Abstract
The European Foot and Ankle Society score is a popular tool for monitoring treatment
outcomes of foot or ankle conditions. However, few studies have assessed its psychometric
properties in patients with hallux valgus. We aimed to validate the European Foot
and Ankle Society score in patients with hallux valgus in Singapore. This is a cohort
study of 121 patients with operatively managed hallux valgus from a tertiary referral
hospital, evaluated preoperatively and at 6 months postoperatively with the primary
endpoint of restoring patients to premorbid status. Internal consistency was assessed
via Cronbach's alpha. Construct validity was assessed through 7 a priori hypotheses by correlating the European Foot and Ankle Society score with other patient‐reported
outcomes measures. Structural validity was assessed via Confirmatory Factor Analysis,
whereby a good fit was indicated when Comparative Fit Index >0.95, Tucker‐Lewis Index
>0.95, Root Mean Square Error of Approximation <0.06, and Standardized Root Mean Residuals
<0.08. Among our subjects, the European Foot and Ankle Society score demonstrated
reliability, reflected by a good internal consistency (Cronbach's alpha = 0.773).
Six out of the 7 a priori hypotheses were fulfilled, indicating both convergent and divergent construct validity.
Structural validity was confirmed with our European Foot and Ankle Society score model
which showed good fit for a 1‐factor structure (Confirmatory Factor Analysis = 0.998,
Tucker‐Lewis Index = 0.996, Root Mean Square Error of Approximation = 0.025 [90% CI:
0-0.111], Standardized Root Mean Residuals = 0.027). In conclusion, the European Foot
and Ankle Society score was validated for monitoring treatment outcomes of patients
with hallux valgus in Singapore.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: August 14, 2022
Footnotes
Financial Disclosure: This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.
Conflict of Interest: None reported.
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© 2022 by the American College of Foot and Ankle Surgeons. All rights reserved.
