Knee Injury and Osteoarthritis Outcome Score - Child: Difference between revisions

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== Development  ==
== Development  ==


Historially it was known that as there were no specific paediatric outcome measures for knee pain, therefore the KOOS for adults was being used on children. It was only in 2012 when a group of researchers decided to look at the use of the adult KOOS with children.<ref>Örtqvist M1, Roos EM, Broström EW, Janarv PM, Iversen MD. Development of the Knee Injury and Osteoarthritis Outcome Score for children (KOOS-Child):Comprehensibility and content validity. Acta Orthopaedica 2012; 83(6): 666–673</ref>&nbsp;They conducted cognitive interviews with 34 sweedish children between the ages of 10 and 16 years old. Cognitive interviews has been found to be the gold standard methodology for assessing the flaws in surveys due to lack of comprehnasion of the subjects.&nbsp;<ref>Willis G B, Royston P, Bercini D. The use of verbal report methods in the development and testing of survey questionnaires. Applied cognitive Psychology 1991; 5: 251-67.</ref><ref>Willis G B. Cognitive interviewing: A tool for improving questionnaire design. Sage Publications, Thousand Oaks 2005</ref><ref>Tourangeau R, Rips L J, Rasinski K. The psychology of survey response. Cambridge University Press, Cambridge 2002</ref>  
Historically it was known that as there were no specific paediatric outcome measures for knee pain, therefore the KOOS for adults was being used on children. It was only in 2012 when a group of researchers decided to look at the use of the adult KOOS with children.<ref>Örtqvist M1, Roos EM, Broström EW, Janarv PM, Iversen MD. Development of the Knee Injury and Osteoarthritis Outcome Score for children (KOOS-Child):Comprehensibility and content validity. Acta Orthopaedica 2012; 83(6): 666–673</ref>&nbsp;They conducted cognitive interviews with 34 Swedish children between the ages of 10 and 16 years old. Cognitive interviews has been found to be the gold standard methodology for assessing the flaws in surveys due to lack of comprehension of the subjects.&nbsp;<ref>Willis G B, Royston P, Bercini D. The use of verbal report methods in the development and testing of survey questionnaires. Applied cognitive Psychology 1991; 5: 251-67.</ref><ref>Willis G B. Cognitive interviewing: A tool for improving questionnaire design. Sage Publications, Thousand Oaks 2005</ref><ref>Tourangeau R, Rips L J, Rasinski K. The psychology of survey response. Cambridge University Press, Cambridge 2002</ref>  


It was highlighted form this study that children who had undergone knee surgery of physiotherapy had a greater understanding of the medical terminlogy than those who had not, therefore they had better comprehension of the KOOS for adults. It was recommended that due to this lack of comprehension in those who were not familiar with the terminology or younger children that the KOOS would need to be modified for them. This study did not identify a cut off age that the KOOS adult should be used but to recommend that comprehension was limited in younger children.&nbsp;<ref>Örtqvist M1, Roos EM, Broström EW, Janarv PM, Iversen MD. Development of the Knee Injury and Osteoarthritis Outcome Score for children (KOOS-Child):Comprehensibility and content validity. Acta Orthopaedica 2012; 83(6): 666–673</ref>  
It was highlighted form this study that children who had undergone knee surgery of physiotherapy had a greater understanding of the medical terminology than those who had not, therefore they had better comprehension of the KOOS for adults. It was recommended that due to this lack of comprehension in those who were not familiar with the terminology or younger children that the KOOS would need to be modified for them. This study did not identify a cut off age that the KOOS adult should be used but to recommend that comprehension was limited in younger children.&nbsp;<ref>Örtqvist M1, Roos EM, Broström EW, Janarv PM, Iversen MD. Development of the Knee Injury and Osteoarthritis Outcome Score for children (KOOS-Child):Comprehensibility and content validity. Acta Orthopaedica 2012; 83(6): 666–673</ref>  


The development of the KOOS - Child has lead to there being 5 sections with 39 questions in total. These catagories are split into:  
The development of the KOOS - Child has lead to there being 5 sections with 39 questions in total. These categories are split into:  


*Knee Problems  
*Knee Problems  
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*How has your injury affected your life
*How has your injury affected your life


Within these catagories there are:  
Within these categories there are:  


*7 questions on symptoms  
*7 questions on symptoms  
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After the development of the KOOS - Child the psychometric properties were evaluated in 2014. This study looked at children who were seeking medical attention for knee symptoms between the ages of 7-16 years old. They looked at:  
After the development of the KOOS - Child the psychometric properties were evaluated in 2014. This study looked at children who were seeking medical attention for knee symptoms between the ages of 7-16 years old. They looked at:  


*Construct validity - All of the hypothesis were confirmed therefore this indicated that there was excellend consruct validity.  
*Construct validity - All of the hypothesis were confirmed therefore this indicated that there was excellent construct validity.  
*Test-retest reliability - found that all test-retest's were excellent for all subscale except the symptoms scale which was slightly lower reliability.&nbsp;  
*Test-retest reliability - found that all test-retest's were excellent for all sub-scale except the symptoms scale which was slightly lower reliability.&nbsp;  
*Responsivness - a hypothesis of a correlation of&nbsp; ≥ 0.3 between the KOOS Child subscale scores and the Global Perceived Effect (GPE) was confirmed therefore confirming the responsivness of the KOOS Child. &nbsp;  
*Responsiveness - a hypothesis of a correlation of&nbsp; ≥ 0.3 between the KOOS Child sub-scale scores and the Global Perceived Effect (GPE) was confirmed therefore confirming the responsiveness of the KOOS Child. &nbsp;  
*Interperability - there were no floor to ceiling effects found. Minimal important changes (MIC) were found to complement the 95% Confidence Intervals (CI), and the MIC were better than the smallest detectable change (SDC) &nbsp;for subjects who reported they were 'better' and 'much better'<br>
*Interperability - there were no floor to ceiling effects found. Minimal important changes (MIC) were found to complement the 95% Confidence Intervals (CI), and the MIC were better than the smallest detectable change (SDC) &nbsp;for subjects who reported they were 'better' and 'much better'<br>


Overall the KOOS-Child shows excellent psychometric properties in all areas except internal consistency where the catagory 'symptoms' as this showed lower homogeneity, which is similar to the KOOS - Adult and this is explained as a patients can experience a wide variety of symptoms with knee conditions. &nbsp;<br>  
Overall the KOOS-Child shows excellent psychometric properties in all areas except internal consistency where the category 'symptoms' as this showed lower homogeneity, which is similar to the KOOS - Adult and this is explained as a patients can experience a wide variety of symptoms with knee conditions. &nbsp;<br>  


== Uses&nbsp;  ==
== Uses&nbsp;  ==


Unlike the KOOS - Adult where certain conditions are recommended for it's use the KOOS - Child can be used in a broad population of children with different knee disorders.<ref>Örtqvist M, Iversen MD, Janarv P-M, Broström EW, Roos EM. Psychometric properties of the Knee injury and Osteoarthritis Outcome Score for Children (KOOS-Child) in children with knee disorders. British Journal of Sports Medicine 2014; 48:1437–1446</ref> This [http://www.physio-pedia.com/Paediatric_Knee page]&nbsp;on paediatric knee disorders explorers different pathologies which it may be used for.&nbsp;  
Unlike the KOOS - Adult where certain conditions are recommended for it's use the KOOS - Child can be used in a broad population of children with different knee disorders.<ref>Örtqvist M, Iversen MD, Janarv P-M, Broström EW, Roos EM. Psychometric properties of the Knee injury and Osteoarthritis Outcome Score for Children (KOOS-Child) in children with knee disorders. British Journal of Sports Medicine 2014; 48:1437–1446</ref> This [http://www.physio-pedia.com/Paediatric_Knee page]&nbsp;on paediatric knee disorders explorers different pathological which it may be used for.&nbsp;  


== Scoring  ==
== Scoring  ==
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=== Calculating the score  ===
=== Calculating the score  ===


Each subcatagory is then added together. for example all the questions relating to pain are numbered P1, P2, P3, all the questions relating to symptoms are numbered S1, S2, S3 etc.&nbsp;<br>  
Each subcategory is then added together. for example all the questions relating to pain are numbered P1, P2, P3, all the questions relating to symptoms are numbered S1, S2, S3 etc.&nbsp;<br>  


The following is the manual calculation once you have done this you will have&nbsp;the KOOS-Child subscale estimate for that particular<br>cross-sectional assessment of the individual patient:  
The following is the manual calculation once you have done this you will have&nbsp;the KOOS-Child subscale estimate for that particular<br>cross-sectional assessment of the individual patient:  


[[Image:KOOS Child calc.png|center]]Alternativley there is an excel spreadsheet which is downloadable from this [http://www.koos.nu/ website]. The files name is the updated scoring file.&nbsp;  
[[Image:KOOS Child calc.png|center]]Alternatively there is an excel spreadsheet which is downloadable from this [http://www.koos.nu/ website]. The files name is the updated scoring file.&nbsp;  


== Resources&nbsp;  ==
== Resources&nbsp;  ==

Revision as of 21:55, 20 November 2016

Original Editor - Michelle Lee Top Contributors - Michelle Lee, Evan Thomas, Kim Jackson, Admin, WikiSysop, Vidya Acharya and Rucha Gadgil

Introduction[edit | edit source]

The knee injury osteoarthritis score (KOOS) is an adult outcome measure used for assessing the patients perspectives of their knee pain and disability. This tool was developed initially to use on adults, which you can read about in more detail on this page. The KOOS pschometric properties have shown highly reliability, validity, and is responsive to change in subjects with knee degeneration or with a knee injury.[1] 

Development[edit | edit source]

Historically it was known that as there were no specific paediatric outcome measures for knee pain, therefore the KOOS for adults was being used on children. It was only in 2012 when a group of researchers decided to look at the use of the adult KOOS with children.[2] They conducted cognitive interviews with 34 Swedish children between the ages of 10 and 16 years old. Cognitive interviews has been found to be the gold standard methodology for assessing the flaws in surveys due to lack of comprehension of the subjects. [3][4][5]

It was highlighted form this study that children who had undergone knee surgery of physiotherapy had a greater understanding of the medical terminology than those who had not, therefore they had better comprehension of the KOOS for adults. It was recommended that due to this lack of comprehension in those who were not familiar with the terminology or younger children that the KOOS would need to be modified for them. This study did not identify a cut off age that the KOOS adult should be used but to recommend that comprehension was limited in younger children. [6]

The development of the KOOS - Child has lead to there being 5 sections with 39 questions in total. These categories are split into:

  • Knee Problems
  • How Painful
  • Difficulty during daily activities 
  • Difficulty during sport and playing
  • How has your injury affected your life

Within these categories there are:

  • 7 questions on symptoms
  • 8 questions on pain
  • 11 questions on activities 
  • 7 questions on sports and play, and 
  • 6 questions on quality of life 

Psychometric Properties [7][edit | edit source]

After the development of the KOOS - Child the psychometric properties were evaluated in 2014. This study looked at children who were seeking medical attention for knee symptoms between the ages of 7-16 years old. They looked at:

  • Construct validity - All of the hypothesis were confirmed therefore this indicated that there was excellent construct validity.
  • Test-retest reliability - found that all test-retest's were excellent for all sub-scale except the symptoms scale which was slightly lower reliability. 
  • Responsiveness - a hypothesis of a correlation of  ≥ 0.3 between the KOOS Child sub-scale scores and the Global Perceived Effect (GPE) was confirmed therefore confirming the responsiveness of the KOOS Child.  
  • Interperability - there were no floor to ceiling effects found. Minimal important changes (MIC) were found to complement the 95% Confidence Intervals (CI), and the MIC were better than the smallest detectable change (SDC)  for subjects who reported they were 'better' and 'much better'

Overall the KOOS-Child shows excellent psychometric properties in all areas except internal consistency where the category 'symptoms' as this showed lower homogeneity, which is similar to the KOOS - Adult and this is explained as a patients can experience a wide variety of symptoms with knee conditions.  

Uses [edit | edit source]

Unlike the KOOS - Adult where certain conditions are recommended for it's use the KOOS - Child can be used in a broad population of children with different knee disorders.[8] This page on paediatric knee disorders explorers different pathological which it may be used for. 

Scoring[edit | edit source]

Each question has 5 possible answers each score ranging from 0-4. The answer which is least sever is scores a 0 and the most sever is scored a 4. For example:

  1. During the past month, how often have you experienced knee pain?  
  • Never = 0
  • Rarely = 1
  • Sometimes = 2
  • Often = 3
  • Always = 4

Calculating the score[edit | edit source]

Each subcategory is then added together. for example all the questions relating to pain are numbered P1, P2, P3, all the questions relating to symptoms are numbered S1, S2, S3 etc. 

The following is the manual calculation once you have done this you will have the KOOS-Child subscale estimate for that particular
cross-sectional assessment of the individual patient:

KOOS Child calc.png

Alternatively there is an excel spreadsheet which is downloadable from this website. The files name is the updated scoring file. 

Resources [edit | edit source]

References

  1. ↑ Roos E M, Roos H P, Ekdahl C, Lohmander L S. Knee injury and Osteoarthritis Outcome Score (KOOS)—validation of a Swedish version. Scandinavian Journal of Medical Science and Sports 1998; 8:439-48.
  2. ↑ Örtqvist M1, Roos EM, Broström EW, Janarv PM, Iversen MD. Development of the Knee Injury and Osteoarthritis Outcome Score for children (KOOS-Child):Comprehensibility and content validity. Acta Orthopaedica 2012; 83(6): 666–673
  3. ↑ Willis G B, Royston P, Bercini D. The use of verbal report methods in the development and testing of survey questionnaires. Applied cognitive Psychology 1991; 5: 251-67.
  4. ↑ Willis G B. Cognitive interviewing: A tool for improving questionnaire design. Sage Publications, Thousand Oaks 2005
  5. ↑ Tourangeau R, Rips L J, Rasinski K. The psychology of survey response. Cambridge University Press, Cambridge 2002
  6. ↑ Örtqvist M1, Roos EM, Broström EW, Janarv PM, Iversen MD. Development of the Knee Injury and Osteoarthritis Outcome Score for children (KOOS-Child):Comprehensibility and content validity. Acta Orthopaedica 2012; 83(6): 666–673
  7. ↑ Örtqvist M, Iversen MD, Janarv P-M, Broström EW, Roos EM. Psychometric properties of the Knee injury and Osteoarthritis Outcome Score for Children (KOOS-Child) in children with knee disorders. British Journal of Sports Medicine 2014; 48:1437–1446
  8. ↑ Örtqvist M, Iversen MD, Janarv P-M, Broström EW, Roos EM. Psychometric properties of the Knee injury and Osteoarthritis Outcome Score for Children (KOOS-Child) in children with knee disorders. British Journal of Sports Medicine 2014; 48:1437–1446
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