Pedi-IKDC or KOOS-child: which questionnaire should be used in children with knee disorders?

Abstract

Background The Pedi International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) child are validated questionnaires for children with knee disorders. The aim of this study was to translate these questionnaires in Dutch and to recommend which questionnaires should – based on their psychometric properties – be used in clinical practice. Methods The English Pedi-IKDC and KOOS-Child were translated by the forward-backward procedure. Subsequently, content validity of the Pedi-IKDC and KOOS-Child was evaluated by both patients ( n = 18) and experts ( n = 18). To evaluate construct validity and interpretability participants with knee disorders ( n = 100) completed the Numeric Rating Scale Pain, Lysholm Knee Scoring Scale, EuroQol-5 Dimension, Pedi-IKDC and KOOS-Child at baseline. Participants completed the anchor question, Pedi-IKDC and KOOS-child two weeks ( n = 54) and one year ( n = 71) after baseline, for evaluating the test-retest reliability and responsiveness. Psychometric properties were interpreted following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria. Results The Pedi-IKDC showed adequate test-retest reliability (intraclass correlation coefficient (ICC) 0.9; standard error of measurement (SEM) 8.6; smallest detectable change (SDC) 23.8), adequate content validity (> 75% relevant), adequate construct validity (75% confirmed hypotheses), low floor or ceiling effects (scores between 5 and 95) and adequate responsiveness (> 75% confirmed hypotheses). The KOOS-Child showed an adequate test-retest reliability (ICC 0.8–0.9; SEM 8.9–16.9; SDC 24.7–46.9), adequate content validity (> 75% relevant, except KOOS-Child subscale ADL), adequate construct validity (75% confirmed hypotheses), low floor and ceiling effects (scores between 5 and 95, except KOOS-Child subscale activities of daily living and Sport/play) and moderate responsiveness (40% confirmed hypotheses). Conclusions The Pedi IKDC showed better psychometric properties than the KOOS-Child and should therefore be used in children with knee disorders.

Measures of Adult Knee Function

“…There are consistent reports of high convergent and divergent construct validity, with the IKDC Subjective Knee Evaluation Form more strongly correlated with the Short Form 36 (SF‐36) physical subscales and component summary than with the mental subscales and component summary . Construct validity is acceptable in the pediatric form and improved over the KOOS‐Child form . Studies have shown the IKDC Subjective Knee Evaluation Form score to be highly correlated with the Cincinnati Knee Rating System, pain visual analog scale (VAS), Oxford 12 Questionnaire, WOMAC, Lysholm score, and SF‐36 physical component, physical function, and bodily pain subscales .…”

Treatment Decision after Anterior Cruciate Ligament Injury, and Evaluation of Measurement Properties of a Patient Reported Outcome Measure

“…It was also the reason to exclude studies from the systematic review update. Nine additional studies 15,53,58,62,67,68,121,124,125 were added following the updated search, and hypotheses were all confirmed. The former conclusion of conflicting evidence for hypothesis testing changed to strongly positive.…”

“…Only three studies 56,82,126 had sufficient methodological quality to be assessed. In the updated review seven additional studies were included 15,53,58,67,68,121,124,125 and the updated review result suggests strong positive findings. The Swedish IKDC-SKF had poor methodological quality for measurement error, due to small sample size, but the result of the testing is consistent with previous findings.…”

“…The score was intermediate, mainly because no comparisons of similar patient groups in the original language (English) and the target language were made. In the updated review, eight additional studies 48 15,53,57,58,62,67,121,125 were assessed; two had a good methodological score, three had fair. The low methodological quality in many studies (the Swedish version included) were mainly due to small samples and no differential function item (DIF) testing.…”

“…Content validity was assessed in three studies 68,124,125 in the updated review; two were of excellent methodological quality. There was a strong positive score for content validity for the IKDC-SKF.…”