scholarly journals Intraobserver and Interobserver Reliability of Three Classification Systems for Hallux Rigidus

2018 ◽  
Vol 110 (3) ◽  
Author(s):  
Peter Pham ◽  
Sarita Dillard ◽  
Christina Schilero ◽  
Sharon Chiang
Keyword(s):  
Interobserver Reliability ◽  
Intraclass Correlation ◽  
Plain Radiograph ◽  
Hallux Rigidus ◽  
Classification Systems ◽  
Foot And Ankle ◽  
Intrarater Reliability ◽  
Single Measure ◽  
The Mean ◽  
Prognostic Implications

Background There are more than ten classification systems currently used in the staging of hallux rigidus. This results in confusion and inconsistency with radiographic interpretation and treatment. The reliability of hallux rigidus classification systems has not yet been tested. We sought to evaluate the intraobserver and interobserver reliabilities of three commonly used classifications for hallux rigidus. Methods Twenty-one plain radiograph sets were presented to ten American College of Foot and Ankle Surgeons board-certified foot and ankle surgeons. Each physician classified each radiograph based on clinical experience and knowledge according to the Regnauld, Roukis, and Hattrup and Johnson classification systems. The two-way mixed single-measure consistency intraclass correlation coefficient was used to calculate intrarater and interrater reliabilities. Results The mean ± SD intrarater reliability of individual sets for the Roukis (0.62 ± 0.19) and Hattrup and Johnson (0.62 ± 0.28) classification systems was fair to good and for the Regnauld system bordered between fair to good and poor (0.43 ± 0.24). The interrater reliability of the mean classification was excellent for all three classification systems. Conclusions Reliable and reproducible classification systems are essential for treatment and prognostic implications in hallux rigidus. Herein, the Roukis classification system had the best intrarater reliability. Although there are various classification systems for hallux rigidus, the present results indicate that the three classification systems evaluated show reliability and reproducibility.

scholarly journals In vitro validation of Digital Image Analysis Sequence (DIAS) for the assessment of the marginal fit of cement-retained implant-supported experimental crowns

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Aristeidis A. Villias ◽  
Stefanos G. Kourtis ◽  
Hercules C. Karkazis ◽  
Gregory L. Polyzois
Keyword(s):  
Image Analysis ◽  
Digital Image ◽  
Confidence Level ◽  
Digital Image Analysis ◽  
Statistical Tests ◽  
Interobserver Reliability ◽  
Intraclass Correlation ◽  
Marginal Fit ◽  
Smallest Detectable Change ◽  
The Mean

Abstract Background The replica technique with its modifications (negative replica) has been used for the assessment of marginal fit (MF). However, identification of the boundaries between prosthesis, cement, and abutment is challenging. The recently developed Digital Image Analysis Sequence (DIAS) addresses this limitation. Although DIAS is applicable, its reliability has not yet been proven. The purpose of this study was to verify the DIAS as an acceptable method for the quantitative assessment of MF at cemented crowns, by conducting statistical tests of agreement between different examiners. Methods One hundred fifty-one implant-supported experimental crowns were cemented. Equal negative replicas were produced from the assemblies. Each replica was sectioned in six parts, which were photographed under an optical microscope. From the 906 standardized digital photomicrographs (0.65 μm/pixel), 130 were randomly selected for analysis. DIAS included tracing the profile of the crown and the abutment and marking the margin definition points before cementation. Next, the traced and marked outlines were superimposed on each digital image, highlighting the components’ boundaries and enabling MF measurements. One researcher ran the analysis twice and three others once, independently. Five groups of 130 measurements were formed. Intra- and interobserver reliability was evaluated with intraclass correlation coefficient (ICC). Agreement was estimated with the standard error of measurement (SEM), the smallest detectable change at the 95% confidence level (SDC95%), and the Bland and Altman method of limits of agreement (LoA). Results Measured MF ranged between 22.83 and 286.58 pixels. Both the intra- and interobserver reliability were excellent, ICC = 1 at 95% confidence level. The intra- and interobserver SEM and SDC95% were less than 1 and 3 pixels, respectively. The Bland–Altman analysis presented graphically high level of agreement between the mean measurement of the first observer and each of the three other observers’ measurements. Differences between observers were normally distributed. In all three cases, the mean difference was less than 1 pixel and within ± 3 pixels LoA laid at least 95% of differences. T tests of the differences did not reveal any fixed bias (P > .05, not significant). Conclusion The DIAS is an objective and reliable method able to detect and quantify MF at ranges observed in clinical practice.

Correlations between radiological classification systems and confirmed cartilage loss in severe knee osteoarthritis

2020 ◽  
Vol 102-B (3) ◽  
pp. 301-309 ◽  
Author(s):  
Oisin J. F. Keenan ◽  
George Holland ◽  
Julian F. Maempel ◽  
John F. Keating ◽  
Chloe E. H. Scott
Keyword(s):  
Knee Osteoarthritis ◽  
Correlation Coefficient ◽  
Interobserver Reliability ◽  
Severe Disease ◽  
Intraclass Correlation ◽  
Lateral Compartment ◽  
Classification Systems ◽  
Medial Compartment ◽  
Cartilage Loss ◽  
Radiological Classification

Aims Although knee osteoarthritis (OA) is diagnosed and monitored radiologically, actual full-thickness cartilage loss (FTCL) has rarely been correlated with radiological classification. This study aims to analyze which classification system correlates best with FTCL and to assess their reliability. Methods A prospective study of 300 consecutive patients undergoing unilateral total knee arthroplasty (TKA) for OA (mean age 69 years (44 to 91; standard deviation (SD) 9.5), 178 (59%) female). Two blinded examiners independently graded preoperative radiographs using five common systems: Kellgren-Lawrence (KL); International Knee Documentation Committee (IKDC); Fairbank; Brandt; and Ahlbäck. Interobserver agreement was assessed using the intraclass correlation coefficient (ICC). Intraoperatively, anterior cruciate ligament (ACL) status and the presence of FTCL in 16 regions of interest were recorded. Radiological classification and FTCL were correlated using the Spearman correlation coefficient. Results Knees had a mean of 6.8 regions of FTCL (SD 3.1), most common medially. The commonest patterns of FTCL were medial ± patellofemoral (143/300, 48%) and tricompartmental (89/300, 30%). ACL status was associated with pattern of FTCL (p = 0.023). All radiological classification systems demonstrated moderate ICC, but this was highest for the IKDC: whole knee 0.68 (95% confidence interval (CI) 0.60 to 0.74); medial compartment 0.84 (95% CI 0.80 to 0.87); and lateral compartment 0.79 (95% CI 0.73 to 0.83). Correlation with actual FTCL was strongest for Ahlbäck (Spearman rho 0.27 to 0.39) and KL (0.30 to 0.33) systems, although all systems demonstrated medium correlation. The Ahlbäck score was the most discriminating in severe knee OA. Osteophyte presence in the medial compartment had high positive predictive value (PPV) for FTCL, but not in the lateral compartment. Conclusion The Ahlbäck and KL systems had the highest correlation with confirmed cartilage loss at TKA. However, the IKDC system displayed the best interobserver reliability, with favourable correlation with FTCL in medial and lateral compartments, although it was less discriminating in more severe disease. Cite this article: Bone Joint J 2020;102-B(3):301–309

scholarly journals Intrarater Reliability of Chest Expansion using Cloth Tape Measure Technique

2012 ◽  
Vol 11 (4) ◽  
pp. 307-311 ◽  
Author(s):  
Vikram Mohan ◽  
Nurul Hafizah Dzulkifli ◽  
Maria Justine ◽  
Rohani Haron ◽  
Leonard Joseph H ◽  
...  
Keyword(s):  
Intraclass Correlation ◽  
Medical Science ◽  
Standing Position ◽  
Anatomical Landmarks ◽  
Intrarater Reliability ◽  
Chest Expansion ◽  
Tape Measure ◽  
The Mean ◽  
Test Retest Reliability ◽  
Acceptable Reliability

Objective: The Objective of this study was to determine the intrarater reliability of chest expansion at three different anatomical landmarks using a cloth tape measure among healthy peoples. Materials and Methods: 120 healthy male and female volunteers were evaluated on two occasions in different days. The measures   consisted of chest expansion measurement at axilla, fourth intercostals and xiphoid levels. The measurements   were taken in the standing position with the arms hanging sideways at all the three different anatomical landmarks. The test-retest reliability of the measurements was determined by intraclass correlation coefficient (ICC) and standard error of measurements (SEMs). Results: An acceptable reliability was determined  by ICC values greater than than 0.85 and SEMs less than 5%. The mean age of the subjects was 21.93 years. ICC of all measures ranged between 0.95 to 0.97 and SEMs were 1.9%, 1.8%, 1.5% at the axillary, fourth intercostals and xiphoid level respectively. Conclusions: The findings of this study suggested that, the cloth   tape measurement was reliable at all the three different anatomical landmarks of the chest wall. Therefore, this measurement technique could be used as an outcome measure for chest expansion in the management   of cardiorespiratory conditions. DOI: http://dx.doi.org/10.3329/bjms.v11i4.12602 Bangladesh Journal of Medical Science Vol. 11 No. 04 Oct’12

scholarly journals Joint Preservation of the 1st MTP

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Bryan Van Dyke ◽  
Gregory Berlet ◽  
Justin Daigre ◽  
Christopher Hyer ◽  
Terrence Philbin
Keyword(s):  
Articular Cartilage ◽  
Early Detection ◽  
Metatarsal Head ◽  
Hallux Rigidus ◽  
Pain Level ◽  
Foot And Ankle ◽  
Inclusion Criteria ◽  
First Metatarsal ◽  
The Mean ◽  
One Year

Category: Midfoot/Forefoot Introduction/Purpose: Focal damage to articular cartilage and the supporting subchondral plate, commonly referred to as an osteochondral defect (OCD), can be a cause of joint pain and subsequent decreased range of motion. There are few studies specifically describing these lesions in the first metatarsophalangeal (MTP) joint, where they are traditionally grouped into hallux rigidus. There exists an opportunity for early detection and intervention with the intent to prevent deterioration and improve patient outcomes. One contemporary treatment concept is to implant particulated juvenile cartilage allograft to restore articular cartilage. The aim of our study was to review the clinical results of patients that had undergone this procedure for first metatarsal head OCDs. Methods: After IRB approval, a retrospective review of a consecutive case series was studied utilizing the records of three foot and ankle surgeons. Inclusion criteria included all adult patients who were a minimum of one year post surgery and consented to participate. Patient demographics and preoperative visual analog scale (VAS) pain level were recorded from a standardized intake sheet. From the operative note, the OCD size and location was recorded, as well as any concomitant procedures. At a minimum follow up of one year, we obtained objective measurements of arthritis grade and subjective considerations of pain and function, including VAS pain level, Foot Function Index (FFI) questionnaire, the American Orthopaedic Foot and Ankle Society (AOFAS) Hallux Metatarsophalangeal-Interphalangeal scale, and an overall patient satisfaction score. Results: Nine patients met inclusion criteria, 4 males and 5 females. The average age was 41 years old (±11.77, range 21-65). The mean preoperative VAS pain score was 57.50 (±18.32, range 30-80). Four OCDs were located centrally on the first metatarsal head. The average OCD size intraoperatively was 30 mm2 (range 16-49). The average time since surgery was 3.26 years (±1.21, range 1.41-5.62). Average first MTP dorsiflexion was 41.78 degrees (±20.70, range 6-70). The average postoperative hallux rigidus classification was grade 2 (range 1-3). The mean VAS pain score improved to 5.22 (±8.44, range 0-20). The average AOFAS score was 88 (±15.91, range 52-100). The average FFI score was 8.04 (±12.60, range 0-30.6). All but one patient were satisfied or very satisfied with their results. Conclusion: At an average of 3.26 years postoperatively, patients had improved pain, did not show significant progression of their first MTP joint degeneration, and were satisfied with their results. Patients reported very little, if any, limitations in their activity level. We believe that articular damage of the first MTP should be viewed in the same way as OCD lesions in larger joints with emphasis on early detection and treatment to avoid the progression to arthritis. Particulated juvenile cartilage allograft is a valuable tool for surgeons to use in treating focal articular defects of the first metatarsal head.

scholarly journals Hindfoot Alignment in Stage II Adult Acquired Flatfoot Deformity

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0020
Author(s):  
Cesar de Cesar Netto ◽  
Lauren Roberts ◽  
Grace Kunas ◽  
Anca Marinescu ◽  
Dylan Soukup ◽  
...  
Keyword(s):  
Clinical Evaluation ◽  
Interobserver Reliability ◽  
Intraclass Correlation ◽  
Treatment Algorithm ◽  
Stage Ii ◽  
Hindfoot Alignment ◽  
Radiographic Measurements ◽  
Alignment Angle ◽  
Adult Acquired Flatfoot Deformity ◽  
The Mean

Category: Hindfoot Introduction/Purpose: Previous work has demonstrated that the amount of radiographic hindfoot correction required at the time of adult acquired flatfoot deformity (AAFD) surgical treatment can be predicted by the amount of radiographic deformity present before surgery. Successful outcomes after reconstruction are closely correlated with hindfoot valgus correction. However, it is not clear if differences exist between clinical and radiographic assessment of hindfoot valgus. The purpose of this study was to evaluate the correlation between radiographic and clinical evaluation of hindfoot alignment in patients with stage II AAFD. Methods: Twenty-nine patients (30 feet) with stage II AAFD, 17 men and 12 women, mean age of 51 (range, 20 to 71) years, were prospectively recruited. In a controlled and standardized fashion, bilateral weightbearing radiographic hindfoot alignment views were taken. Radiographic parameters were measured by two blinded and independent readers: hindfoot alignment angle (HAA) and hindfoot moment arm (HMA). Clinical photographs of hindfoot alignment were taken, in three different vertical camera angulations (0, 20 and 40 degrees). Pictures were assessed by the same readers for standing tibiocalcaneal angle (STCA) and resting calcaneal stance position (RCSP). Intra- and interobserver reliability were assessed by Pearson/Spearman’s and intraclass correlation coefficient (ICC), respectively. Relationship between clinical and radiographic hindfoot alignment was evaluated by a linear regression model. Comparison between the different angles (RCSP, STCA and HAA) was performed using Wilcoxon rank sum test. P-values of less than 0.05 were considered significant. Results: We found overall almost perfect intra- (range, 0.91-0.99) and interobserver reliability (range, 0.74-0.98) for all measures. Mean value and confidence interval (CI) for RCSP and STCA were 10.78 degrees (CI: 10.09-11.47) and 12.55 degrees (CI: 11.71- 13.40), respectively. The position of the camera did not influence readings of clinical alignment (p>.05). The mean HMA was 18.74 mm (CI: 16.34-21.14 mm) and the mean HAA was 23.54 degrees (CI: 21.08-25.99). Clinical and radiographic hindfoot alignment were found to significantly correlate (p<.05). However, the radiographic hindfoot alignment (HAA) demonstrated increased valgus when compared to both clinical alignment measurements, with a mean difference of 12.76 degrees from the RCSP (CI: 10.99-14.53, p<.0001) and 10.98 degrees from the STCA (CI: 9.22-12.76, p<.0001). Conclusion: We found significant correlation between radiographic and clinical hindfoot alignment in patients with stage II AAFD. However, radiographic measurements of hindfoot alignment angle demonstrated significantly more pronounced valgus alignment than the clinical evaluation. The results of our study suggest that clinical evaluation of hindfoot alignment in patients with AAFD potentially underestimates the bony valgus deformity. One should consider these findings when using clinical evaluation in the treatment algorithm of flatfoot patients.

Arthrodesis of the First Metatarsophalangeal Joint

2012 ◽  
Vol 102 (1) ◽  
pp. 13-17 ◽  
Author(s):  
Kalpesh Shah ◽  
Angelica Augustine ◽  
Robert Carter ◽  
Angus McFadyen
Keyword(s):  
Interobserver Reliability ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
First Metatarsophalangeal Joint ◽  
Lag Screw ◽  
Fixation Group ◽  
Joint Fusion ◽  
Bone Fragments ◽  
The Mean ◽  
Mean Time

Background: There are cadaveric and biomechanical studies comparing different methods of fixation for achieving arthrodesis in hallux rigidus. However, there are no comparative clinical studies. We compared the clinical and radiologic outcomes of first metatarsophalangeal joint fusion using three different techniques: lag screw, lag screw and circlage wire, and Memory staples. Methods: This was a retrospective study of 46 patients who underwent first metatarsophalangeal joint fusion. All of the operations were performed by experienced surgeons. Each patient had clinical and radiologic assessments postoperatively. Results: The three groups were matching in terms of demographic features and comorbidity. Intraobserver and interobserver reliability for radiographic metatarsophalangeal joint fusion was excellent. The mean time to clinical and radiologic union in the Memory staples group was earlier (7.6 weeks) than that of the other two techniques (8.0 and 8.1 weeks). The Memory staples group also had the lowest incidence of nonunion (1 of 15 compared with 4 of 15 in the single lag screw fixation group and 3 of 16 in the lag screw and circlage wire fixation group) and no hardware-related problems. Conclusions: Our experience corroborates the advantages of Memory staples as described in the literature, including good approximation of bone fragments, technically easy application with fewer steps than an AO-applied screw, and an adequate source of internal fixation to achieve metatarsophalangeal joint fusion. There is also a suggestion that the time to achieve fusion is shorter. (J Am Podiatr Med Assoc 102(1): 13-17, 2012)

scholarly journals An Analysis of Arches of Foot: A Comparison between Ink Foot Print Method and Custom Made Podoscope Device Method

2021 ◽  
pp. 249-256
Author(s):  
K. Vijayakumar ◽  
Rameshkumar Subramanian ◽  
S. Senthilkumar ◽  
D. Dineshkumar
Keyword(s):  
Rural Areas ◽  
Descriptive Analysis ◽  
Intraclass Correlation ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Intrarater Reliability ◽  
Custom Made ◽  
The Mean ◽  
Arch Index ◽  
Healthy Participants

The present study aimed to assess the validity of the podoscopic images compared with ink footprint methods (comparing the two different methods using the same parameters). Objective: The evaluation of the reliability and accuracy of arch angle (AA) is the purpose of this paper's study. It includes Chippaux-Smirak Index (CSI), Staheli Index (SI), and Arch Index (AI) by comparing footprints obtained from ink footprint and custom-made podoscopic footprints. Methods: Measurements of AA, CSI, SI, and AI are obtained from ink footprints and custom-made podoscope among 416 healthy participants (aged 21 to 65). Accuracy and reliability were calculated for all the footprint indices obtained using the two methods. Minimal detectable change and the Standard error (SE) of measurement were also calculated. Results: SPSS Statistical software (version 20) at 95% confidence interval was used to execute and observe the statistical analysis. Descriptive analysis was used to calculate the Mean and standard deviations (SD). The intrarater reliability of ink footprints and podoscopic footprints were analyzed using Intraclass correlation (IC) executed at 95% confidence intervals (CIs). Reliability of the podoscopic method was interpreted when the values (≥0.75) as excellent, (0.4-0.74) as moderate, and (0-0.39) as poor. Our study reported that AA, CSI, SI, and AI obtained from the ink footprints and podoscope had high intrarater reliability and reproducible. The podoscope was designed in a lightweight manner for transportation purposes and utilized in under-served and rural areas. This custom-made device may be utilized in orthopedics, and it can also be used to collect data and for diagnostic purposes.

Assessment of the plane of maximum curvature for patients with adolescent idiopathic scoliosis via computed tomography

2020 ◽  
Vol 44 (5) ◽  
pp. 298-304
Author(s):  
Hui-Dong Wu ◽  
Winnie Chiu-Wing Chu ◽  
Cheng-Qi He ◽  
Man-Sang Wong
Keyword(s):  
Computed Tomography ◽  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Cobb Angle ◽  
Correlation Coefficient ◽  
Intraclass Correlation ◽  
Intrarater Reliability ◽  
Maximum Curvature ◽  
Curvature Measurements ◽  
The Mean

Background: In the assessment of three-dimensional features of adolescent idiopathic scoliosis, the plane of maximum curvature was compared with the coronal Cobb angle. Objectives: To investigate the intrarater reliability, variability, and difference of the prone plane of maximum curvature measurements taken from computed tomography using the constrained and unconstrained Cobb methods; to assess the difference and correlation between the prone plane of maximum curvature measurements obtained using the constrained and unconstrained Cobb methods; and to examine differences and correlation between the prone plane of maximum curvature Cobb angle and coronal Cobb angle measurements. Study design: Retrospective study. Methods: Records of 29 subjects with adolescent idiopathic scoliosis aged 15.8 ± 3.5 years were reviewed (25 thoracic and 24 thoracolumbar/lumbar curves). An experienced rater measured the plane of maximum curvature using the constrained and unconstrained Cobb methods, and the coronal Cobb angles using the conventional Cobb method on computed tomography images 3 times each with 1-week interval. The intraclass correlation coefficient (2,1), Pearson correlation coefficient ( r), one-way repeated measures analysis of variance, and paired t test were applied for various analyses. Results: The intraclass correlation coefficients for all intrarater reliability assessments were greater than 0.87. The plane of maximum curvature measurements of the two Cobb methods were excellently correlated ( r ⩾ 0.97) with no significant difference ( P > 0.05). The mean plane of maximum curvature Cobb angle was moderately correlated with ( r > 0.72) but significantly greater ( P < 0.001) than the mean coronal Cobb angle. Conclusion: The plane of maximum curvature measurements obtained from computed tomography were found to be reliable while the plane of maximum curvature measurements of the two Cobb methods were comparable. The mean plane of maximum curvature Cobb angle was moderately correlated with but significantly greater than the mean coronal Cobb angle. Clinical relevance The plane of maximum curvature measurements taken from computed tomography was found to be reliable, hence it could be used as a supplement to the coronal Cobb angle in the assessment and management of adolescent idiopathic scoliosis. With technological advancement, the radiation dose of computed tomography can be further reduced to a safer level for a broader range of cases.

scholarly journals 2020 Roger A. Mann Award Winner: Application of Computerized Adaptive Testing to the Foot and Ankle Ability Measure

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0006
Author(s):  
Joseph T. O’Neil ◽  
Otho R. Plummer ◽  
Steven M. Raikin
Keyword(s):  
Computerized Adaptive Testing ◽  
Wide Spectrum ◽  
Intraclass Correlation ◽  
Adaptive Testing ◽  
Mean Difference ◽  
Foot And Ankle ◽  
Patient Reported ◽  
The Mean ◽  
Ability Measure ◽  
The Impact

Category: Other Introduction/Purpose: Patient-reported outcome measures (PROMs) are an increasingly important tool for assessing the impact of treatments orthopaedic surgeons render to patients. They provide information directly reported by the patient pertaining to the perception of their own outcome, functional status, and quality of life. Despite their importance, they can present a burden for patients as well as for a busy outpatient clinic. The Foot and Ankle Ability Measure (FAAM) is a freely available validated anatomy-specific outcome measure consisting of 32 questions, and has been found to be reliable for patients with a wide spectrum of foot and ankle conditions. We examined the validity and utility of a computerized adaptive testing (CAT) method to reduce the number of questions on the Foot and Ankle Ability Measure. Methods: A previously developed FAAM CAT system was applied to the responses of patients undergoing foot and ankle evaluation and treatment at a busy tertiary referral orthopaedic practice over a 3-year period (2017-2019). A total of 15,902 responses for the Activities of Daily Living (ADL) subscale and a total of 14,344 responses for the Sports subscale were analyzed. The accuracy of the CAT to replicate the full-form score was assessed using the mean and standard deviation of scores for both groups (FAAM versus CAT), frequency distributions of the scores and score differences for both groups, Pearson and intraclass correlation coefficients, and Bland-Altman assessments of patterns in score differences. Results: The CAT system required 11 questions to be answered for the ADL subscale in 85.1% of cases (compared to 22 questions for the FAAM) and 12 in 14.9% of cases. The number of questions answered on the Sports subscale was 6 in 66.4% of cases (compared to 10 for the FAAM) and 5 in 33.6% of cases. The mean difference between the full FAAM ADL subscale (out of 100 points) and CAT was 0.6266 of a point and scores were within 7.5 points in greater than 95% of cases. The mean difference between the FAAM Sports subscale (out of 100 points) and CAT was 0.5967 of a point and scores were within the minimal clinically important difference of 9 in greater than 95% of cases. Conclusion: The FAAM CAT was able to reduce the number of responses a patient would need to answer by nearly 50%, while still providing a valid outcome score. This measure can therefore be directly correlated with previously obtained full FAAM scores in addition to providing a foot/ankle-specific measure, which previously reported CAT systems are not able to do.

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