Outcome measurement in the ACL deficient knee - what's the score?
Outcome measurement in the ACL deficient knee - what's the score?
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DOI：
10.1016/s0968-0160(01)00068-0
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发表时间：
2001-03-01
期刊：
影响因子：
1.9
通讯作者：
Smith, RB
中科院分区：
文献类型：
--
作者：
Johnson, DS;Smith, RB
在联合王国内部，要求对每一位医生的表现以及他们所执行的程序进行透明评估的压力越来越大。不幸的是，用于评估这类程序的结果衡量标准的有效性受到了质疑。这一点在前十字韧带(ACL)缺乏的膝关节中得到了很好的说明。目前已经确定了54种不同的用于评估前交叉韧带缺陷膝关节的结果指标，其中很少有在最初发表时进行正式评估的。对于那些最经常使用的人，Lysholm(I和II)膝关节评分表和Tegner活动度评分是唯一在使用前经过充分验证的评分。辛辛那提分级系统和国际膝关节文件委员会(IKDC)的表格没有进行评估，自那以后这两种测量的可靠性一直受到质疑。经过适当测试的较新测量方法包括IKDC主观膝关节评估表、Mohtadi的ACL生活质量结果测量以及膝关节损伤和骨关节炎结果评分(KOOS)。我们建议使用Lysholm II膝关节评分表和Tegner活动度评分对患者进行临床随访，并将其作为未来措施可以比较的金标准。这些都有其不足之处，最终将需要更换。鉴于其作者的国际地位，IKDC主观膝盖评估表可能会优先使用，而不是Koos，尽管它具有吸引力。对于长期临床试验，也应该使用SF-36。需要进一步的研究来制定适当的措施来评估前交叉韧带缺陷的膝关节，这项工作应该得到适当的资助。(C)2001 Elsevier Science B.V.保留所有权利。
There is increasing pressure within the United Kingdom for transparent assessment of the performance of every doctor along with the procedures they perform. Unfortunately, the validation of the outcome measures used to assess such procedures has been questioned. This has been well illustrated in the anterior cruciate ligament (ACL) deficient knee. Over 54 different outcome measures used to assess the ACL deficient knee have been identified, few of which were formally assessed at their initial publication. For those most frequently used the Lysholm (I and II) knee scoring scale and Tegner activity score are the only ones to have been adequately Validated prior to use. The Cincinnati rating system and International Knee Documentation Committee (IKDC) form were not assessed and the reliability of both measures has since been questioned. Appropriately tested newer measures include the IKDC subjective knee evaluation form, Mohtadi's ACL quality of life outcome measure and the Knee injury and osteoarthritis outcome score (KOOS). We recommend use of the Lysholm II knee scoring scale and Tegner activity score for clinical follow-up of patients and for use as a gold standard to which future measures can be compared. These have their deficiencies and will ultimately require replacement. In view of the international standing of its authors, the IKDC subjective knee evaluation form is likely to be used in preference to the KOOS despite its attractions. For long-term clinical trials the SF-36 should also be used. Further research is required to produce suitable measures for assessing the ACL deficient knee and this work should be appropriately funded. (C) 2001 Elsevier Science B.V. All rights reserved.