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Liegl G, Fischer FH, Canaud B, Woodward M, Barth C, Davenport A, Török M, Strippoli GFM, Hegbrant J, Cromm K, Bots ML, Blankestijn PJ, Fischer KI, Rose M. Using a measurement type-independent metric to compare patterns of determinants between patient-reported versus performance-based physical function in hemodialysis patients. Qual Life Res 2024:10.1007/s11136-024-03745-6. [PMID: 39103575 DOI: 10.1007/s11136-024-03745-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE We applied a previously established common T-score metric for patient-reported and performance-based physical function (PF), offering the unique opportunity to directly compare measurement type-specific patterns of associations with potential laboratory-based, psychosocial, sociodemographic, and health-related determinants in hemodialysis patients. METHODS We analyzed baseline data from the CONVINCE trial (N = 1,360), a multinational randomized controlled trial comparing high-flux hemodialysis with high-dose hemodiafiltration. To explore the associations of potential determinants with performance-based versus patient-reported PF, we conducted multiple linear regression (backward elimination with cross-validation and Lasso regression). We used standardized T-scores as estimated from the PROMIS PF short-form 4a (patient-reported PF) and the Physical Performance Test (performance-based PF) as dependent variables. RESULTS Performance-based and patient-reported PF were both significantly associated with a laboratory marker-based indicator of muscle mass (simplified creatinine index), although the effects were relatively small (partial f2 = 0.04). Age was negatively associated with PF; the effect size was larger for performance-based (partial f2 = 0.12) than for patient-reported PF (partial f2 = 0.08). Compared to performance-based PF, patient-reported PF showed a stronger association with self-reported health domains, particularly pain interference and fatigue. When using the individual difference between patient-reported and performance-based T-scores as outcome, we found that younger age and more fatigue were associated with lower patient-reported PF compared to performance-based PF (small effect size). CONCLUSION Patient-reported and performance-based assessments were similarly associated with an objective marker of physical impairment in hemodialysis patients. Age and fatigue may result in discrepancies when comparing performance-based and patient-reported scores on the common PF scale. Trial Registration CONVINCE is registered in the Dutch Trial Register (Register ID: NL64750.041.18). The registration can be accessed at: https://onderzoekmetmensen.nl/en/trial/52958 .
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Affiliation(s)
- Gregor Liegl
- Center for Patient-Centered Outcomes Research (CPCOR), Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, 10117, Berlin, Germany.
| | - Felix H Fischer
- Center for Patient-Centered Outcomes Research (CPCOR), Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, 10117, Berlin, Germany
| | - Bernard Canaud
- Global Medical Office, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Germany
- School of Medicine, Montpellier University, Montpellier, France
| | - Mark Woodward
- School of Public Health, The George Institute for Global Health, Imperial College London, London, UK
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Claudia Barth
- Medical Scientific Affairs, B. Braun Avitum AG, Melsungen, Germany
| | - Andrew Davenport
- Department of Renal Medicine, UCL, Royal Free Hospital & University College London, London, UK
| | | | - Giovanni F M Strippoli
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J) University of Bari, Italy & School of Public Health, University of Sydney, Darlington, Australia
| | - Jörgen Hegbrant
- Division of Nephrology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Krister Cromm
- Center for Patient-Centered Outcomes Research (CPCOR), Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, 10117, Berlin, Germany
- Global Medical Office, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Germany
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Peter J Blankestijn
- Department of Nephrology & Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Kathrin I Fischer
- Center for Patient-Centered Outcomes Research (CPCOR), Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, 10117, Berlin, Germany
| | - Matthias Rose
- Center for Patient-Centered Outcomes Research (CPCOR), Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, 10117, Berlin, Germany
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Fréz AR, Coelho GR, de Barros Pereira B, Binda AC, Cabral CMN. Development of a brief core set for knee dysfunction based on the International Classification of Functioning, Disability and Health: assessing construct validity and measurement potential. BMC Musculoskelet Disord 2024; 25:512. [PMID: 38961358 PMCID: PMC11221104 DOI: 10.1186/s12891-024-07635-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 06/27/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND The comprehensive core set for knee dysfunction was developed to classify the functioning of people with any knee dysfunction. To be used as a clinical instrument to measure the functioning of people with knee dysfunction, the construct validity of the core set still needs to be assessed. The purpose of this study was to analyze the construct validity of the comprehensive core set for knee dysfunction as an instrument to measure functioning. METHODS A cross-sectional study with 200 participants with knee dysfunction with or without clinical diagnosis of knee pathology, with or without complaint of pain, with or without instability, and/or with or without knee movement restriction of any type. Participants were assessed using the comprehensive core set for knee dysfunction with 25 categories, the subjective form from the International Knee Documentation Committee scale, and measures of self-perceived general health and functioning. The construct validity of the core set was assessed by Rasch analysis, and the external construct validity was assessed by correlation between the score of the brief core set for knee dysfunction with the subjective form from the International Knee Documentation Committee scale, and scores of self-perception of health and functioning. RESULTS Twelve categories were consistent with a unidimensional construct, with no difference in the response pattern for age, sex, educational level, and time of complaint. These categories were included in the brief core set for knee dysfunction. The mean score of the brief core set was 37 ± 21 points, a value classified as moderate impairment regarding functioning. Correlations with the subjective form from the International Knee Documentation Committee scale and scores of self-perception were adequate (p < 0.01; r > 0.5). CONCLUSION The brief core set for knee dysfunction, a set with 12 categories, can be used as a clinical instrument to measure and score the functioning of people with knee dysfunction, aged between 18 and 89 years, with adequate construct validity.
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Affiliation(s)
- Andersom Ricardo Fréz
- Physical Therapy Department, Universidade Estadual do Centro-Oeste, Alameda Élio Antonio Dalla Vecchia, 838, Guarapuava, Paraná, 85040-167, Brazil.
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil.
| | - Geide Rosa Coelho
- Master's and Doctoral Program in Physics Teaching, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Bruno de Barros Pereira
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Aline Cristiane Binda
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
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Fréz AR, Alouche SR, Binda AC, Nunes Cabral CM. Content validity of the International Classification of Functioning, Disability and Health core set for knee dysfunction: a Delphi study. Physiother Theory Pract 2024; 40:110-117. [PMID: 35837751 DOI: 10.1080/09593985.2022.2101037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 07/07/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To assess the content validity of the preliminary core set for knee dysfunction based on the opinion of experts. DESIGN A panel of 180 experts in knee disorders or on the use of the International Classification of Functioning, Disability, and Health for musculoskeletal conditions was invited for this Delphi study. The experts gave their opinion on whether to include the categories of the preliminary core set for knee dysfunction in a more comprehensive core set, using a six-item Likert scale. Kappa coefficient was used to analyze the agreement between the experts, and a consensus of 75% among responses was considered acceptable. RESULTS Nineteen experts participated in all rounds. Of the 24 categories from the preliminary core set for knee dysfunction, 15 remained in the comprehensive core set and one category was further detailed into three new categories. Seven new categories were included. Thus, the comprehensive core set for knee dysfunction was composed of 25 categories with an agreement of 81.5% among responses and a Kappa value of 0.63. CONCLUSION After validation by experts, the comprehensive core set for knee dysfunction was composed of 25 categories that can be used to assess the functioning of patients with knee dysfunction.
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Affiliation(s)
- Andersom Ricardo Fréz
- Physical Therapy Department, Universidade Estadual do Centro-Oeste, Guarapuava, Brazil
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Sandra Regina Alouche
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Aline Cristiane Binda
- Physical Therapy Department, Universidade Estadual do Centro-Oeste, Guarapuava, Brazil
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
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