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Psychometrical properties of the Turkish translation of the New Knee Society Scoring System.

ABSTRACT: OBJECTIVE:To translate the New Knee Society Scoring System (KSS) into Turkish and to evaluate the psychometric properties of the translated questionnaire. METHODS:This study was conducted on 66 knees of 43 pre-op patients who were scheduled for total knee arthroplasty (TKA) and 50 knees of 26 knee arthroplasty patients at least 6 months postoperatively. KSS was translated and culturally adapted according to the guidelines of Guillemin and Beaton. Demographic and clinical characteristics of the patients were recorded. Patients completed WOMAC, KOOS and SF-36 surveys along with the Turkish version of the new KSS. After the initial evaluation, patients were asked to refill the new KSS 1 week later. Internal consistency and reliability were tested using Cronbach's alpha coefficient and intraclass correlation coefficient (ICC). Validity was assessed by calculating the Spearman's correlation coefficient between the new KSS and WOMAC, KOOS and SF-36 scores. RESULTS:The mean ages of the pre and post-operative groups were 67.16 ± 7.85 years and 71.65 ± 6.95 years respectively. The Cronbach's alpha coefficients of the new KSS calculated for symptoms (0.814), patient satisfaction (0.947), patient expectations (pre-op = 1.000, post-op = 0.997) and functional activities (0.864) were high. The ICC scores ranged between 0.790 and 0.951. The pain subscore of the new KSS and the pain subscores of the WOMAC (r = -0.720; p < 0.01), KOOS (r = 0.550; p < 0.01) and SF-36 (r = -0.434; p < 0.01) were highly correlated. Emotional role functioning (RH), mental health (MH) and social role functioning (SF) subscores of SF-36 showed no correlation with the all subscores of the new KSS (p > 0.05). No floor or ceiling effects in the new KSS scores were detected. CONCLUSION:It is concluded that the new KSS is a valid and reliable questionnaire which can be used in evaluating the pre and post-operative Turkish speaking TKA patients. LEVEL OF EVIDENCE:Level III Diagnostic Study.

SUBMITTER: Ozden F

PROVIDER: S-EPMC6601126 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Psychometrical properties of the Turkish translation of the New Knee Society Scoring System.

Özden Fatih F Tuğay Nazan N Umut Tuğay Baki B Yalın Kılınç Cem C

Acta orthopaedica et traumatologica turcica 20190405 3

<h4>Objective</h4>To translate the New Knee Society Scoring System (KSS) into Turkish and to evaluate the psychometric properties of the translated questionnaire.<h4>Methods</h4>This study was conducted on 66 knees of 43 pre-op patients who were scheduled for total knee arthroplasty (TKA) and 50 knees of 26 knee arthroplasty patients at least 6 months postoperatively. KSS was translated and culturally adapted according to the guidelines of Guillemin and Beaton. Demographic and clinical character ...[more]

PMID: 30961927

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Project description:BackgroundVarious scoring systems document improvement after TKA, but most are associated with a ceiling effect that may fail to distinguish between patients having different levels of knee function after TKA. We therefore developed a new scoring system for patients with higher levels of flexion to eliminate ceiling effects observed with current systems.Questions/purposesThe purposes of this study were (1) to determine whether the high-flexion knee score eliminates the ceiling effect, (2) to assess the validity and responsiveness of the high-flexion knee score, and (3) to determine whether the high-flexion knee score can aid in differentiation of the knee status of patients at the ceiling level.MethodsWe prospectively studied 165 patients with 201 well-functioning knees who had undergone primary TKA. We obtained Knee Society scores, WOMAC scores, Feller scores, SF-36 scores, and high-flexion knee scores for all patients. The high-flexion knee score includes items that reflect knee function in the high functional range, such as sitting on or rising from the floor, squatting, or kneeling. We determined the ceiling effects and score distributions of various scoring systems. We performed a convergent validity test of the high-flexion knee score by correlation analysis with these various scoring systems. Responsiveness of the high-flexion knee score was assessed by correlation analysis of changes in various scoring systems. To determine whether the high-flexion knee score can aid in differentiation of knee status of patients at the ceiling level, relative responsiveness of the various scores in the ceiling versus below the ceiling range was determined.ResultsThe high-flexion knee score showed no ceiling effect, whereas the other systems did. Addition of the high-flexion knee score to the other scoring systems eliminated these ceiling effects and resulted in more normalized score distributions. The high-flexion knee score correlated (r = -0.77) with WOMAC in postoperative scores, and it also correlated with the changes in WOMAC (r = -0.69) and SF-36 physical functioning (r = 0.62). The correlation of WOMAC score with SF-36 physical function score was lower in patients at the ceiling level of the Knee Society knee score and Knee Society function score, compared with the correlation at below-ceiling range, whereas the high-flexion knee score maintained a correlation with the SF-36 physical function score, even at the ceiling level of the Knee Society knee score and Knee Society function score.ConclusionsCompared with other systems, the high-function knee score appears valid for evaluating the knee status in the high-flexion range. Our data suggest the high-flexion knee score differentiates among the knee status in the high-function range. Furthermore, the high-function knee score eliminates the ceiling effect of the currently used scoring tools, and thus may be useful when combined with other scoring systems.Level of evidenceLevel III, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.

Project description:BackgroundThe Knee Society Score (KSS) instrument is one of the most commonly reported primary outcome measures for total knee arthroplasty (TKA). Originally developed in 1989, the KSS was expanded and updated in 2011; however, the original KSS does not directly translate into the 2011 KSS. To date, no conversion algorithm has been developed, hindering the ability of researchers to adopt the 2011 KSS while maintaining their historical/longitudinal original KSS data.Questions/purposesThe purpose of this study is to develop regression equations to map the original KSS to the 2011 KSS, allowing original and 2011 KSS data sets to be combined.MethodsIn this multicenter, nonrandomized study, a convenience sample of 815 patients undergoing primary TKA completed the original KSS questionnaire and the 2011 KSS questionnaire. Additionally, patient gender, patient age, and patient ethnicity were recorded. These data were then used to generate regression models to estimate the 2011 objective and function KSS from the original KSS. Of the 815 study patients, 476 (58%) were female and 339 (42%) were male at an average age of 67 years (SD 9.4). Roughly half of patients were assessed preoperatively (430 of 815 [53%]) with the remaining patients assessed postoperatively (386 of 815 [47%]). The average followup for postoperative patients was 4.4 years (SD 3.5 years).ResultsWe have created a spreadsheet that can be used by individuals with no statistical training to crosswalk the objective and function subscores from the original KSS to the 2011 KSS [Supplemental materials are available with the online version of CORR®.]. The predictive model very accurately estimated the 2011 objective score, on average, within 0.22 points on the 100-point 2011 objective KSS at the cohort or aggregate level. The objective model accurately estimated the 2011 objective KSS within 8.83 points, on average, of the actual 2011 objective KSS at the individual patient level. However, as a result of large outliers, 37% of the estimated 2011 objective KSS were greater than 10 points from the actual 2011 objective KSS. To illustrate, if you use the model to estimate the 2011 objective KSS on a cohort of 100 patients, a patient with an original objective KSS of 88 will have an estimated objective KSS between 79 and 97 points. On the other hand, if you calculate an average original objective KSS of 88 for all 100 patients, the estimated average 2011 objective KSS will be 88 for the group. The predictive model accurately estimated the 2011 function KSS within 0.14 points on the 1000-point 2011 function KSS at the cohort level. At the patient level, the 2011 function KSS was also estimated within 8.8 points of the actual 2011 function KSS. However, 43% of the estimated function scores were greater than 10 points of the actual 2011 function KSS.ConclusionsClinicians and researchers can input their original KSS with demographic data into these equations to estimate the 2011 KSS objective and function scores. The small prediction error of 0.22 points that we calculated indicates that these models can be used to estimate the 2011 objective and function KSS at the aggregated cohort level. Although the average error score was within 10 points at the individual patient level, there was a high percentage of large errors resulting from outliers in the data set. These outliers seemed to be related to patients with excellent range of motion who had substantial pain and limited function or patients who have poor range of motion with excellent function and little pain. This may be inherent with the KSS or with the study sample. Nevertheless, one must use caution when estimating at the patient level. Additionally, the accuracy of the prediction scores decreases if any of the demographic variables included in this study are not available.

Project description:BACKGROUND: Neck pain is a common problem that can greatly affect a person's activities of daily living. Functional status questionnaires are important in assessing this effect, and are used to follow up neck pain management programs. The Neck Disability Index (NDI) is the first-created scale for neck pain-related disability and is widely translated and in common used in many countries. Our aim is investigate to clinometric properties of a Turkish version of modified NDI and to give a choice in daily practise of versions to be used. METHODS: The modified NDI was applied to 30 patients for reliability. 185 patients participated in the validity study. All patients were recruited from the outpatient clinic of our department. The scale was translated by the forward and backward translation procedure according to the COSMIN criteria. The test was repeated at 48 hours interval for reliability study. SPSS-10.0, software was used for statistical analyses. The Intraclass correlation coefficient was used for the test- retest reliability of the modified NDI. Cronbach ? was used for internal consistency. Factor analysis was used for construct validity. The validity of the modified NDI with respect to the SF-36, HAD, VAS pain, VAS disability was assessed using Spearman correlations. RESULTS: The Intraclass correlation coefficient between first and second (within 48 hours) evaluation of test (rs) was 0.92. Questions 1,4,6,8,10 were shown to have excellent reliability. (rs > 0.9). Question 10 was the most frequently challenged question because "recreational and social activities" do not have not the same meanings in Turkey than in western countries. This required that detailed explanations be provided by the investigators. Cronbach's alpha for the total index was 0.88. A single factor accounting for 80.2% of the variance was obtained. Validity studies demonstrated good and moderate correlations (rs) among NDI, HAD, VAS, physical function subtitle of SF 36 (0.62, 0.76, 0.68). CONCLUSIONS: The modified NDI-Turkish version is a reliable and valid test and is suitable for daily practise.

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Psychometrical properties of the Turkish translation of the New Knee Society Scoring System.

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Psychometrical properties of the Turkish translation of the New Knee Society Scoring System.

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