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Development of a Valid and Reliable Knee Articular Cartilage Condition-Specific Study Methodological Quality Score.

Harris JD, Erickson BJ, Cvetanovich GL, Abrams GD, McCormick FM, Gupta AK, Verma NN, Bach BR, Cole BJ - Orthop J Sports Med (2014)

Bottom Line: Condition-specific questionnaires are important components in evaluation of outcomes of surgical interventions.Interobserver reliability for the overall score was good (intraclass correlation coefficient [ICC], 0.842), and for all individual items of the MARK score, acceptable to perfect (ICC, 0.70-1.000).The MARK score is a valid and reliable knee articular cartilage condition-specific study methodological quality instrument.

View Article: PubMed Central - PubMed

Affiliation: Houston Methodist Center for Orthopaedics & Sports Medicine, Houston, Texas, USA. ; Rush University Medical Center, Chicago, Illinois, USA.

ABSTRACT

Background: Condition-specific questionnaires are important components in evaluation of outcomes of surgical interventions. No condition-specific study methodological quality questionnaire exists for evaluation of outcomes of articular cartilage surgery in the knee.

Purpose: To develop a reliable and valid knee articular cartilage-specific study methodological quality questionnaire.

Study design: Cross-sectional study.

Methods: A stepwise, a priori-designed framework was created for development of a novel questionnaire. Relevant items to the topic were identified and extracted from a recent systematic review of 194 investigations of knee articular cartilage surgery. In addition, relevant items from existing generic study methodological quality questionnaires were identified. Items for a preliminary questionnaire were generated. Redundant and irrelevant items were eliminated, and acceptable items modified. The instrument was pretested and items weighed. The instrument, the MARK score (Methodological quality of ARticular cartilage studies of the Knee), was tested for validity (criterion validity) and reliability (inter- and intraobserver).

Results: A 19-item, 3-domain MARK score was developed. The 100-point scale score demonstrated face validity (focus group of 8 orthopaedic surgeons) and criterion validity (strong correlation to Cochrane Quality Assessment score and Modified Coleman Methodology Score). Interobserver reliability for the overall score was good (intraclass correlation coefficient [ICC], 0.842), and for all individual items of the MARK score, acceptable to perfect (ICC, 0.70-1.000). Intraobserver reliability ICC assessed over a 3-week interval was strong for 2 reviewers (≥0.90).

Conclusion: The MARK score is a valid and reliable knee articular cartilage condition-specific study methodological quality instrument.

Clinical relevance: This condition-specific questionnaire may be used to evaluate the quality of studies reporting outcomes of articular cartilage surgery in the knee.

No MeSH data available.


Flowchart illustrating the selection of 91 unique individual items via item identification, generation, and reduction for focus group review, analysis, and Likert-style ranking.
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fig1-2325967113512606: Flowchart illustrating the selection of 91 unique individual items via item identification, generation, and reduction for focus group review, analysis, and Likert-style ranking.

Mentions: A recent systematic review was used to evaluate the quality of 194 articular cartilage studies in the knee using 9 different study methodological quality questionnaires.19 There were 124 total individual items within the 9 questionnaires. Duplicate items were removed, leaving 31 unique or acceptably similar items. Within all 194 studies analyzed, each study’s primary, secondary, and any exploratory outcome measures (eg, purpose[s], hypothesis[es], result[s]) were analyzed with respect to all patient-, knee-, limb-, and defect-specific characteristics. For example, if a study’s primary outcome was the 2-year Lysholm follow-up after microfracture, then this outcome score (Lysholm) was counted. Clinical outcome measures were extracted from all 194 investigations, and duplicate or acceptably similar outcome measures were removed, leaving 23 distinct measures. Similarly, duplicate or acceptably similar patient-, knee-/limb-, and defect-specific parameters were removed, leaving 14 (patient), 11 (knee/limb), and 12 (defect) unique items. The sum of the potentially inclusive items was 91 (Figure 1).


Development of a Valid and Reliable Knee Articular Cartilage Condition-Specific Study Methodological Quality Score.

Harris JD, Erickson BJ, Cvetanovich GL, Abrams GD, McCormick FM, Gupta AK, Verma NN, Bach BR, Cole BJ - Orthop J Sports Med (2014)

Flowchart illustrating the selection of 91 unique individual items via item identification, generation, and reduction for focus group review, analysis, and Likert-style ranking.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4555619&req=5

fig1-2325967113512606: Flowchart illustrating the selection of 91 unique individual items via item identification, generation, and reduction for focus group review, analysis, and Likert-style ranking.
Mentions: A recent systematic review was used to evaluate the quality of 194 articular cartilage studies in the knee using 9 different study methodological quality questionnaires.19 There were 124 total individual items within the 9 questionnaires. Duplicate items were removed, leaving 31 unique or acceptably similar items. Within all 194 studies analyzed, each study’s primary, secondary, and any exploratory outcome measures (eg, purpose[s], hypothesis[es], result[s]) were analyzed with respect to all patient-, knee-, limb-, and defect-specific characteristics. For example, if a study’s primary outcome was the 2-year Lysholm follow-up after microfracture, then this outcome score (Lysholm) was counted. Clinical outcome measures were extracted from all 194 investigations, and duplicate or acceptably similar outcome measures were removed, leaving 23 distinct measures. Similarly, duplicate or acceptably similar patient-, knee-/limb-, and defect-specific parameters were removed, leaving 14 (patient), 11 (knee/limb), and 12 (defect) unique items. The sum of the potentially inclusive items was 91 (Figure 1).

Bottom Line: Condition-specific questionnaires are important components in evaluation of outcomes of surgical interventions.Interobserver reliability for the overall score was good (intraclass correlation coefficient [ICC], 0.842), and for all individual items of the MARK score, acceptable to perfect (ICC, 0.70-1.000).The MARK score is a valid and reliable knee articular cartilage condition-specific study methodological quality instrument.

View Article: PubMed Central - PubMed

Affiliation: Houston Methodist Center for Orthopaedics & Sports Medicine, Houston, Texas, USA. ; Rush University Medical Center, Chicago, Illinois, USA.

ABSTRACT

Background: Condition-specific questionnaires are important components in evaluation of outcomes of surgical interventions. No condition-specific study methodological quality questionnaire exists for evaluation of outcomes of articular cartilage surgery in the knee.

Purpose: To develop a reliable and valid knee articular cartilage-specific study methodological quality questionnaire.

Study design: Cross-sectional study.

Methods: A stepwise, a priori-designed framework was created for development of a novel questionnaire. Relevant items to the topic were identified and extracted from a recent systematic review of 194 investigations of knee articular cartilage surgery. In addition, relevant items from existing generic study methodological quality questionnaires were identified. Items for a preliminary questionnaire were generated. Redundant and irrelevant items were eliminated, and acceptable items modified. The instrument was pretested and items weighed. The instrument, the MARK score (Methodological quality of ARticular cartilage studies of the Knee), was tested for validity (criterion validity) and reliability (inter- and intraobserver).

Results: A 19-item, 3-domain MARK score was developed. The 100-point scale score demonstrated face validity (focus group of 8 orthopaedic surgeons) and criterion validity (strong correlation to Cochrane Quality Assessment score and Modified Coleman Methodology Score). Interobserver reliability for the overall score was good (intraclass correlation coefficient [ICC], 0.842), and for all individual items of the MARK score, acceptable to perfect (ICC, 0.70-1.000). Intraobserver reliability ICC assessed over a 3-week interval was strong for 2 reviewers (≥0.90).

Conclusion: The MARK score is a valid and reliable knee articular cartilage condition-specific study methodological quality instrument.

Clinical relevance: This condition-specific questionnaire may be used to evaluate the quality of studies reporting outcomes of articular cartilage surgery in the knee.

No MeSH data available.