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Quality of Life Research

, Volume 15, Issue 7, pp 1211–1222 | Cite as

A patient-based questionnaire to assess outcomes of foot surgery: Validation in the context of surgery for hallux valgus

  • Jill DawsonEmail author
  • Jane Coffey
  • Helen Doll
  • Grahame Lavis
  • Paul Cooke
  • Mark Herron
  • Crispin Jenkinson
Article

Abstract

Background: A patient-based outcome measure with good measurement properties is urgently needed for use in clinical trials of foot surgery. Methods: We evaluated an existing foot pain and disability questionnaire (the Manchester Foot Pain and Disability Questionnaire) for its suitability as an outcome measure in the context of hallux valgus corrective surgery. Interviews with patients led to initial changes, resulting in 20 candidate questionnaire items with five response categories each. These were tested in a prospective study of 100 patients (representing 138 foot operations) undergoing hallux valgus corrective surgery. Analysis of underlying factor structure, dimensionality, internal reliability, construct validity and responsiveness of the questionnaire items in relation to (i) SF-36 general health survey and (ii) American Orthopaedic Foot & Ankle Society (AOFAS) hallux clinical scale resulted in a final 16 item questionnaire (the ‘Manchester-Oxford Foot Questionnaire’ (MOXFQ)), consisting of three domains/scales: ‘Walking/standing’ (seven items), ‘Pain’ (five items) and ‘Social interaction’ (four items) each having good measurement properties. All three domains were unidimensional. Conclusions: The new 16-item MOXFQ has good measurement properties in the context of outcomes assessment of surgery for hallux valgus. Future studies should assess the MOXFQ in the context of surgery for other foot and ankle conditions.

Keywords

Foot Function Hallux valgus Pain Patient-based outcome measure Surgery 

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References

  1. 1.
    Mann RA and Plattner PF (1990). Ankle and foot: Editorial overview. Curr Opin Orth 1: 111–112Google Scholar
  2. 2.
    Ferrari J, Higgins JP and Prior TD (2004). Interventions for treating hallux valgus (abductovalgus) and bunions. Cochrane Database Syst Rev 1: CD000964PubMedGoogle Scholar
  3. 3.
    Parker J, Nester CJ, Long AF and Barrie J (2003). The problem with measuring patient perceptions of outcome with existing outcome measures in foot and ankle surgery. Foot Ankle Int 24: 56–60PubMedGoogle Scholar
  4. 4.
    Katsambas A, Abeck D and Haneke E (2005). The effects of foot␣disease on quality of life: Results of the Achilles Project. J Eur Acad Dermatol Venereol 19: 191–195PubMedCrossRefGoogle Scholar
  5. 5.
    Budiman ME, Conrad KJ and Roach KE (1991). The Foot Function Index: A measure of foot pain and disability. J Clin Epidemiol 44: 561–570CrossRefGoogle Scholar
  6. 6.
    Bennett PJ, Patterson C, Wearing S and Baglioni T (1998). Development and validation of a questionnaire designed to measure foot-health status. J Am Podiatr Med Assoc 88: 419–428PubMedGoogle Scholar
  7. 7.
    AAOS Outcome Questionnaire. Musculoskeletal outcomes data evaluation and management system (MODEMS). Version 2000. 2000Google Scholar
  8. 8.
    Wilson DW (1988). Hallux valgus and rigidus. In: Helal, B and Wilson, D (eds) The Foot, pp 411–483. Churchill Livingstone, LondonGoogle Scholar
  9. 9.
    Dawson J, Thorogood M, Marks S-A, Juszczak E, Dodd C and Lavis G (2002). The prevalence of foot problems in older women: A cause for concern. J Public Health Med 24: 77–84PubMedCrossRefGoogle Scholar
  10. 10.
    Resch S, Stenstrom A, Jonsson K and Reynisson K (1993). Results after chevron osteotomy and proximal osteotomy for hallux valgus: A prospective, randomised study. The Foot 3: 99–104CrossRefGoogle Scholar
  11. 11.
    Garrow AP, Papageorgiou AC, Silman AJ, Thomas E, Jayson MI and Macfarlane GJ (2000). Development and validation of a questionnaire to assess disabling foot pain. Pain 85: 107–113PubMedCrossRefGoogle Scholar
  12. 12.
    Barrett P and Kline P (1981). The observation to variable ratio in factor analysis. J Personal Group Behav 1: 23–33Google Scholar
  13. 13.
    Ware-JE J and Sherbourne CD (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30: 473–483PubMedCrossRefGoogle Scholar
  14. 14.
    Jenkinson C, Stewart-Brown S, Petersen S and Paice C (1999). Assessment of the SF-36 version 2 in the United Kingdom. J Epidemiol Commun Health 53: 46–50Google Scholar
  15. 15.
    Ware JE, Kosinski M and Keller S (1994). SF-36 Physical and Mental Summary Scales: A User’s Manual. The Health Institute, New England Medical Center, Boston, MassachusettsGoogle Scholar
  16. 16.
    Kitaoka H, Alexander I, Adelaar R, Nunley J, Myerson M and Sanders M (1994). Clinical rating systems for ankle-hindfoot, midfoot, hallux and lesser toes. Foot Ankle Int 15: 349–353PubMedGoogle Scholar
  17. 17.
    Guyton GP (2005). Theoretical limitations of the AOFAS scoring systems: An analysis using Monte Carlo modeling. Foot Ankle Int 22: 779–787Google Scholar
  18. 18.
    SPSS Inc. SPSS Statistical Software. Release 11.5. Headquarters, 233 S. Wacker Drive, 11th floor Chicago, Illinois 60606, USA.: SPSS Inc., 2002Google Scholar
  19. 19.
    Rasch Unidimensional Measurement Models. RUMM2010. 14 Dodonaea Court, Duncraig WA 6023, Australia., RUMM Laboratory Pty Ltd, 1998Google Scholar
  20. 20.
    Prieto L, Alonso J and Lamarca R (2003). Classical test theory versus Rasch analysis for quality of life questionnaire reduction. Health Qual Life Outcomes 1: 1–27CrossRefGoogle Scholar
  21. 21.
    Wolfe F and Kong SX (1999). Rasch analysis of the Western Ontario MacMaster Questionnaire (WOMAC) in 2205 patients with osteoarthritis, rheumatoid arthritis and fibromyalgia. Ann Rheum Dis 58: 563–568PubMedGoogle Scholar
  22. 22.
    Hambleton RK and Jones RW (1993). Comparison of classical test theory and item response theory and their applications to test development. Educ Measure Issues Practice 12: 38–47CrossRefGoogle Scholar
  23. 23.
    Andrich D (1988). Rasch Models for Measurement. Sage Publications, LondonGoogle Scholar
  24. 24.
    Guyatt GH, Feeny DH and Patrick DL (1993). Measuring health-related quality of life. Ann Intern Med 118: 622–629PubMedGoogle Scholar
  25. 25.
    Nunnally JC and Bernstein IH. (1978). Psychometric Theory. Columbus, New YorkGoogle Scholar
  26. 26.
    Kline P (1993). A Handbook of Psychological Testing. Routledge, LondonGoogle Scholar
  27. 27.
    Kazis LE, Anderson JJ and Meenan RF (1989). Effect sizes for interpreting changes in health status. Med Care 27: S178–S189PubMedCrossRefGoogle Scholar
  28. 28.
    Jenkinson C, Stewart-Brown S, Petersen S and Paice C (1999). Evaluation of the SF-36 Version II in the United Kingdom. J Epidemiol Commun Health 53: 46–50CrossRefGoogle Scholar
  29. 29.
    Royal College of Surgeons of England. Background to outcomes database. http://www.rcseng.ac.uk/surgical/research/ceu/projects_ongoing/proj_outcomes_html. 2004
  30. 30.
    O’Doherty DP, Lowrie IG, Magnussen PA and Gregg PJ (1990). The management of the painful first metatarsophalangeal joint␣in the older patient. Arthrodesis or Keller’s arthroplasty?. J Bone Joint Surg [Br] 72: 839–842Google Scholar
  31. 31.
    Amadio PC (1993). Outcomes measurements [editorial]. J Bone Joint Surg [Am] 75: 1583–1584Google Scholar
  32. 32.
    Fitzpatrick R, Fletcher A, Gore S, Jones D, Spiegelhalter D and Cox D (1992). Quality of life measures in health care. I: Applications and issues in assessment. Br Med J 305: 1074–1077CrossRefGoogle Scholar
  33. 33.
    Streiner DL and Norman GR (1989). Health Measurement Scales – A Practical Guide to their Development and Use. Oxford University Press, New YorkGoogle Scholar
  34. 34.
    Fayers PM and Machin D (2000). Quality of Life – Assessment, Analysis and Interpretation. John Wiley & Sons Ltd, ChichesterGoogle Scholar

Copyright information

© Springer 2006

Authors and Affiliations

  • Jill Dawson
    • 1
    Email author
  • Jane Coffey
    • 2
  • Helen Doll
    • 1
  • Grahame Lavis
    • 3
  • Paul Cooke
    • 3
  • Mark Herron
    • 4
  • Crispin Jenkinson
    • 1
  1. 1.Department of Public HealthUniversity of OxfordHeadington, OxfordUK
  2. 2.School of Health and Social CareOxford Brookes UniversityOxfordUK
  3. 3.Nuffield Orthopaedic CentreOxfordUK
  4. 4.The Royal Orthopaedic HospitalBirminghamUK

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