The rheumatoid foot: a systematic literature review of patient‐reported outcome measures

Abstract

BackgroundThe foot is often the first area of the body to be systematically affected by rheumatoid arthritis. The multidimensional consequences of foot problems for patients can be subjectively evaluated using patient-reported outcome measures (PROMs). However, there is currently no systematic review which has focused specifically upon the PROMs available for the foot with rheumatoid arthritis. The aim of this systematic review was to appraise the foot-specific PROMs available for the assessment and/or evaluation of the foot affected with rheumatoid arthritis.MethodsA systematic search of databases was conducted according to pre-defined inclusion/exclusion criteria. PROMs identified were reviewed in terms of: conceptual bases, quality of construction, measurement aims and evidence to support their measurement properties.ResultsA total of 11 PROMs were identified and 5 papers that provided evidence for the measurement properties of some of the PROMs. Only one of the PROMs was found to be RA disease-specific. The quality of construction, pretesting and presence of evidence for their measurement properties was found to be highly variable. Conceptual bases of many of the PROMs was either restricted or based on reductionist biomedical models. All of the PROMs were found to consist of fixed scales.ConclusionsThere is a need to develop an RA-disease and foot-specific PROM with a greater emphasis on a biopsychosocial conceptual basis, cognitive pre-testing methods, patient preference-based qualities and evidence to support the full complement of measurement properties.

The foot function index is more sensitive to change than the Leeds Foot Impact Scale for evaluating rheumatoid arthritis patients after forefoot or hindfoot reconstruction

“…As Guyatt and Deyo remarked, the answer on the anchor question will never solitarily rely on operative outcome, but subsequently measures satisfaction with the program, rehabilitation process, or desire to show gratitude to those who have spent time and effort trying to help the patient [7]. The FFI questionnaire is an attractive measurement for physicians who wish to have a sensitive, reliable and responsive questionnaire for routine clinical practice [26].…”

Rheumatic Diseases

“…Evidence for the responsiveness of the MFPDQ has yet to be clearly demonstrated and provision for clinical interpretability is similarly lacking. Walmsley et al (2010) suggested that this tool might be more useful in non-RA populations.…”

“…In their review of patient-reported measures, Walmsley et al (2010) identified a need to develop an RA-disease and foot-specific tool with a greater emphasis on a bio-psychosocial conceptual basis. The Salford Arthritis Foot Evaluation (SAFE) (Walmsley et al 2012) tool incorporates the development of items that have meaning to both the patient and clinician.…”

“…The SAFEPart A has strong evidence for convergent validity and test-retest reliability. However, Walmsley et al (2010) acknowledge that the SAFE-Part B currently has no quantitative measurement properties, such as construct validity and test-retest reliability. There are no typical scores for patients with RA using this scale, as it is a new tool.…”

Development of a patient-reported outcome measure for the foot affected by rheumatoid arthritis

“…The numerous consequences of living with feet affected by RA can be assessed and evaluated using a class of subjective outcome measures known as patient-reported outcome measures (PROMs) [7]. The Darzi report [8] has recommended the use of PROMs to provide a greater focus on the patient-centered perspective.…”