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Clinical reliability and validity of elbow functional assessment in rheumatoid arthritis.
Boer, Y.A. de, Ende, C.H.M. van den, Eygendaal, D., Jolie, I.M.M., Hazes, J.M.W., Rozing, P.M. Clinical reliability and validity of elbow functional assessment in rheumatoid arthritis. Journal of Rheumatology: 1999, 26(9), 1909-1917
OBJECTIVES: (1) To investigate the measurement characteristics of the
Hospital for Special Surgery (HSS) and Mayo Clinic elbow assessment
instruments, utilizing methodological criteria including feasibility,
reliability, validity, and discriminative ability; and (2) to develop an
efficient and disease-specific rating system for elbow function assessment
(EFA) in adult patients with RA, using a combination of self-reported
subjective items and objective measures, and comparing its characteristics
with the HSS and Mayo Clinic scales. METHODS: (1) Selection of
elbow-specific items. (2) Investigation of reliability and validity of all
separate items, as well as the total HSS and Mayo Clinic scores, in 42
patients with RA (mean age 60 yrs). Direct observation of functional elbow
performance was defined as the gold standard against which criterion
validity was compared. (3) Reaching agreement within a team of
professionals on the different scale dimensions and the assigned weight.
(4) Item reduction by eliminating unreliable, inaccurate, unfeasible, and
ambiguous items. Finally, the EFA scale was constructed by selecting the
most reliable and accurate items. RESULTS: The EFA scale showed a superior
or equal degree of reliability as reflected in intraclass correlation
coefficients of more than 0.88, and also superior validity, compared with
the HSS and Mayo Clinic measures. CONCLUSION: Although the elbow scoring
systems currently available provide a reliable measure, they seem
restricted in evaluating elbow-specific functional ability. The EFA scale
was found to be most suitable to measure elbow functional ability in RA,
and was also shown to be highly reliable and practical in clinical
practice. (aut.ref.)
Hospital for Special Surgery (HSS) and Mayo Clinic elbow assessment
instruments, utilizing methodological criteria including feasibility,
reliability, validity, and discriminative ability; and (2) to develop an
efficient and disease-specific rating system for elbow function assessment
(EFA) in adult patients with RA, using a combination of self-reported
subjective items and objective measures, and comparing its characteristics
with the HSS and Mayo Clinic scales. METHODS: (1) Selection of
elbow-specific items. (2) Investigation of reliability and validity of all
separate items, as well as the total HSS and Mayo Clinic scores, in 42
patients with RA (mean age 60 yrs). Direct observation of functional elbow
performance was defined as the gold standard against which criterion
validity was compared. (3) Reaching agreement within a team of
professionals on the different scale dimensions and the assigned weight.
(4) Item reduction by eliminating unreliable, inaccurate, unfeasible, and
ambiguous items. Finally, the EFA scale was constructed by selecting the
most reliable and accurate items. RESULTS: The EFA scale showed a superior
or equal degree of reliability as reflected in intraclass correlation
coefficients of more than 0.88, and also superior validity, compared with
the HSS and Mayo Clinic measures. CONCLUSION: Although the elbow scoring
systems currently available provide a reliable measure, they seem
restricted in evaluating elbow-specific functional ability. The EFA scale
was found to be most suitable to measure elbow functional ability in RA,
and was also shown to be highly reliable and practical in clinical
practice. (aut.ref.)
OBJECTIVES: (1) To investigate the measurement characteristics of the
Hospital for Special Surgery (HSS) and Mayo Clinic elbow assessment
instruments, utilizing methodological criteria including feasibility,
reliability, validity, and discriminative ability; and (2) to develop an
efficient and disease-specific rating system for elbow function assessment
(EFA) in adult patients with RA, using a combination of self-reported
subjective items and objective measures, and comparing its characteristics
with the HSS and Mayo Clinic scales. METHODS: (1) Selection of
elbow-specific items. (2) Investigation of reliability and validity of all
separate items, as well as the total HSS and Mayo Clinic scores, in 42
patients with RA (mean age 60 yrs). Direct observation of functional elbow
performance was defined as the gold standard against which criterion
validity was compared. (3) Reaching agreement within a team of
professionals on the different scale dimensions and the assigned weight.
(4) Item reduction by eliminating unreliable, inaccurate, unfeasible, and
ambiguous items. Finally, the EFA scale was constructed by selecting the
most reliable and accurate items. RESULTS: The EFA scale showed a superior
or equal degree of reliability as reflected in intraclass correlation
coefficients of more than 0.88, and also superior validity, compared with
the HSS and Mayo Clinic measures. CONCLUSION: Although the elbow scoring
systems currently available provide a reliable measure, they seem
restricted in evaluating elbow-specific functional ability. The EFA scale
was found to be most suitable to measure elbow functional ability in RA,
and was also shown to be highly reliable and practical in clinical
practice. (aut.ref.)
Hospital for Special Surgery (HSS) and Mayo Clinic elbow assessment
instruments, utilizing methodological criteria including feasibility,
reliability, validity, and discriminative ability; and (2) to develop an
efficient and disease-specific rating system for elbow function assessment
(EFA) in adult patients with RA, using a combination of self-reported
subjective items and objective measures, and comparing its characteristics
with the HSS and Mayo Clinic scales. METHODS: (1) Selection of
elbow-specific items. (2) Investigation of reliability and validity of all
separate items, as well as the total HSS and Mayo Clinic scores, in 42
patients with RA (mean age 60 yrs). Direct observation of functional elbow
performance was defined as the gold standard against which criterion
validity was compared. (3) Reaching agreement within a team of
professionals on the different scale dimensions and the assigned weight.
(4) Item reduction by eliminating unreliable, inaccurate, unfeasible, and
ambiguous items. Finally, the EFA scale was constructed by selecting the
most reliable and accurate items. RESULTS: The EFA scale showed a superior
or equal degree of reliability as reflected in intraclass correlation
coefficients of more than 0.88, and also superior validity, compared with
the HSS and Mayo Clinic measures. CONCLUSION: Although the elbow scoring
systems currently available provide a reliable measure, they seem
restricted in evaluating elbow-specific functional ability. The EFA scale
was found to be most suitable to measure elbow functional ability in RA,
and was also shown to be highly reliable and practical in clinical
practice. (aut.ref.)