Validation of the Ankle Osteoarthritis Scale Instrument for Preoperative Evaluation of End-Stage Ankle Arthritis Patients Using Item Response Theory

2019 ◽  
Vol 40 (4) ◽  
pp. 422-429 ◽  
Author(s):  
Guiping Liu ◽  
Alexander C. Peterson ◽  
Kevin Wing ◽  
Trafford Crump ◽  
Alastair Younger ◽  
...  
Keyword(s):  
Item Response Theory ◽  
Item Response ◽  
Ankle Arthrodesis ◽  
Ankle Arthritis ◽  
Response Theory ◽  
Ankle Osteoarthritis ◽  
Differential Item Function ◽  
Ankle Replacement ◽  
End Stage ◽  
Pain Domain

Background: Significant ankle arthritis results in functional limitations and patient morbidity. There is a need to measure symptoms and the impact of interventions on patient’s quality of life using valid and reliable patient-reported measurement instruments. The objective of this research was to validate the Ankle Osteoarthritis Scale instrument in the preoperative setting using factor analysis, item response theory, and differential item function methods. Methods: This research is based on secondary analysis of patients scheduled for ankle arthrodesis or total ankle replacement in Vancouver, Canada. Participants completed the instrument between September 2014 and August 2017. Item response theory was used to estimate item difficulty and discrimination parameters, controlling for study participants’ underlying level of ankle function. Differential item function was examined for sex, age group, and surgery. There were 88 participants. Results: Modification indices suggested that item 10, “walking around the house,” would better fit the pain domain rather than the disability domain. Items in the pain domain displayed a range of discrimination and difficulty. Items in the disability domain exhibited a range of discrimination, though the disability domain had low difficulty. Differential item functioning for sex, age group, and ankle arthrodesis or total ankle replacement appeared to be ignorable. Conclusion: This evaluation of the Ankle Osteoarthritis Scale found the instrument to be a strong measure of the effect of pain and dysfunction among patients with end-stage ankle arthritis, even when removing items 7 and 8, supporting its prior use in numerous clinical studies. Level of Evidence: Level II, prospective comparative study.

Total Ankle Arthroplasty Survivorship, Complication, and Revision Rates in Patients Younger Than 55 Years

2021 ◽  
pp. 193864002098092
Author(s):  
Devon W. Consul ◽  
Anson Chu ◽  
Travis M. Langan ◽  
Christopher F. Hyer ◽  
Gregory Berlet
Keyword(s):  
Case Series ◽  
Ankle Arthrodesis ◽  
Total Ankle Replacement ◽  
Implant Survival ◽  
Ankle Arthritis ◽  
Single Institution ◽  
Retrospective Case ◽  
Ankle Replacement ◽  
End Stage

Total ankle replacement has become a viable alternative to ankle arthrodesis in the surgical management of advanced ankle arthritis. Total ankle replacement has generally been reserved for patients who are older and for those who will have a lower demand on the replacement. The purpose of the current study is to review patient outcomes, complications, and implant survival in patients younger than 55 years who underwent total ankle replacement at a single institution. A single-center chart and radiographic review was performed of consecutive patients who underwent total ankle replacement for treatment of end-stage ankle arthritis. All surgeries were performed by 1 of 5 fellowship-trained foot and ankle surgeons at a single institution. A total of 51 patients met inclusion criteria with a mean follow-up of 31.2 months (SD = 16.2). Implant survival was 94%, There were 7 major complications (13%) requiring an unplanned return to the operating room and 8 minor complications (15%) that resolved with conservative care. The results of this study show that total ankle replacement is a viable treatment option for patients younger than 55 years. Levels of Evidence: A retrospective case series

scholarly journals An item response theory analysis of an item pool for the recovering quality of life (ReQoL) measure

2020 ◽  
Author(s):  
Anju Devianee Keetharuth ◽  
Jakob Bue Bjorner ◽  
Michael Barkham ◽  
John Browne ◽  
Tim Croudace ◽  
...  
Keyword(s):  
Mental Health ◽  
Item Response Theory ◽  
Item Response ◽  
Measurement Precision ◽  
Model Parameters ◽  
Item Pool ◽  
Response Theory ◽  
Differential Item Function ◽  
Wide Range ◽  
Internal Construct Validity

Abstract Purpose ReQoL-10 and ReQoL-20 have been developed for use as outcome measures with individuals aged 16 and over, experiencing mental health difficulties. This paper reports modelling results from the item response theory (IRT) analyses that were used for item reduction. Methods From several stages of preparatory work including focus groups and a previous psychometric survey, a pool of items was developed. After confirming that the ReQoL item pool was sufficiently unidimensional for scoring, IRT model parameters were estimated using Samejima’s Graded Response Model (GRM). All 39 mental health items were evaluated with respect to item fit and differential item function regarding age, gender, ethnicity, and diagnosis. Scales were evaluated regarding overall measurement precision and known-groups validity (by care setting type and self-rating of overall mental health). Results The study recruited 4266 participants with a wide range of mental health diagnoses from multiple settings. The IRT parameters demonstrated excellent coverage of the latent construct with the centres of item information functions ranging from − 0.98 to 0.21 and with discrimination slope parameters from 1.4 to 3.6. We identified only two poorly fitting items and no evidence of differential item functioning of concern. Scales showed excellent measurement precision and known-groups validity. Conclusion The results from the IRT analyses confirm the robust structure properties and internal construct validity of the ReQoL instruments. The strong psychometric evidence generated guided item selection for the final versions of the ReQoL measures.

Nationwide Analysis of Total Ankle Replacement and Ankle Arthrodesis in Medicare Patients: Trends, Complications, and Cost

2020 ◽  
pp. 193864002095018
Author(s):  
William A. Tucker ◽  
Brandon L. Barnds ◽  
Brandon L. Morris ◽  
Armin Tarakemeh ◽  
Scott Mullen ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Ankle Arthrodesis ◽  
Total Ankle Replacement ◽  
Complication Rates ◽  
Ankle Arthritis ◽  
Ankle Replacement ◽  
Procedure Cost ◽  
Medicare Patients ◽  
Retrospective Comparative Study ◽  
End Stage

Background Surgical management of end-stage ankle arthritis consists of either ankle arthrodesis (AA) or total ankle replacement (TAR). The purpose of this study was to evaluate utilization trends in TAR and AA and compare cost and complications. Methods Medicare patients with the diagnosis of ankle arthritis were reviewed. Patients undergoing surgical intervention were split into AA and TAR groups, which were evaluated for trends as well as postoperative complications, revision rates, and procedure cost. Results A total of 673 789 patients were identified with ankle arthritis. A total of 19 120 patients underwent AA and 9059 underwent TAR. While rates of AA remained relatively constant, even decreasing, with 2080 performed in 2005 and 1823 performed in 2014, TAR rates nearly quadrupled. Average cost associated with TAR was $12559.12 compared with $6962.99 for AA ( P < .001). Overall complication rates were 24.9% in the AA group with a 16.5% revision rate compared with 15.1% and 11.0%, respectively, in the TAR group ( P < .001). Patients younger than 65 years had both higher complication and revision rates. Discussion TAR has become an increasingly popular option for the management of end-stage ankle arthritis. In our study, TAR demonstrated both lower revision and complication rates than AA. However, TAR represents a more expensive treatment option. Levels of Evidence: Level III: Retrospective comparative study

Outcomes of Total Ankle Replacement, Arthroscopic Ankle Arthrodesis, and Open Ankle Arthrodesis for Isolated Non-Deformed End-Stage Ankle Arthritis

2019 ◽  
Vol 101 (17) ◽  
pp. 1523-1529 ◽  
Author(s):  
Andrea N. Veljkovic ◽  
Timothy R. Daniels ◽  
Mark A. Glazebrook ◽  
Peter J. Dryden ◽  
Murray J. Penner ◽  
...  
Keyword(s):  
Ankle Arthrodesis ◽  
Total Ankle Replacement ◽  
Ankle Arthritis ◽  
Ankle Replacement ◽  
End Stage

Sex Differences in End-Stage Ankle Arthritis and Following Total Ankle Replacement or Ankle Arthrodesis

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Andrew Dodd ◽  
Ellie Pinsker ◽  
Alastair S.E. Younger ◽  
Murray J. Penner ◽  
Kevin J. Wing ◽  
...  
Keyword(s):  
Sex Differences ◽  
Ankle Arthrodesis ◽  
Total Ankle Replacement ◽  
Ankle Arthritis ◽  
Ankle Replacement ◽  
End Stage

scholarly journals Outcome after 52 Salto Ankle Prostheses Implanted by a Single Surgeon

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Frank W. M. Faber ◽  
Monique J. L. Mastboom ◽  
Sabine T. van Vliet-Koppert ◽  
Ilse C. E. Bouman ◽  
Paulien M. van Kampen
Keyword(s):  
Ankle Arthrodesis ◽  
Total Ankle Replacement ◽  
Ankle Arthritis ◽  
Hospital Data ◽  
Gold Standard Method ◽  
Satisfaction Rate ◽  
Ankle Replacement ◽  
High Satisfaction Rate ◽  
Reliable Solution ◽  
End Stage

While ankle arthrodesis was traditionally the gold standard method of treatment for disabling end-stage ankle arthritis, total ankle replacement (TAR) has been an acceptable alternative. The satisfaction rate of patients with TAR however differs. The purpose of our study is to investigate whether implant survival and results with special emphasis on the satisfaction rate of patients treated with a TAR implanted by a single surgeon were comparable to the literature. This was a retrospective cohort study in a teaching hospital. Data was collected from 52 patients who received a total ankle replacement (TAR) between 05/2002 and 06/2014. The mean follow-up time was 4.2 years (95% CI 3.3 – 5.0). Results showed a high satisfaction rate of 94% and 94% survival of the TAR after 5 years. We conclude that TAR with the Salto prosthesis is, in our hands, a reliable solution for end-stage ankle arthritis, with results comparable to the literature.

scholarly journals A psychometric evaluation of the 12-item EPQ-R neuroticism scale in 502,591 UK Biobank participants using item response theory (IRT)

2020 ◽  
Author(s):  
Sarah Bauermeister ◽  
John Gallacher
Keyword(s):  
Item Response Theory ◽  
Item Response ◽  
Psychometric Evaluation ◽  
Item Bias ◽  
Uk Biobank ◽  
Response Theory ◽  
Personality Dimension ◽  
Differential Item Function ◽  
Neuroticism Scale ◽  
Item Scale

Abstract Background Neuroticism has been described as a broad and pervasive personality dimension or ‘heterogeneous’ trait measuring components of mood instability such as worry; anxiety; irritability; moodiness; self-consciousness; sadness and irritabililty. Consistent with depression and anxiety-related disorders, increased neuroticism places an individual vulnerable for other unipolar and bipolar mood disorders. However, the measurement of neuroticism remains a challenge. Our aim was to identify psychometrically efficient items and inform the inclusion of redundant items across the 12-item EPQ-R Neuroticism scale using Item Response Theory (IRT). Methods The 12-item binary EPQ-R Neuroticism scale was evaluated by estimating a two-parameter (2-PL) IRT model on data from 502,591 UK Biobank participants aged 37 to 73 years (M = 56.53 years; SD = 8.05), 54% female. Models were run listwise (n= 401,648) and post-estimation mathematical assumptions were computed. All analyses were conducted in STATA 16 SE on the Dementias Platform UK (DPUK) Data Portal. Results A plot of θ values (Item Information functions) showed that most items clustered around the mid-range where discrimination values ranged from 1.34 to 2.28. Difficulty values for individual item θ scores ranged from -0.13 to 1.41. A Mokken analysis suggested a weak to medium level of monotonicity between the items, no items reach strong scalability (H=0.35-0.47). Systematic item deletions and rescaling found that an 7-item scale is more efficient and with information (discrimination) ranging from 1.56 to 2.57 and stronger range of scalability (H=0.47-0.52). A 3-item scale is highly discriminatory but offers a narrow range of person ability (difficulty). A logistic regression differential item function (DIF) analysis exposed significant gender item bias functioning uniformly across all versions of the scale. Conclusions Across 401,648 UK Biobank participants, the 12-item EPQ-R neuroticism scale exhibited psychometric inefficiency with poor discrimination at the extremes of the scale-range. High and low scores are relatively poorly represented and uninformative suggesting that high neuroticism scores derived from the EPQ-R are a function of cumulative mid-range values. The scale also shows evidence of gender item bias and future scale development should consider the former along with item deletions.

scholarly journals Survival of the Scandinavian Total Ankle Replacement (STAR)

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0022
Author(s):  
Arno Frigg ◽  
Ursula Germann ◽  
Martin Huber ◽  
Monika Horisberger
Keyword(s):  
Survival Rate ◽  
Total Ankle Replacement ◽  
Ankle Arthritis ◽  
Ankle Osteoarthritis ◽  
Metallic Component ◽  
Kaplan Meier ◽  
Ankle Replacement ◽  
One Year ◽  
End Stage

Category: Ankle Arthritis Introduction/Purpose: The purpose of this study was to evaluate survival and clinical outcome of the Scandinavian total ankle replacement (STAR) prosthesis after a minimum of ten years up to a maximum of 19 years. Methods: Fifty STAR prostheses in 46 patients with end stage ankle osteoarthritis operated between 1996 and 2006 by the same surgeon (MH) were included. Minimal follow-up was ten years (median 14.6 years, 95% confidence interval [CI] 12.9-16.4). Clinical (Kofoed score) and radiological assessments were taken before the operation and at one, ten (+2), and 16 (±3) years after implantation. The primary endpoint was defined as exchange of the whole prosthesis or conversion to arthrodesis (def. 1), exchange of at least one metallic component (def. 2), or exchange of any component including the inlay (due to breakage or wear) (def. 3). Survival was estimated according to Kaplan-Meier. Further reoperations related to STAR were also recorded. Results: The ten year survival rate was (def. 1) 94% (CI 82- 98%), (def. 2) 90% (CI, 77-96%), and (def. 3) 78% (CI 64-87%). The 19-year survival rate was (def. 1) 91% (CI 78-97%), (def. 2) 75% (CI 53-88%), and (def. 3) 55% (CI 34-71%). Considering any re-operations related to STAR, 52% (26/50) of prostheses were affected by re-operations. Mean pre-operative Kofoed score was 49, which improved to 84 after one year (n = 50), to 90 after ten years (n = 46), and to 89 after 16 years (n = 28). Conclusion: The survival rate for def. 1 and 2 was high. However, re-operations occurred in 52% of all STAR prosthesis.

scholarly journals A psychometric evaluation of the 12-item EPQ-R neuroticism scale in 502,591 UK Biobank participants using item response theory (IRT)

2019 ◽  
Author(s):  
Sarah Bauermeister ◽  
John Gallacher
Keyword(s):  
Item Response Theory ◽  
Item Response ◽  
Psychometric Evaluation ◽  
Item Bias ◽  
Uk Biobank ◽  
Response Theory ◽  
Personality Dimension ◽  
Differential Item Function ◽  
Neuroticism Scale ◽  
Item Scale

AbstractBackgroundNeuroticism has been described as a broad and pervasive personality dimension or ‘heterogeneous’ trait measuring components of mood instability such as worry; anxiety; irritability; moodiness; self-consciousness; sadness and irritabililty. Consistent with depression and anxiety-related disorders, increased neuroticism places an individual vulnerable for other unipolar and bipolar mood disorders. However, the measurement of neuroticism remains a challenge. Our aim was to identify psychometrically efficient items and inform the inclusion of redundant items across the 12-item EPQ-R Neuroticism scale using Item Response Theory (IRT).MethodsThe 12-item binary EPQ-R Neuroticism scale was evaluated by estimating a two-parameter (2-PL) IRT model on data from 502,591 UK Biobank participants aged 37 to 73 years (M = 56.53 years; SD = 8.05), 54% female. Models were run listwise (n= 401,648) and post-estimation mathematical assumptions were computed. All analyses were conducted in STATA 16 SE on the Dementias Platform UK (DPUK) Data Portal.ResultsA plot of θ values (Item Information functions) showed that most items clustered around the mid-range where discrimination values ranged from 1.34 to 2.28. Difficulty values for individual item θ scores ranged from −0.13 to 1.41. A Mokken analysis suggested a weak to medium level of monotonicity between the items, no items reach strong scalability (H=0.35-0.47). Systematic item deletions and rescaling found that an 7-item scale is more efficient and with information (discrimination) ranging from 1.56 to 2.57 and stronger range of scalability (H=0.47-0.52). A 3-item scale is highly discriminatory but offers a narrow range of person ability (difficulty). A logistic regression differential item function (DIF) analysis exposed significant gender item bias functioning uniformly across all versions of the scale.ConclusionsAcross 401,648 UK Biobank participants, the 12-item EPQ-R neuroticism scale exhibited psychometric inefficiency with poor discrimination at the extremes of the scale-range. High and low scores are relatively poorly represented and uninformative suggesting that high neuroticism scores derived from the EPQ-R are a function of cumulative mid-range values. The scale also shows evidence of gender item bias and future scale development should consider the former along with item deletions.

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