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  • 1. Richter, Martinus
    et al.
    Agren, Per-Henrik
    Sophiahemmet University.
    Besse, Jean-Luc
    Cöster, Maria
    Kofoed, Hakon
    Maffulli, Nicola
    Rosenbaum, Dieter
    Steultjens, Martijn
    Alvarez, Fernando
    Boszczyk, Andrzej
    Buedts, Kris
    Guelfi, Marco
    Liszka, Henryk
    Louwerens, Jan-Willem
    Repo, Jussi P
    Samaila, Elena
    Stephens, Michael
    Witteveen, Angelique G H
    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)2018In: Foot and Ankle Surgery, ISSN 1268-7731, E-ISSN 1460-9584, Vol. 24, no 3, p. 185-204, article id S1268-7731(18)30186-3Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A scientifically sound validated foot and ankle specific score validated ab initio for different languages is missing. The aim of a project of the European Foot and Ankle Society (EFAS) was to develop, validate, and publish a new score(the EFAS-Score) for different European languages.

    METHODS: The EFAS Score was developed and validated in three stages: (1) item (question) identification, (2) item reduction and scale exploration, (3) confirmatory analyses and responsiveness. The following score specifications were chosen: scale/subscale (Likert 0-4), questionnaire based, outcome measure, patient related outcome measurement. For stage 3, data were collected pre-operatively and at a minimum follow-up of 3 months and mean follow-up of 6 months. Item reduction, scale exploration, confirmatory analyses and responsiveness were executed using analyses from classical test theory and item response theory.

    RESULTS: Stage 1 resulted in 31 general and 7 sports related questions. In stage 2, a 6-item general EFAS Score was constructed using English, German, French and Swedish language data. In stage 3, internal consistency of the scale was confirmed in seven languages: the original four languages, plus Dutch, Italian and Polish (Cronbach's Alpha >0.86 in all language versions). Responsiveness was good, with moderate to large effect sizes in all languages, and significant positive association between the EFAS Score and patient-reported improvement. No sound EFAS Sports Score could be constructed.

    CONCLUSIONS: The multi-language EFAS Score was successfully validated in the orthopaedic ankle and foot surgery patient population, including a wide variety of foot and ankle pathologies. All score versions are freely available at www.efas.co.

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More languages
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