title: Development of a methodological PubMed search filter for finding studies on measurement properties of measurement instruments The reliability, validity and responsiveness of an aggregated locomotor function (ALF) score in patients with osteoarthritis of the knee. Comparison of the responsiveness of the Harris Hip Score with generic measures for hip function in osteoarthritis of the hip OMERACT-OARSI initiative: Osteoarthritis Research Society International set of responder criteria for osteoarthritis clinical trials revisited. Tests of walking ability at different speeds in patients with knee osteoarthritis. A comparison of 3 methodological approaches to defining major clinically important improvement of 4 performance measures in patients with hip osteoarthritis.
abstract: Objectives For the measurement of  patient-reported outcomes , such as ( health-related ) quality of life , often many measurement instruments exist that intend to measure the same construct . To facilitate instrument selection , our aim was to develop a highly sensitive search filter for finding studies on measurement properties of measurement instruments in PubMed and a more precise search filter that needs less abstract s to be screened , but at a higher risk of missing relevant studies . Methods A r and om sample of 10,000 PubMed records ( 01 - 01 - 1990 to 31 - 12 - 2006 ) was used as a gold st and ard . Studies on measurement properties were identified using an exclusion filter and h and search ing . Search terms were selected from the relevant records in the gold st and ard as well as from 100 systematic review s of measurement properties and combined based on sensitivity and precision . The performance of the filters was tested in the gold st and ard as well as in two validation sets , by calculating sensitivity , precision , specificity , and number needed to read . Results We identified 116 studies on measurement properties in the gold st and ard . The sensitive search filter was able to retrieve 113 of these 116 studies ( sensitivity 97.4 % , precision 4.4 % ) . The precise search filter had a sensitivity of 93.1 % and a precision of 9.4 % . Both filters performed very well in the validation sets . Conclusion The use of these search filters will contribute to evidence -based selection of measurement instruments in all medical fields OBJECTIVES The aggregated locomotor function ( ALF ) score , a simple measure of observed locomotor function , using timed walking , stairs and transfers , was developed and evaluated for intra-tester reliability , criterion-related validity and responsiveness in a sample of patients with knee osteoarthritis . METHODS Patients with knee osteoarthritis ( n = 214 ) were recruited for inclusion in a r and omized controlled trial investigating two methods of exercise provision . Before treatment , patients completed the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) and Short Form 36 health survey ( SF-36 ) question naires and were timed whilst performing an 8 m walk , ascending and descending a set of gymnasium stairs and completing a test of transferring in and out of a chair . A group of 15 patients also undertook a replicate test-retest reliability study of the above outcome measures . St and ardized response means were calculated for the ALF , WOMAC and SF-36 from data from the clinical trial . RESULTS The ALF takes 10 min to administer and demonstrated excellent intra-tester reliability , with excellent intra-class correlation coefficient ( ICC ) statistics ( ICC(2,k ) 0.99 ; 95 % CI 0.98 - 0.99 ) , and low st and ard error of measurement ( 0.86 s ) and smallest detectable difference ( 9.5 % ) values . Criterion-related validity with the physical function dimensions of the WOMAC and SF-36 was good , with correlation coefficients of 0.59 and - 0.53 respectively . St and ardized response means were higher for the ALF ( 0.49 ) than for both the WOMAC ( 0.39 ) and the SF-36 ( 0.12 ) . CONCLUSIONS This work has demonstrated that the ALF can be used as a measure of physical function status and as a means of quantifying treatment response . The measure offers a simple and convenient outcome in the assessment and treatment of locomotor dysfunction . The ALF score is a reliable , valid and responsive outcome measure over 12 months and can be recommended for use in the evaluation of patients with knee osteoarthritis Objective : To compare responsiveness of the Harris Hip Score with generic measures ( that is , the Short Form-36 ( SF-36 ) , and a test of walking speed and pain during walking ) in patients with osteoarthritis ( OA ) of the hip . Method : The first 75 cases within the population of a r and omised clinical trial on manual therapy and exercise therapy  were selected for secondary analysis . Experienced ( self reported ) recovery by the patients after treatment ( five weeks ) was used as an external criterion for clinical ly relevant improvement . Responsiveness was evaluated by comparing responsiveness ratios and receiver operating characteristic curves . Results : The responsiveness ratio for the Harris Hip Score was high ( 1.70 ) compared with walking speed ( 0.45 ) , pain during walking ( 0.66 ) , and the subscales of the SF-36—“bodily pain ” ( 0.42 ) and “ physical functioning ” ( 0.36 ) . The area under the curve also was highest for the Harris Hip Score ( 0.92 ) compared with walking speed ( 0.71 ) , pain during walking ( 0.73 ) , and the SF-36 subscales — bodily pain and physical functioning ( both 0.66 ) . Conclusion : The Harris Hip Score  is more responsive than the test of walking speed , pain , and subscales for function of the SF-36 in patients with OA of the hip . The Harris Hip Score seems to be a suitable instrument to evaluate change in hip function in patients with OA of the hip BACKGROUND The OARSI St and ing Committee for Clinical Trials Response Criteria Initiative had developed two sets of responder criteria to present the results of changes after treatment in three symptomatic domains ( pain , function , and patient 's global assessment ) as a single variable for clinical trials ( 1 ) . For each domain , a response was defined by both a relative and an absolute change , with different cut-offs with regard to the drug , the route of administration and the OA localization . OBJECTIVE To propose a simplified set of responder criteria with a similar cut-off , whatever the drug , the route or the OA localization . METHODS Data driven approach : ( 1 ) Two data bases were considered : the " elaboration " data base with which the formal OARSI sets of responder criteria were elaborated , and the " revisit " data base . ( 2 ) Six different scenarios were evaluated : The two formal OARSI sets of criteria ; Four proposed scenarios of simplified sets of criteria . Data from clinical r and omized blinded placebo controlled trials were used to evaluate the performances of the two formal scenarios with two different data bases ( " elaboration " versus " revisit " ) and those of the four proposed simplified scenarios within the " revisit " data base . The placebo effect , active effect , treatment effect , and the required sample arm size to obtain the placebo effect and the active treatment effect observed were the performances evaluated for each of the six scenarios . Experts ' opinion approach : Results were discussed among the participants of the OMERACT VI meeting , who voted to select the definite OMERACT-OARSI set of criteria ( one of the six evaluated scenarios ) . RESULTS Data driven approach : Fourteen trials totaling 1886 OA patients and fifteen studies involving 8164 OA patients were evaluated in the " elaboration " and the " revisit " data bases respectively . The variability of the performances observed in the " revisit " data base when using the different simplified scenarios was similar to that observed between the two data bases ( " elaboration " versus " revisit " ) when using the formal scenarios . The treatment effect and the required sample arm size were similar for each set of criteria . Experts ' opinion approach : According to the experts , these two previous performances were the most important of an optimal set of responder criteria . They chose the set of criteria considering both pain and function as evaluation domain and requiring an absolute change and a relative change from baseline to define a response , with similar cut-offs whatever the drug , the route of administration or the OA localization . CONCLUSION This data driven and experts ' opinion approach is the basis for proposing an optimal simplified set of responder criteria for OA clinical trials . Other studies , using other sets of OA patients , are required in order to further vali date this proposed OMERACT-OARSI set of criteria BACKGROUND AND PURPOSE Measurements of walking speeds are commonly used as an objective measure of functional performance in patients with knee osteoarthritis ( OA ) and are easily performed in a clinical setting . However , the choice in which the walking speed evaluation should be performed is controversial . The aim of this study was to identify the most discriminating walking speed after surgical interventions in patients with knee osteoarthritis , and to compare the responsiveness of the different gait speeds . METHOD A prospect i ve clinical one-year follow-up study involving 54 patients with knee osteoarthritis ( 63 ( + /-5 ) years of age ) who were operated with either a unicompartmental knee arthroplasty or a high tibial osteotomy was undertaken . Thirty-nine patients had unilateral knee OA and 15 patients had bilateral knee OA or other symptoms from the lower extremities that could influence walking . The patients were examined at a gait laboratory before surgery , and one year after surgery . The patients were instructed to walk at slow , normal and fast walking speed . RESULTS All patients ( n=54 ) walked.faster one year after the surgical intervention compared to before surgery ( p = 0.001 ) at slow ( + 15 % ) , normal ( + 8 % ) and fast ( + 7 % ) walking speed . This increase was similar for the three walking speeds ( p = 0.171 ) . Patients with unilateral knee OA ( n=39 ) reached an average change of + 0.12 m/s , which was considered clinical ly important , while patients with bilateral knee OA ( n=15 ) did not increase their walking speed > 0.12 m/s . Effect size was moderate for slow walking speed and small for normal and fast walking speeds , respectively . CONCLUSIONS The different walking speeds were equally good in detecting changes one year after surgical interventions . In this study , responsiveness favoured slow walking speed , however , the advantages of normal walking speed are discussed STUDY DESIGN Prospect i ve cohort study . OBJECTIVES To establish the major clinical ly important improvement ( MCII ) of the timed up- and -go test ( TUG ) , 40-meter self-paced walk test ( 40-m SPWT ) , 30-second chair st and ( 30 CST ) , and a 20-cm step test in patients with hip osteoarthritis ( OA ) undergoing physiotherapy treatment . As a secondary aim , a comparison of methods was employed to evaluate the effect of method on the reported MCII . BACKGROUND Minimal clinical ly important difference scores are commonly used by rehabilitation professionals to determine patient response following treatment . A gold st and ard for calculating MCII has yet to be determined , which has result ed in problems of interpretation due to varied results . METHODS As part of a r and omized controlled trial , 65 patients were r and omized into a physiotherapy treatment group for hip OA , in which they completed 4 physical performance measures at baseline and 9 weeks . Upon completion of physiotherapy , patients assessed their response to treatment on a 15-point global rating of change scale ( GRCS ) . MCII was estimated using 3 variations of an anchor-based method , based on the patient 's opinion . RESULTS A comparison of 3 methods result ed in the following change scores being best associated with our definition of MCII : a reduction equal to or greater than 0.8 , 1.4 , and 1.2 seconds for the TUG ; an increase equal to or greater than 0.2 , 0.3 , and 0.2 m/s for the 40-m SPWT ; an increase equal to or greater than 2.0 , 2.6 , and 2.1 repetitions for the 30 CST ; an increase equal to or greater than 5.0 , 12.8 , and 16.4 steps for the 20-cm step test . CONCLUSION The variation in methods provided very different results . This illustrates the importance of comparing method ologies and reporting a range of values associated with the MCII , as such values vary , depending upon the methodology chosen
target: On balance of the limited evidence , the 40 m self-paced test was the best rated walk test , the 30 s-chair st and test and timed up and go test were the best rated sit to st and tests , and the Stratford battery , Physical Activity Restrictions and Functional Assessment System were the best rated multi-activity measures .
background: OBJECTIVES To systematic ally review the measurement properties of performance-based measures to assess physical function in people with hip and /or knee osteoarthritis ( OA ) .