Professor Justin Roe


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