Description of the Simple Ankle Value: A Simplified Patient-Reported Outcome Measure for the Assessment of Ankle and Hindfoot Function

Overview

Journal Orthop J Sports Med

Specialty Orthopedics

Date 2023 Oct 23

PMID 37868219

Authors

Thomas Barnavon

Alexandre Hardy

Tristan Duguay

Pierre-Alban Bouche

Ronny Lopes

Affiliations

Soon will be listed here.

Abstract

Background: The Simple Ankle Value (SAV) is a patient-reported outcome measure (PROM) in which patients grade their ankle function as a percentage of that of their contralateral uninjured ankle.

Purpose/hypothesis: The primary aims of this study were to validate the SAV and evaluate its correlation with other PROMs. It was hypothesized that the SAV would be seen as a valid score that provides results comparable with those of the Foot and Ankle Ability Measure (FAAM) and the European Foot & Ankle Society (EFAS) score.

Study Design: Cohort study (Diagnosis); Level of evidence, 2.

Methods: Patients seen for an ankle or hindfoot tissue were divided into those treated operatively and nonoperatively. A control group of patients treated for issues outside of the foot and ankle was also created. All patients completed the SAV followed by the FAAM and the EFAS scores. Patients treated operatively completed the questionnaires before surgery and 3 months after surgery. Patients treated nonoperatively completed the questionnaires twice 15 days apart. The correlation between the SAV score, the FAAM score, and the EFAS score was estimated with the Spearman correlation coefficient.

Results: A total of 209 patients (79 in the operative group, 103 in the nonoperative group, and 27 in the control group) were asked to complete the questionnaire, and all were included. The test-retest reliability of the SAV was excellent (intraclass correlation coefficient, 0.92; 95% CI, 0.88-0.94). No ceiling or floor effect was reported. Strong correlation was found between the SAV and the FAAM and EFAS scores. The SAV was able to discriminate patients from controls (54.18 ± 21.22 and 93.52 ± 9.589; < .0001); however, SAV was not able to detect change from preoperative to 3 months postoperative (from 54.18 ± 21.22 to 62.53 ± 20.83; = .44).

Conclusion: Our study suggests that the SAV is correlated with existing accepted ankle PROMs. Further work with this PROM is needed to validate the questionnaire.

References

Marot V, Justo A, Alshanquiti A, Reina N, Accadbled F, Berard E . Simple Knee Value: a simple evaluation correlated to existing knee PROMs. Knee Surg Sports Traumatol Arthrosc. 2020; 29(6):1952-1959. DOI: 10.1007/s00167-020-06281-1. View

Eechaute C, Vaes P, Van Aerschot L, Asman S, Duquet W . The clinimetric qualities of patient-assessed instruments for measuring chronic ankle instability: a systematic review. BMC Musculoskelet Disord. 2007; 8:6. PMC: 1797175. DOI: 10.1186/1471-2474-8-6. View

Casalino L, Gans D, Weber R, Cea M, Tuchovsky A, Bishop T . US Physician Practices Spend More Than $15.4 Billion Annually To Report Quality Measures. Health Aff (Millwood). 2016; 35(3):401-6. DOI: 10.1377/hlthaff.2015.1258. View

Borloz S, Crevoisier X, Deriaz O, Ballabeni P, Martin R, Luthi F . Evidence for validity and reliability of a French version of the FAAM. BMC Musculoskelet Disord. 2011; 12:40. PMC: 3045395. DOI: 10.1186/1471-2474-12-40. View

Uimonen M, Ponkilainen V, Toom A, Miettinen M, Hakkinen A, Sandelin H . Validity of five foot and ankle specific electronic patient-reported outcome (ePRO) instruments in patients undergoing elective orthopedic foot or ankle surgery. Foot Ankle Surg. 2020; 27(1):52-59. DOI: 10.1016/j.fas.2020.02.003. View

Martin R, Irrgang J, Burdett R, Conti S, Van Swearingen J . Evidence of validity for the Foot and Ankle Ability Measure (FAAM). Foot Ankle Int. 2005; 26(11):968-83. DOI: 10.1177/107110070502601113. View

Williams G, Gangel T, Arciero R, Uhorchak J, Taylor D . Comparison of the Single Assessment Numeric Evaluation method and two shoulder rating scales. Outcomes measures after shoulder surgery. Am J Sports Med. 1999; 27(2):214-21. DOI: 10.1177/03635465990270021701. View

Hutchings A, Frie K, Neuburger J, van der Meulen J, Black N . Late response to patient-reported outcome questionnaires after surgery was associated with worse outcome. J Clin Epidemiol. 2012; 66(2):218-25. DOI: 10.1016/j.jclinepi.2012.09.001. View

Shazadeh Safavi P, Janney C, Jupiter D, Kunzler D, Bui R, Panchbhavi V . A Systematic Review of the Outcome Evaluation Tools for the Foot and Ankle. Foot Ankle Spec. 2018; 12(5):461-470. DOI: 10.1177/1938640018803747. View

10.

Hunt K, Hurwit D . Use of patient-reported outcome measures in foot and ankle research. J Bone Joint Surg Am. 2013; 95(16):e118(1-9). DOI: 10.2106/JBJS.L.01476. View

11.

Dawson J, Doll H, Fitzpatrick R, Jenkinson C, Carr A . The routine use of patient reported outcome measures in healthcare settings. BMJ. 2010; 340:c186. DOI: 10.1136/bmj.c186. View

12.

SooHoo N, Shuler M, Fleming L . Evaluation of the validity of the AOFAS Clinical Rating Systems by correlation to the SF-36. Foot Ankle Int. 2003; 24(1):50-5. DOI: 10.1177/107110070302400108. View

13.

Goulart Neto A, Maffulli N, Migliorini F, de Menezes F, Okubo R . Validation of Foot and Ankle Ability Measure (FAAM) and the Foot and Ankle Outcome Score (FAOS) in individuals with chronic ankle instability: a cross-sectional observational study. J Orthop Surg Res. 2022; 17(1):38. PMC: 8781557. DOI: 10.1186/s13018-022-02925-9. View

14.

Toolan B, Wright Quinones V, Cunningham B, Brage M . An evaluation of the use of retrospectively acquired preoperative AOFAS clinical rating scores to assess surgical outcome after elective foot and ankle surgery. Foot Ankle Int. 2001; 22(10):775-8. DOI: 10.1177/107110070102201002. View

15.

Pynsent P . Choosing an outcome measure. J Bone Joint Surg Br. 2001; 83(6):792-4. DOI: 10.1302/0301-620x.83b6.11973. View

16.

Williams G, Taylor D, Gangel T, Uhorchak J, Arciero R . Comparison of the single assessment numeric evaluation method and the Lysholm score. Clin Orthop Relat Res. 2000; (373):184-92. DOI: 10.1097/00003086-200004000-00022. View

17.

Carcia C, Martin R, Drouin J . Validity of the Foot and Ankle Ability Measure in athletes with chronic ankle instability. J Athl Train. 2008; 43(2):179-83. PMC: 2267323. DOI: 10.4085/1062-6050-43.2.179. View

18.

Shelbourne K, Barnes A, Gray T . Correlation of a single assessment numeric evaluation (SANE) rating with modified Cincinnati knee rating system and IKDC subjective total scores for patients after ACL reconstruction or knee arthroscopy. Am J Sports Med. 2012; 40(11):2487-91. DOI: 10.1177/0363546512458576. View

19.

Richter M, Agren P, Besse J, Coster M, Kofoed H, Maffulli N . EFAS Score - Multilingual development and validation of a patient-reported outcome measure (PROM) by the score committee of the European Foot and Ankle Society (EFAS). Foot Ankle Surg. 2018; 24(3):185-204. DOI: 10.1016/j.fas.2018.05.004. View

20.

Guyton G . Theoretical limitations of the AOFAS scoring systems: an analysis using Monte Carlo modeling. Foot Ankle Int. 2001; 22(10):779-87. DOI: 10.1177/107110070102201003. View