A 5-Year Review of Clinical Outcome Measures Published in the Journal of the American Podiatric Medical Association and the Journal of Foot and Ankle Surgery

2017 ◽  
Vol 107 (3) ◽  
pp. 176-179 ◽  
Author(s):  
Todd Hasenstein ◽  
Timothy Greene ◽  
Andrew J. Meyr
Keyword(s):  
Medical Association ◽  
Clinical Outcome ◽  
Outcome Measures ◽  
Short Form ◽  
Outcome Measurement ◽  
Time Frame ◽  
Original Research ◽  
Foot And Ankle ◽  
Ankle Surgery ◽  
American Orthopaedic

This investigation presents a review of all of the clinical outcome measures used by authors and published in the Journal of the American Podiatric Medical Association and the Journal of Foot and Ankle Surgery from January 1, 2011, to December 31, 2015. Of 1,336 articles published during this time frame, 655 (49.0%) were classified as original research and included in this analysis. Of these 655 articles, 151 (23.1%) included at least one clinical outcome measure. Thirty-seven unique clinical outcome scales were used by authors and published during this period. The most frequently reported scales in the 151 included articles were the American Orthopaedic Foot and Ankle Society scales (54.3%; n = 82), visual analog scale (35.8%; n = 54), Medical Outcomes Study Short Form Health Survey (any version) (10.6%; n = 16), Foot Function Index (5.3%; n = 8), Maryland Foot Score (4.0%; n = 6), and Olerud and Molander scoring system (4.0%; n = 6). Twenty-four articles (15.9%) used some form of original/subjective measure of patient satisfaction/expectation. The results of this investigation detail the considerable variety of clinical outcome measurement tools used by authors in the Journal of the American Podiatric Medical Association and the Journal of Foot and Ankle Surgery and might support the need for a shift toward the consistent use of a smaller number of valid, reliable, and clinically useful scales in the podiatric medical literature.

The Popularity of Outcome Measures Used in the Foot and Ankle Literature

2019 ◽  
Vol 13 (1) ◽  
pp. 58-68 ◽  
Author(s):  
Fady Y. Hijji ◽  
Andrew D. Schneider ◽  
Michael Pyper ◽  
Richard T. Laughlin
Keyword(s):  
Outcome Measures ◽  
Outcome Measure ◽  
Outcome Measurement ◽  
Error Variance ◽  
Journal Title ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Study Characteristics ◽  
American Orthopaedic ◽  
Disease Specific

Background. Outcome measures are frequently employed in clinical studies to determine the efficacy of orthopaedic surgical procedures. However, substantial variability exists among the outcome instruments utilized in foot and ankle (F&A) literature. The purpose of this study is to determine the number of outcome measures reported in F&A literature recently published in major orthopaedic journals and the association between study characteristics and the use of particular outcome measurement categories. Methods. All manuscripts published in 6 major orthopaedic journals between 2013-2017 reporting at least one clinical outcome measure were collected. For each manuscript, the journal, title, authors, country/region of origin, level of evidence, topic, and anatomic location were recorded. Outcome measures were characterized as generic, F&A specific, and disease specific. Poisson regression with robust error variance was used to test for association between study characteristics and outcome measure categories. Results. A total of 541 F&A articles were included with fifty-two different outcome measures reported. The most popular tool was the American Orthopaedic Foot and Ankle Score (AOFAS) (56.9%). Generic outcome measures were used in 331 (61.1%) studies, while 440 (81.3%) studies used F&A specific measures and 64 (11.8%) used disease-specific measures. The use of generic and disease-specific outcome measures was associated with a higher level of evidence (p < 0.001). Conclusion. AA substantial variety of outcome measures are employed among recent published studies, with many studies utilizing non-validated measures. Reporting a combination of validated and focused outcome measures is necessary to improve the quality and generalizability of published studies in foot and ankle literature. Levels of Evidence: Level II: Systematic review

scholarly journals Publications Rates for Podium and Poster Presentations from the American Orthopaedic Foot and Ankle Society

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0004
Author(s):  
Benjamin Williams ◽  
Grace Kunas ◽  
Jonathan Deland ◽  
Scott Ellis
Keyword(s):  
Full Text ◽  
Odds Ratio ◽  
Sports Medicine ◽  
Publication Rate ◽  
Foot And Ankle ◽  
Publication Rates ◽  
Ankle Surgery ◽  
Orthopaedic Society ◽  
American Orthopaedic ◽  
Poster Presentations

Category: Other Introduction/Purpose: National orthopaedic meetings are used to disseminate current research. These abstracts are commonly intended to go on to full-text publication in peer-reviewed journals. Several studies have reviewed the abstract to full-text journal publications for orthopaedic society meetings and reported a 34% to 73% publication rate. This has not been studied for the foot and ankle literature. The purpose of this study is to determine the full-text journal publication rates of podium and poster presentations from the American Orthopaedic Foot and Ankle Society (AOFAS) Annual meetings between 2008 and 2012. Methods: All abstracts submitted to and subsequently accepted for podium and poster presentations from the 2008 to 2012 AOFAS annual meetings were compiled from the AOFAS and the published meeting programs. In May 2016, PubMed searches were performed using individual key words in the abstract title with all authors’ names. The results were reviewed for matches to the meeting abstracts with regards to content similarities. Time to full-text publication was recorded. Full-text publication rates for podium and poster presentations were calculated per year. The top journals of publication for podium and poster abstracts were calculated. Continuous data was summarized using mean ± standard deviation and categorical data was summarized using counts and percents. Difference in publication rates between podium and poster presentations was determined by an odds ratio. Results: From 2008 to 2012, 1262 abstracts were submitted to the annual meeting. The overall abstract publication rate was 62.4%: 73.7% for podium abstracts and 55.8% for poster abstracts. Podium presentations were significantly more likely to be published compared to posters (p< 0.0001; odds ratio 2.17, 95% CI, 1.64-2.86). Mean time to publication was 1.53 and 1.37 years for podium and poster presentations, respectively (p=0.124). The three most common journals for published podium abstracts were Foot and Ankle International (FAI) (50.4%), Journal of Bone and Joint Surgery (JBJS) (13.0%) and The American Journal of Sports Medicine (AJSM) (4.3%). For poster abstracts, the three most common journals were: FAI (36.9%), Journal of Foot and Ankle Surgery (9.4%) and Foot and Ankle Specialist (8.5%). Conclusion: Podium abstracts were over two times more likely to be published compared to poster abstracts. The overall full- text publication rate for the AOFAS was one of the higher reported rates compared to other national orthopaedic society meetings. The significance of the high full-text publication rate is unclear; it may reflect the quality of presented material or commitment to publication by the authors. The top journal for podium and poster abstracts was FAI, indicating the presentations’ specialty-focus.

Appraisal of Candidate Instruments for Assessment of the Physical Function Domain in Patients with Psoriatic Arthritis

2020 ◽  
Vol 48 (1) ◽  
pp. 58-66 ◽  
Author(s):  
Ying Ying Leung ◽  
Ana-Maria Orbai ◽  
Alexis Ogdie ◽  
Pil Hojgaard ◽  
Richard Holland ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Physical Function ◽  
Outcome Measures ◽  
Physical Functioning ◽  
Working Group ◽  
Short Form ◽  
Outcome Measurement ◽  
Patient Reported Outcome Measures ◽  
Measurement Information ◽  
Patient Reported

Objective.Numerous patient-reported outcome measures (PROM) exist for the measurement of physical function for psoriatic arthritis (PsA), but only a few are validated comprehensively. The objective of this project was to prioritize PROM for measuring physical function for potential incorporation into a standardized outcome measurement set for PsA.Methods.A working group of 13 members including 2 patient research partners was formed. PROM measuring physical function in PsA were identified through a systematic literature review and recommendations by the working group. The rationale for inclusion and exclusion from the original list of existing PROM was thoroughly discussed and 2 rounds of Delphi exercises were conducted to achieve consensus.Results.Twelve PROM were reviewed and discussed. Six PROM were prioritized: Health Assessment Questionnaire (HAQ) and 4 modifications (HAQ-Disability Index, HAQ-Spondyloarthritis, modified HAQ, multidimensional HAQ), Medical Outcomes Study 36-item Short Form survey physical functioning domain, and the Patient-Reported Outcomes Measurement Information System (PROMIS) physical functioning module.Conclusion.Through discussion and Delphi exercises, we achieved consensus to prioritize 6 physical function PROM for PsA. These 6 PROM will undergo further appraisal using the Outcome Measures in Rheumatology (OMERACT) Filter 2.1.

Patient Factors Associated With Higher Expectations From Foot and Ankle Surgery

2017 ◽  
Vol 38 (5) ◽  
pp. 472-478 ◽  
Author(s):  
Elizabeth A. Cody ◽  
Carol A. Mancuso ◽  
Jayme C. Burket ◽  
Anca Marinescu ◽  
Aoife MacMahon ◽  
...  
Keyword(s):  
Short Form ◽  
Cross Sectional Study ◽  
Assistive Device ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Ankle Surgery ◽  
Patient Health ◽  
Pain Visual Analog Scale ◽  
Special Surgery

Background: Few authors have investigated patients’ expectations from foot and ankle surgery. In this study, we aimed to examine relationships between patients’ preoperative expectations and their demographic and clinical characteristics. We hypothesized that patients with more disability and those with anxiety or depressive symptoms would have greater expectations. Methods: All adult patients scheduled for elective foot or ankle surgery by 1 of 6 orthopaedic foot and ankle surgeons were screened for inclusion over 8 months. Preoperatively, all patients completed the Hospital for Special Surgery Foot & Ankle Surgery Expectations Survey in addition to the Foot & Ankle Outcome Score (FAOS), Short Form (SF)–12, Patient Health Questionnaire (PHQ)–8, Generalized Anxiety Disorder 7-item scale (GAD-7), and pain visual analog scale (VAS). The expectations survey contained 23 expectations categories, each with 5 answer choices ranging from “I do not have this expectation” to “complete improvement” expected. It was scored from 0 to 100, with higher scores indicating more expectations. Differences in expectations relating to numerous patient demographic and clinical variables were assessed. In total, 352 patients with an average age of 55 ± 15 (range, 18-86) years were enrolled. Results: Expectations scores were not related to age ( P = .36). On average, women expected to achieve complete improvement more often than men ( P = .011). Variables that were significantly associated with higher expectations scores ( P < .05) included nonwhite race, use of a cane or other assistive device, and greater medical comorbidity. Worse function and quality of life (as assessed by all FAOS subscales and the SF-12 physical and mental components), more depressive and anxiety symptoms, and higher pain VAS scores were associated with higher expectations scores and more expectations ( P < .01 for all). Conclusions: The results of this study may help inform surgeons’ preoperative discussions with their patients regarding realistic expectations from surgery. Generally, patients with worse function and more disability had higher expectations from surgery. Addressing these patients’ expectations preoperatively may help improve their ultimate satisfaction with surgery. Level of Evidence: Level II, cross sectional study.

Report on the 1989 American Orthopaedic Foot and Ankle Society Fellow Scholarship

Foot & Ankle ◽  
1992 ◽  
Vol 13 (3) ◽  
pp. 161-166
Author(s):  
Arthur Manoli
Keyword(s):  
Medical Center ◽  
Foot And Ankle ◽  
University Of Washington ◽  
Ankle Surgery ◽  
American Orthopaedic ◽  
Vanderbilt University

In 1989, the American Orthopaedic Foot and Ankle Society, Inc., sponsored a scholarship for a member to return to training to do a fellowship in foot and ankle surgery. The following is the account of Arthur Manoli, II, M.D., who served 3 months with Sigvard T. Hansen, Jr., M.D., at the Harborview Medical Center, University of Washington, Seattle, Washington, and 9 months with Marion C. Harper, M.D., at Vanderbilt University, Nashville, Tennessee.

Joint Debridement and Metatarsal Remodeling in Freiberg’s Infraction

2013 ◽  
Vol 103 (3) ◽  
pp. 185-190 ◽  
Author(s):  
Mehmet Erdil ◽  
Yunus Imren ◽  
Kerem Bilsel ◽  
Ayhan Erzincanli ◽  
Murat Bülbül ◽  
...  
Keyword(s):  
Health Survey ◽  
Short Form ◽  
Metatarsal Head ◽  
Advanced Stage ◽  
Foot And Ankle ◽  
Short Form Health Survey ◽  
Form Health ◽  
American Orthopaedic ◽  
Freiberg’S Infraction ◽  
Short Form Health

Background: Freiberg’s infraction is an osteochondrosis that is characterized by osteonecrosis of the metatarsal head, with pain and tenderness around the metatarsophalangeal joint. We sought to evaluate the outcome of joint debridement and metatarsal remodeling for the treatment of advanced-stage Freiberg’s infraction. Methods: Between March 1, 2006, and April 30, 2011, 14 patients (eight females and six males) with symptomatic unilateral Freiberg’s disease refractory to conservative treatment (Smillie stages IV and V) underwent joint debridement with metatarsal head remodeling by two surgeons. To evaluate functional outcome, American Orthopaedic Foot and Ankle Society and 36-Item Short Form Health Survey forms were completed by the patients preoperatively and postoperatively at months 3, 6, and 12. Active-assisted range-of-motion exercise was allowed after 4 weeks of short-leg walking cast wear, and weightbearing on the forefoot was allowed as tolerated. Results: Mean patient age was 27.0 years (range, 16–53 years), and mean follow-up was 40.2 months (range, 14–54 months). Mean ± SD American Orthopaedic Foot and Ankle Society and 36-Item Short Form Health Survey scores were 46.8 ± 8.95 and 28.9 ± 4.3 preoperatively and 76.2 ± 9.5 and 45.6 ± 7.7 1 year after surgery, respectively. There was a significant increase in both scores (P ≤ .001). Conclusions: In advanced-stage Freiberg’s infraction of the second metatarsal, joint debridement and metatarsal head remodeling is a safe and simple therapeutic option, and it provides better quality of life for patients. (J Am Podiatr Med Assoc 103(3): 185–190, 2013)

Survey of Tourniquet Use in Orthopaedic Foot and Ankle Surgery

2005 ◽  
Vol 26 (3) ◽  
pp. 208-217 ◽  
Author(s):  
Alastair S.E. Younger ◽  
Timothy P. Kalla ◽  
James A. McEwen ◽  
Kevin Inkpen
Keyword(s):  
Cuff Pressure ◽  
Standard Of Care ◽  
Foot And Ankle ◽  
Occlusion Pressure ◽  
Current Standard ◽  
Breakthrough Bleeding ◽  
Pressure Setting ◽  
Ankle Surgery ◽  
American Orthopaedic ◽  
Limb Occlusion Pressure

Background: Tourniquet technique varies among foot and ankle surgeons, and to establish a standard practice guideline the current standard of care should be examined. Methods: One hundred and forty responses were received after 253 surveys were mailed to American Orthopaedic Foot and Ankle Society (AOFAS) members, concerning type of tourniquets, location, and pressures used. Results: Cuff pressures most commonly used were 301 to 350 mmHg for thigh cuffs (49% of thigh cuff users) and 201 to 250 mmHG for calf and ankle cuffs (52% of calf cuff users, 66% of ankle cuff users). A substantial number of foot and ankle surgeons who use calf and ankle cuffs frequently use pressures above 250 mmHg (41% of calf cuff users, 19% of ankle cuff users). Only 9% use limb occlusion pressure when determining cuff pressure. Conclusion: Based on the existing evidence-based literature these pressures may be higher than necessary for many patients, and increased adoption of optimal pressure setting techniques as reported in the literature may help reduce tourniquet pressures used and risk of tourniquet injury. Respondents reported experiencing or hearing reports of breakthrough bleeding, nerve injury, and skin injuries under the cuff.

scholarly journals Treatment of Bone Marrow Edema of the Foot and Ankle With the Prostacyclin Analog Iloprost

2018 ◽  
Vol 39 (10) ◽  
pp. 1183-1191 ◽  
Author(s):  
Hubert Hörterer ◽  
Sebastian Felix Baumbach ◽  
Johanne Gregersen ◽  
Stefanie Kriegelstein ◽  
Oliver Gottschalk ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Outcome Measures ◽  
Bone Marrow Edema ◽  
Pain Treatment ◽  
Short Form ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Prostacyclin Analog ◽  
Marrow Edema

Background: Bone marrow edema (BME) of the foot and ankle is challenging to treat. One approach is intravenous Iloprost treatment, which is a vasoactive prostacyclin analog. The aim of this study was to evaluate the early and intermediate outcome of intravenous Iloprost therapy on BME of the foot and ankle and to analyze the influence of its etiology and Association Research Circulation Osseous (ARCO) stage on the outcome. Methods: This was a retrospective study with prospective follow-up. All patients treated by intravenous Iloprost for BME of the foot and ankle (ARCO I-III) at a single orthopedic reference center were included. Demographics, medical history, and MRIs were assessed prior to treatment (t0). MRIs were used to assess the BMEs’ etiology (idiopathic/ischemic/metabolic, mechanical/degenerative, traumatic) and severity (ARCO). Complications as well as changes in pain, treatment, and MRI were evaluated after 3 months (t1). The following patient-rated outcome measures (PROMs) were assessed prospectively (t2): 12-Item Short Form Health Survey (SF-12), Visual Analog Scale Foot and Ankle (VAS FA), and the Foot Function Index (FFI) (also at t0). The descriptive outcomes and the influence of the etiology and ARCO on the outcome parameters were evaluated. Out of 70 eligible patients, 42 patients (60%; 47 ± 15 years; 30% female) with a mean follow-up of 28 ± 19 months were included. Results: Twelve patients reported minor complications during Iloprost therapy. At t1, pain decreased significantly in 56%, and the amount of BME decreased in 83% of patients. Both parameters correlated moderately (r = −0.463, P = .015). The PROMs at t2 revealed moderate results. The overall FFI improved from 59 ± 21 to 30 ± 22 ( P < .001), the overall VAS FA was 68 ± 20, the SF-12 Physical Component Summary 42 ± 12 and Mental Component Summary 50 ± 9. Subgroup analysis revealed no significant influence of the etiology or ARCO stage on any outcome measure. Conclusion: Iloprost therapy for BME of the foot and ankle resulted in a 60% pain and 80% edema decrease after 3 months. After 2 years, patient-rated outcome measures showed residual impairment. Neither the etiology nor ARCO stage significantly influenced the outcome. Level of Evidence: Level III, comparative study.

Development of health-system inpatient pharmacy clinical metrics

2019 ◽  
Vol 76 (23) ◽  
pp. 1958-1964
Author(s):  
Stacy Cassat ◽  
Lindsay Massey ◽  
Stephanie Buckingham ◽  
Tamara Kemplay ◽  
Jeff Little
Keyword(s):  
Clinical Outcome ◽  
Health System ◽  
Outcome Measures ◽  
Patient Outcomes ◽  
Assessment Tool ◽  
Time Frame ◽  
Pharmacy Services ◽  
Systematic Process ◽  
Institutional Review Board Review ◽  
The Impact

Abstract Purpose To describe a process to identify metrics that represent the impact of inpatient pharmacy services on patient outcomes across a health system. Summary The authors describe a systematic process of identifying inpatient clinical outcome measures that could represent pharmacists’ impact on patient outcomes and eventually be displayed in a dashboard within the electronic medical record (EMR). A list was generated through literature review, assessment of practices at other sites, evaluation of current pharmacy services, and collaboration with the quality department and System Pharmacy Clinical User Group. The project team narrowed the list through assessment against standardized criteria. An assessment tool was designed and distributed to stakeholders to prioritize clinical outcome measures for inclusion on the dashboard. The clinical outcome measures were transformed into metrics by determining measurement criteria, inclusion and exclusion parameters, and review time frame. After validation, the metrics are planned to be displayed on an inpatient pharmacy EMR dashboard. Exemption from institutional review board review was granted for this project. Conclusion A systematic process was developed and used to identify inpatient clinical outcome metrics.

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