Kristian Thorborg's Phd Thesis

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from patients about a health condition and its treatment.[4,5] The need for reliable and valid PRO instruments is emphasised in a study by Marshall et al.,[82] who demonstrated that clinical trials using unpublished measurement instruments were more likely to report positive effects of treatment than clinical trials using published instruments. Therefore, in order to properly evaluate the large spectrum of treatment strategies and regimens for young to middle-aged physically active patients with hip and groin pain, knowledge of validity, reliability and responsiveness of PRO questionnaires are needed. In the literature, validated patient-reported outcome measures exist for physically active patients with musculoskeletal conditions such as shoulder,[83,84] knee[85-88] and ankle pathology,[89-91] including both traumatic and overuse scenarios, and these instruments have played an important role in the evaluation of different treatments,[92-94] where the patient’s perspective and health-related quality of life is of primary interest. Validity, reliability and responsiveness of clinical outcome measures The concepts of validity, reliability and responsiveness are important to understand when measurement instruments are used in research or clinical practice. In a recent international consensus process, including leading experts in the field of psychology, epidemiology, statistics and clinical medicine from all over the world, consensus on the taxonomy, terminology and definitions of measurement properties for outcome measurements instruments was reached.[95] It was formulated in a COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist.[96] The COSMIN taxonomy comprises three domains (reliability, validity and responsiveness), which contain the measurement properties. Interpretability is also part of the taxonomy and the checklist, although it was not considered a measurement property (Figure 8). 20
Figure 8. The COSMIN taxonomy. Adapted from www.cosmin.nl. Reliability encompasses internal consistency, reliability (reproducibility) and measurement error. Validity encompasses content validity, including face validity, criterion validity and construct validity. Internal consistency is the degree of interrelatedness among the items e.g. in a questionnaire.[1]. Reliability is the extent to which scores for the same patients are unchanged for repeated measurements over time.[1]. Measurement error is the systematic and random error of a patient’s score that is not attributed to true changes in the construct to be measured.[1] Criterion validity is the degree to which scores of a measurement instrument are an adequate reflection of a “gold standard”.[95] Construct validity is the degree to which the scores of a PRO instrument are consistent with a priori hypotheses, based on the assumption that the PRO instrument validly measures the construct to be measured.[1] Responsiveness is defined as the ability of a the instrument to detect change over time in the construct to be measured.[1] Interpretability is the degree to which one can assign qualitative meaning to an instrument’s quantitative scores or change in scores.[1] 21
Page 1 and 2: F A C U L T Y O F H E A L T H S C I
Page 3 and 4: I shall be telling this with a sigh
Page 5 and 6: ACKNOWLEDGEMENTS First of all I wou
Page 7 and 8: LIST OF PUBLICATIONS 2 ABBREVIATION
Page 9 and 10: ABBREVIATIONS ABD Abduction ADD Add
Page 11 and 12: Patient-Reported Outcome (PRO) A PR
Page 13 and 14: THESIS AT A GLANCE Study Question M
Page 15 and 16: playing organised football, and tha
Page 17: evaluated in these studies (Table 1
Page 20 and 21: Muscle strength testing Muscle stre
Page 22 and 23: lower arms between the feet of the
Page 24 and 25: Eccentric strength testing has show
Page 28 and 29: AIMS AND HYPOTHESES The overall aim
Page 30 and 31: Study selection Two reviewers (KT a
Page 32 and 33: Characteristics of studies and inst
Page 34 and 35: the reviewers had overlooked specif
Page 36 and 37: Figure 10. Flowchart of the study p
Page 38 and 39: Figure 11. Clinical study profile I
Page 40 and 41: term “hip and/or groin”, we bel
Page 42 and 43: test-retest ICC should be � 0.70
Page 44 and 45: Floor and ceiling effects are prese
Page 46 and 47: Table 7. Baseline characteristics 4
Page 48 and 49: item, and/or a test-retest reliabil
Page 50 and 51: Testing the final version of HAGOS
Page 52 and 53: Responsiveness As hypothesized, cha
Page 54 and 55: STUDY III Clinical assessment of hi
Page 56 and 57: etest. Relative reliability is the
Page 58 and 59: external rotation-sitting position
Page 60 and 61: andomised before the testing sessio
Page 62 and 63: Hip torque values are shown in Figu
Page 64 and 65: DISCUSSION This thesis is based on
Page 66 and 67: Development of a new patient-report
Page 68 and 69: Construct validity (HAGOS) Validati
Page 70 and 71: minimal change, the estimates fall
Page 72 and 73: without causing stabilisation probl
Page 74 and 75: Groin pain affecting muscle strengt
Page 76 and 77:
CONCLUSION � Reliable, valid and
Page 78 and 79:
SUMMARY Clinical outcome measures f
Page 80 and 81:
assessment of symptoms, activity li
Page 82 and 83:
undersøgelse (studie III) var form
Page 84 and 85:
REFERENCES 1. Mokkink LB, Terwee CB
Page 86 and 87:
30. Birrell F, Lunt M, Macfarlane G
Page 88 and 89:
59. Stratford PW, Balsor BE. A comp
Page 90 and 91:
89. Martin RL, Irrgang JJ, Burdett
Page 92 and 93:
115. Thorborg K, Roos E, Bartels EM
Page 94 and 95:
143. Byrd JW, Jones KS. Arthroscopi
Page 96 and 97:
168. Lequesne MG, Mery C, Samson M,
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Kristian Thorborg's Phd Thesis

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