The Relationship Among 3 Generic Patient-Reported Outcome Instruments in Patients With Lower Extremity Health Conditions.

CONTEXT: Generic patient-reported outcome (PRO) instruments are designed to capture health-related quality-of-life outcomes and to determine treatment effectiveness from the patient's perspective. Multiple generic PROs are used in clinical practice, and an investigation of the psychometric properties of these instruments in a high-functioning, physically active population is important for the future use of these instruments. OBJECTIVE: To determine the relationship among 3 generic PROs: the modified Disablement in the Physically Active (mDPA) Scale, the Patient-Reported Outcome Measurement Information System Physical Function (PROMIS-PF), and the Short Form 12 (SF-12) in physically active patients seeking treatment for a lower extremity health condition. DESIGN: Cross-sectional study. SETTING: Athletic training clinical facility, physical therapy clinic. PATIENTS OR OTHER PARTICIPANTS: One hundred patients seeking rehabilitation services for a lower extremity health condition. MAIN OUTCOME MEASURE(S): All patients completed a demographic questionnaire and the 3 generic PROs at 1 time point during their rehabilitation: the mDPA-Total, mDPA-physical summary component (mDPA-PSC), mDPA-mental summary component (mDPA-MSC), the PROMIS-PF, and SF-12 mental component summary (SF-MCS) and physical component summary (SF-PCS). Separate Spearman rank (r) correlations were performed to assess the strength of the relationship among PRO instruments. The floor and ceiling effects were also examined. RESULTS: A strong relationship was present between the SF-12 PCS and the mDPA-Total (r = -0.65), the mDPA-PSC (r = -0.64), and the PROMIS-PF (r = 0.65). Significant moderate relationships were identified between the mDPA-MSC and the SF-12 PCS (r = -0.43) and MCS (r = -0.53). Weak relationships were noted between the mDPA-Total and SF-12 MCS (r = -0.21) and the SF-12 MCS and mDPA-PSC (r = -0.10) and PROMIS-PF (r = 0.20). CONCLUSIONS: The PROMIS-PF and mDPA had good convergent and divergent validity. Clinicians treating physically active patients should consider these instruments for use in clinical practice. Future researchers should examine additional psychometric properties of these instruments in physically active patients.

The Validity of the Quick-FAAM in Patients Seeking Treatment for an Acute or Subacute Foot or Ankle Health Condition.

CONTEXT: Documented barriers to implementation of patient-reported outcome instruments (PROs) in practice include administration and scoring time. The Quick Foot and Ankle Ability Measure (Quick-FAAM) was developed to decrease these barriers; however, the clinometric properties in an acute population are unknown. PURPOSE: To determine the internal consistency, validity, and the floor and ceiling effects of the Quick-FAAM in patients seeking treatment for an acute or subacute ankle or foot health condition. STUDY DESIGN: Cross-Sectional. SETTING: Healthcare facilities. PATIENTS: 50 patients (20.3 ± 2.2 y, 177.9 ± 10.7 cm, 80 ± 19.4 kg) seeking treatment for an acute or subacute ankle or foot condition. MAIN OUTCOME MEASURES: Each patient completed a demographic and health-history questionnaire followed by 5 PROs: the Quick-FAAM, the FAAM-Activities of Daily Living (ADL), FAAM-Sport, the modified Disablement in the Physically Active Scale (mDPA), the Short-Form 12 (SF-12) and the PROMISv1.2 Physical Function (PROMIS-PF). Cronbach alpha was used to determine internal consistency and Spearman's rank correlations were performed to examine the relationship between the Quick-FAAM and all other outcomes. RESULTS: The Quick-FAAM was very strongly correlated with the FAAM-Total (r = .91, r2 = .83, P < .001), FAAM-ADL (r = .83, r2 = .69, P < .001), FAAM-Sport (r = .89, r2 = .79, P < .001), SF12-Physical Component Score (PCS, r = .74, r2 = .55, P < .001), mDPA-PCS (r = -.83, r2 = .69, P < .001) and PROMIS PF (r = .85, r2 = .72, P < .001). There was a weak or no relationship with the SF12-Mental Component Score (MCS, r = .04, r2 = .00, P < .001) and the mDPA-MCS (r = -.35, r2 = .12, P < .001). A total of 8% (n = 4) of the patients scored a 0, and 2% (n = 1) patients scored a 48. CONCLUSION: he Quick-FAAM demonstrated good convergent and divergent validity along with good internal consistency. There was no evidence of a floor or ceiling effect. Therefore, the Quick-FAAM should be considered for use in practice when determining treatment effectiveness for patients with acute or subacute ankle or foot health conditions. Future research should determine the test-retest reliability and the minimal detectable change of this instrument.