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      Reliability and validation of the Dutch Achilles tendon Total Rupture Score

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          Abstract

          Purpose

          Patient-reported outcome measures (PROMs) have become a cornerstone for the evaluation of the effectiveness of treatment. The Achilles tendon Total Rupture Score (ATRS) is a PROM for outcome and assessment of an Achilles tendon rupture. The aim of this study was to translate the ATRS to Dutch and evaluate its reliability and validity in the Dutch population.

          Methods

          A forward–backward translation procedure was performed according to the guidelines of cross-cultural adaptation process. The Dutch ATRS was evaluated for reliability and validity in patients treated for a total Achilles tendon rupture from 1 January 2012 to 31 December 2014 in one teaching hospital and one academic hospital. Reliability was assessed by the intraclass correlation coefficients (ICC), Cronbach’s alpha and minimal detectable change (MDC). We assessed construct validity by calculation of Spearman’s rho correlation coefficient with domains of the Foot and Ankle Outcome Score (FAOS), Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A) and Numeric Rating Scale (NRS) for pain in rest and during running.

          Results

          The Dutch ATRS had a good test–retest reliability (ICC = 0.852) and a high internal consistency (Cronbach’s alpha = 0.96). MDC was 30.2 at individual level and 3.5 at group level. Construct validity was supported by 75 % of the hypothesized correlations. The Dutch ATRS had a strong correlation with NRS for pain during running ( r = −0.746) and all the five subscales of the Dutch FAOS ( r = 0.724–0.867). There was a moderate correlation with the VISA-A-NL ( r = 0.691) and NRS for pain in rest ( r = −0.580).

          Conclusion

          The Dutch ATRS shows an adequate reliability and validity and can be used in the Dutch population for measuring the outcome of treatment of a total Achilles tendon rupture and for research purposes.

          Level of evidence

          Diagnostic study, Level I.

          Electronic supplementary material

          The online version of this article (doi:10.1007/s00167-016-4242-7) contains supplementary material, which is available to authorized users.

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          Most cited references22

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          Quality criteria were proposed for measurement properties of health status questionnaires.

          Recently, an increasing number of systematic reviews have been published in which the measurement properties of health status questionnaires are compared. For a meaningful comparison, quality criteria for measurement properties are needed. Our aim was to develop quality criteria for design, methods, and outcomes of studies on the development and evaluation of health status questionnaires. Quality criteria for content validity, internal consistency, criterion validity, construct validity, reproducibility, longitudinal validity, responsiveness, floor and ceiling effects, and interpretability were derived from existing guidelines and consensus within our research group. For each measurement property a criterion was defined for a positive, negative, or indeterminate rating, depending on the design, methods, and outcomes of the validation study. Our criteria make a substantial contribution toward defining explicit quality criteria for measurement properties of health status questionnaires. Our criteria can be used in systematic reviews of health status questionnaires, to detect shortcomings and gaps in knowledge of measurement properties, and to design validation studies. The future challenge will be to refine and complete the criteria and to reach broad consensus, especially on quality criteria for good measurement properties.
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            Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM.

            Reliability, the consistency of a test or measurement, is frequently quantified in the movement sciences literature. A common metric is the intraclass correlation coefficient (ICC). In addition, the SEM, which can be calculated from the ICC, is also frequently reported in reliability studies. However, there are several versions of the ICC, and confusion exists in the movement sciences regarding which ICC to use. Further, the utility of the SEM is not fully appreciated. In this review, the basics of classic reliability theory are addressed in the context of choosing and interpreting an ICC. The primary distinction between ICC equations is argued to be one concerning the inclusion (equations 2,1 and 2,k) or exclusion (equations 3,1 and 3,k) of systematic error in the denominator of the ICC equation. Inferential tests of mean differences, which are performed in the process of deriving the necessary variance components for the calculation of ICC values, are useful to determine if systematic error is present. If so, the measurement schedule should be modified (removing trials where learning and/or fatigue effects are present) to remove systematic error, and ICC equations that only consider random error may be safely used. The use of ICC values is discussed in the context of estimating the effects of measurement error on sample size, statistical power, and correlation attenuation. Finally, calculation and application of the SEM are discussed. It is shown how the SEM and its variants can be used to construct confidence intervals for individual scores and to determine the minimal difference needed to be exhibited for one to be confident that a true change in performance of an individual has occurred.
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              The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes.

              Lack of consensus on taxonomy, terminology, and definitions has led to confusion about which measurement properties are relevant and which concepts they represent. The aim was to clarify and standardize terminology and definitions of measurement properties by reaching consensus among a group of experts and to develop a taxonomy of measurement properties relevant for evaluating health instruments. An international Delphi study with four written rounds was performed. Participating experts had a background in epidemiology, statistics, psychology, and clinical medicine. The panel was asked to rate their (dis)agreement about proposals on a five-point scale. Consensus was considered to be reached when at least 67% of the panel agreed. Of 91 invited experts, 57 agreed to participate and 43 actually participated. Consensus was reached on positions of measurement properties in the taxonomy (68-84%), terminology (74-88%, except for structural validity [56%]), and definitions of measurement properties (68-88%). The panel extensively discussed the positions of internal consistency and responsiveness in the taxonomy, the terms "reliability" and "structural validity," and the definitions of internal consistency and reliability. Consensus on taxonomy, terminology, and definitions of measurement properties was reached. Hopefully, this will lead to a more uniform use of terms and definitions in the literature on measurement properties. Copyright 2010 Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                + 31 20 566 6419 , k.t.opdam@amc.uva.nl
                r.zwiers@amc.uva.nl
                j.i.wiegerinck@amc.uva.nl
                A.E.B.Kleipool@olvg.nl
                R.Haverlag@olvg.nl
                j.c.goslings@amc.uva.nl
                c.n.vandijk@amc.uva.nl
                Journal
                Knee Surg Sports Traumatol Arthrosc
                Knee Surg Sports Traumatol Arthrosc
                Knee Surgery, Sports Traumatology, Arthroscopy
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0942-2056
                1433-7347
                14 July 2016
                14 July 2016
                2018
                : 26
                : 3
                : 862-868
                Affiliations
                [1 ]ISNI 0000000084992262, GRID grid.7177.6, Department of Orthopaedic Surgery, Orthopaedic Research Center Amsterdam, Academic Medical Center, , University of Amsterdam, ; Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
                [2 ]GRID grid.440209.b, Department of Orthopaedic Surgery, , Onze Lieve Vrouwe Gasthuis, ; Oosterpark 9, 1091 AC Amsterdam, The Netherlands
                [3 ]GRID grid.440209.b, Department of Surgery, , Onze Lieve Vrouwe Gasthuis, ; Oosterpark 9, 1091 AC Amsterdam, The Netherlands
                [4 ]ISNI 0000000084992262, GRID grid.7177.6, Trauma Unit, Academic Medical Center, , University of Amsterdam, ; Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
                Author information
                http://orcid.org/0000-0002-3784-7876
                Article
                4242
                10.1007/s00167-016-4242-7
                5847201
                27417101
                b4fe372f-dd08-4376-8b38-7c647a453da5
                © The Author(s) 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 2 February 2016
                : 6 July 2016
                Categories
                Ankle
                Custom metadata
                © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018

                Surgery
                achilles tendon rupture,atrs,cross-cultural,reliability,validity,prom,dutch
                Surgery
                achilles tendon rupture, atrs, cross-cultural, reliability, validity, prom, dutch

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