ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2022
Four of five frequently used orthopedic PROMs possess inadequate content validity: a COSMIN evaluation of the mHHS, HAGOS, IKDC-SKF, KOOS and KNEES-ACL.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 4 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Clinical relevance of patient-reported outcome measures in the surgical management of focal chondral defects of the knee: a systematic review.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2026Pooled it
- A systematic review of patient-reported outcome measures for idiopathic adhesive capsulitis - recommendations based on analyses of 16 existing questionnaires.BMC musculoskeletal disorders · 2025Pooled it
- Measures of Subjective Memory for People with Epilepsy: A Systematic Review of Measurement Properties.Neuropsychology review · 2024Pooled it
- Patient-Reported Experience Measures in Adult Inpatient Settings: A Systematic Review.Journal of nursing management · 2024Pooled it
- Development of a Patient-reported Outcome Measure for Adults with Lower Extremity Malignancies: The LIMB-Q ONC.Plastic and reconstructive surgery. Global open · 2026Article
- Inferior Outcomes after Subsequent Revision or Contralateral ACL Reconstruction: A Cross-Sectional Study.Orthopaedic journal of sports medicine · 2026Article
- Patient-Reported Outcomes and Revision Rates After ACL Reconstruction With Quadriceps Versus Hamstring and Patellar Tendon Autografts: Sex-Stratified Results From the Swedish Knee Ligament Registry.The American journal of sports medicine · 2026Article
- Strategies to Translate PROMs to Linguistically Diverse and Lesser-Spoken Languages: Lessons from Wales.The patient · 2026Review
- Article
- Effect of Early Extracorporeal Shockwave Therapy on Postoperative Pain and Functional Recovery After Intramedullary Nailing: An Open-Label Randomized Controlled Trial.Life (Basel, Switzerland) · 2025Article
- Translation and psychometric evaluation of the Danish version of the knee outcome survey - activities of daily living scale in patients with anterior cruciate ligament injuries.BMC musculoskeletal disorders · 2025Article
- A simple, subjective, knee self-evaluation using a single question can be used for a quick assessment of patients undergoing knee surgery.Archives of orthopaedic and trauma surgery · 2024Article
- Hip Arthroscopy for Femoroacetabular Impingement Syndrome in High-Level Athletes: A 10-Year Follow-up.Orthopaedic journal of sports medicine · 2024Article
- Observational
- Item-reduced Forgotten Joint Score provides adequate psychometric properties in ACLR patients.Journal of experimental orthopaedics · 2024Article
- Article
- Influence of Surgeon Experience and Clinic Volume on Subjective Knee Function and Revision Rates in Primary ACL Reconstruction: A Study from the Swedish National Knee Ligament Registry.Orthopaedic journal of sports medicine · 2024Article
- Usefulness of Current Patient-Reported Outcome Scales for ACL Injury: A Mixed-Methods Evaluation of Stakeholder-Perceived Utility of Specific Constructs and Items Across the Rehabilitation Timeline.Orthopaedic journal of sports medicine · 2024Article
- Assessing the Structural Validity of the Knee Injury and Osteoarthritis Outcome Score Scale.Healthcare (Basel, Switzerland) · 2024Article
- Cross-cultural adaptation and validation of the KOOS, JR questionnaire for assessing knee osteoarthritis in Spanish-speaking patients.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeContent validity is the most important property of PROMs. The COSMIN initiative has published guidelines for evaluating the content validity of PROMs, but they have only sparsely been applied to relevant PROMs for musculoskeletal conditions. The aim of this study was to use the COSMIN Risk of Bias checklist to evaluate the content validity of five PROMs, that are highly relevant in musculoskeletal research and used by the arthroscopic surgery community: the modified Harris' Hip Score (mHHS), the Copenhagen Hip and Groin Outcome Score (HAGOS), the International Knee Documentation Committee Subjective Knee evaluation Form (IKDC-SKF), the Knee injury and Osteoarthritis Outcome Score (KOOS) and the Knee Numeric-Entity Evaluation Score ACL (KNEES-ACL).
methodsThe development articles for the five PROMs were identified through searches in PubMed and SCOPUS. A literature search was performed to identify additional studies assessing content validity of the PROMs. Additional information, necessary for the assessments, was obtained from the PROM developers after direct request. To evaluate the quality of the development studies and rate the content validity, the COSMIN Risk of Bias checklist was applied to all studies.
resultsAll five development studies were identified. Three subsequent content validity studies were identified, all evaluating KOOS and one also IKDC. One content validity study was of inadequate quality and excluded from further analysis. The development of mHHS, IKDC-SKF, and KOOS was rated inadequate and possess insufficient content validity for their target populations. Due to the irrelevance of multiple items, KOOS was in particular inappropriate to evaluate patients with an ACL injury. The development of HAGOS was also rated inadequate, although the insufficiency aspects can be regarded as minor. KNEES-ACL possessed sufficient content validity.
conclusionOut of five PROMs, only KNEES-ACL possessed sufficient content validity. Particularly, KOOS should not be used as an outcome for patients with an ACL injury. There is an urgent need for condition-specific PROMs for musculoskeletal conditions, developed with adequate methods. LEVEL OF EVIDENCE: III.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.