We read with interest the review by Ng et al (
1
) concerning the use of patient-reported outcome measures (PROMs) after ankle fracture. Their report sets out their aim to systematically identify the most appropriate functional foot and ankle PROM for use in the ankle fracture populations, as rated by the PROMs' psychometric properties.The authors concluded that the ankle fracture outcome of rehabilitation measure (A-FORM) (
2
) questionnaire is the most rigorously designed questionnaire chiefly because of the robust psychometric methods used to the develop the score, a conclusion with which we agree—despite the lack of contemporary use of the A-FORM in widespread research and clinical practice.We believe however the authors have made two notable omissions in their wider search strategy. First, although the Medical Outcomes Study 36-item short form health survey (SF-36) was included in their review, the EuroQoL EQ-5D was conspicuous by its absence, despite having been used with ankle fractures (
3
). Both the EQ-5D-3L and EQ-5D-5L versions have undergone extensive and structured psychometric development and, of increasing importance, possess the capacity for use within economic evaluations.Second, the authors discounted the Olerud and Molander (O&M) ankle score (
4
), which is the most widely used outcome measure for patients after ankle fracture, as correctly noted by Ng et al (1
). However, they erroneously suggest the score has not been validated. Although not evaluated at the time of construction (the O&M score was devised in the early 1980s when the psychometric properties of outcome measures were poorly understood), we would draw the authors attention to Ponzer et al (5
), Lash et al (3
), Shah et al (6
), and Nilsson et al (7
). The work of these investigators was sadly missed in the construction of their review, and, as a body of work, we believe is widely considered to have contributed to retrospective validation of the O&M score.We would be delighted to hear the authors' views on the concerns we have raised.
References
- Measuring recovery after ankle fractures: a systematic review of the psychometric properties of scoring systems.J Foot Ankle Surg. 2018; 57: 149-154
- Development and validation of the ankle fracture outcome of rehabilitation measure (A-FORM).J Orthop Sports Phys Ther. 2014; 7: 488-499
- Ankle fractures: functional and lifestyle outcomes at 2 years.ANZ J Surg. 2002; 72: 724-730
- A scoring scale for symptom evaluation after ankle fracture.Arch Orthop Trauma Surg. 1984; 103: 190-194
- Functional outcome and quality of life in patients with type B ankle fractures: a two-year follow-up study.J Orthop Trauma. 1999; 13: 363-368
- Five-year functional outcome analysis of ankle fracture fixation.Injury. 2007; 38: 1308-1312
- The Swedish version of OMAS is a reliable and valid outcome measure for patients with ankle fractures.BMC Musculoskelet Disord. 2013; 14: 109
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Published online: April 24, 2018
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© 2018 by the American College of Foot and Ankle Surgeons. All rights reserved.
