A 12-item short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-12): tests of reliability, validity and responsiveness

B. Gandek; E. M. Roos; Patricia Durkin Franklin; J. E. Ware

doi:10.1016/j.joca.2019.01.011

A 12-item short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-12): tests of reliability, validity and responsiveness

B. Gandek^*, E. M. Roos, Patricia Durkin Franklin, J. E. Ware

^*Corresponding author for this work

Medical Social Sciences

Research output: Contribution to journal › Article › peer-review

64 Scopus citations

Abstract

Objective: To evaluate reliability, validity and responsiveness of KOOS-12, a 12-item short form of the 42-item Knee injury and Osteoarthritis Outcome Score (KOOS) that provides Pain, Function and Quality of Life (QOL) scale scores and a summary knee impact score. Design: Data from 1,392 knee osteoarthritis (OA) patients from the FORCE-TJR research cohort who completed KOOS before and 6 and 12 months after total knee replacement (TKR) were analyzed. KOOS-12 includes a pain frequency item and three items measuring pain during increasingly difficult (sitting/lying, walking, stairs) activities; function items about standing, rising from sitting, getting in/out of a car, and twisting/pivoting; and the 4-item KOOS QOL scale. Percent computable scale scores, floor and ceiling effects, internal consistency reliability, validity (scale correlations, tests of known groups validity using one-way analysis of variance (ANOVA)) and responsiveness (effect sizes, standardized response means) were compared for the KOOS-12, full-length KOOS, KOOS-PS and KOOS, JR. Results: Internal consistency reliability was above 0.70 for all KOOS-12 scales and ≥0.90 for the KOOS-12 Summary score. Validity and responsiveness of KOOS-12 Pain, Function and QOL scales was satisfactory and reached similar conclusions as comparable full-length KOOS scales. The KOOS-12 Summary score was most responsive in discriminating between groups who differed in global ratings of post-TKR change in physical capabilities and had the highest effect sizes and standardized response means. Conclusions: KOOS-12 was a reliable and valid alternative to KOOS in TKR patients with moderate to severe OA and provided three domain-specific and summary knee impact scores with substantially reduced respondent burden.

Original language	English (US)
Pages (from-to)	762-770
Number of pages	9
Journal	Osteoarthritis and Cartilage
Volume	27
Issue number	5
DOIs	https://doi.org/10.1016/j.joca.2019.01.011
State	Published - May 2019

Funding

This research was supported by AHRQ grant R03 HS024632 (Gandek PI) and a FORCE-TJR program project award (P50 HS018910, Franklin PI) to the Department of Orthopedics and Physical Rehabilitation at the University of Massachusetts Medical School. The funding sources did not play any role in the study design, collection, analysis or interpretation of data, in the writing of the manuscript, or in the decision to submit the manuscript for publication. The opinions expressed in this document are those of the authors and do not reflect the official position of AHRQ or the U.S. Department of Health and Human Services. The authors thank Jakob Bjorner, MD, PhD for psychometric consultation; Nina Deng, EdD for developing the relative validity bootstrapping software; Celeste Lemay RN, MPH, Wenyun Yang, MS and Hua Zheng, PhD for data and computer support; and the researchers, clinicians and patients who provided feedback on KOOS and HOOS item content and translations. This research was supported by AHRQ grant R03 HS024632 (Gandek PI) and a FORCE-TJR program project award (P50 HS018910, Franklin PI) to the Department of Orthopedics and Physical Rehabilitation at the University of Massachusetts Medical School. The funding sources did not play any role in the study design, collection, analysis or interpretation of data, in the writing of the manuscript, or in the decision to submit the manuscript for publication. The opinions expressed in this document are those of the authors and do not reflect the official position of AHRQ or the U.S. Department of Health and Human Services. This research was supported by AHRQ grant R03 HS024632 (Gandek PI) and a FORCE-TJR program project award ( P50 HS018910 , Franklin PI) to the Department of Orthopedics and Physical Rehabilitation at the University of Massachusetts Medical School . The funding sources did not play any role in the study design, collection, analysis or interpretation of data, in the writing of the manuscript, or in the decision to submit the manuscript for publication. The opinions expressed in this document are those of the authors and do not reflect the official position of AHRQ or the U.S. Department of Health and Human Services.

Keywords

KOOS
Knee
Osteoarthritis
Patient-reported outcome measures
Psychometrics

ASJC Scopus subject areas

Rheumatology
Biomedical Engineering
Orthopedics and Sports Medicine

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10.1016/j.joca.2019.01.011

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title = "A 12-item short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-12): tests of reliability, validity and responsiveness",

abstract = "Objective: To evaluate reliability, validity and responsiveness of KOOS-12, a 12-item short form of the 42-item Knee injury and Osteoarthritis Outcome Score (KOOS) that provides Pain, Function and Quality of Life (QOL) scale scores and a summary knee impact score. Design: Data from 1,392 knee osteoarthritis (OA) patients from the FORCE-TJR research cohort who completed KOOS before and 6 and 12 months after total knee replacement (TKR) were analyzed. KOOS-12 includes a pain frequency item and three items measuring pain during increasingly difficult (sitting/lying, walking, stairs) activities; function items about standing, rising from sitting, getting in/out of a car, and twisting/pivoting; and the 4-item KOOS QOL scale. Percent computable scale scores, floor and ceiling effects, internal consistency reliability, validity (scale correlations, tests of known groups validity using one-way analysis of variance (ANOVA)) and responsiveness (effect sizes, standardized response means) were compared for the KOOS-12, full-length KOOS, KOOS-PS and KOOS, JR. Results: Internal consistency reliability was above 0.70 for all KOOS-12 scales and ≥0.90 for the KOOS-12 Summary score. Validity and responsiveness of KOOS-12 Pain, Function and QOL scales was satisfactory and reached similar conclusions as comparable full-length KOOS scales. The KOOS-12 Summary score was most responsive in discriminating between groups who differed in global ratings of post-TKR change in physical capabilities and had the highest effect sizes and standardized response means. Conclusions: KOOS-12 was a reliable and valid alternative to KOOS in TKR patients with moderate to severe OA and provided three domain-specific and summary knee impact scores with substantially reduced respondent burden.",

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author = "B. Gandek and Roos, {E. M.} and Franklin, {Patricia Durkin} and Ware, {J. E.}",

note = "Publisher Copyright: {\textcopyright} 2019 Osteoarthritis Research Society International",

year = "2019",

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doi = "10.1016/j.joca.2019.01.011",

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T1 - A 12-item short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-12)

T2 - tests of reliability, validity and responsiveness

AU - Gandek, B.

AU - Roos, E. M.

AU - Franklin, Patricia Durkin

AU - Ware, J. E.

PY - 2019/5

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N2 - Objective: To evaluate reliability, validity and responsiveness of KOOS-12, a 12-item short form of the 42-item Knee injury and Osteoarthritis Outcome Score (KOOS) that provides Pain, Function and Quality of Life (QOL) scale scores and a summary knee impact score. Design: Data from 1,392 knee osteoarthritis (OA) patients from the FORCE-TJR research cohort who completed KOOS before and 6 and 12 months after total knee replacement (TKR) were analyzed. KOOS-12 includes a pain frequency item and three items measuring pain during increasingly difficult (sitting/lying, walking, stairs) activities; function items about standing, rising from sitting, getting in/out of a car, and twisting/pivoting; and the 4-item KOOS QOL scale. Percent computable scale scores, floor and ceiling effects, internal consistency reliability, validity (scale correlations, tests of known groups validity using one-way analysis of variance (ANOVA)) and responsiveness (effect sizes, standardized response means) were compared for the KOOS-12, full-length KOOS, KOOS-PS and KOOS, JR. Results: Internal consistency reliability was above 0.70 for all KOOS-12 scales and ≥0.90 for the KOOS-12 Summary score. Validity and responsiveness of KOOS-12 Pain, Function and QOL scales was satisfactory and reached similar conclusions as comparable full-length KOOS scales. The KOOS-12 Summary score was most responsive in discriminating between groups who differed in global ratings of post-TKR change in physical capabilities and had the highest effect sizes and standardized response means. Conclusions: KOOS-12 was a reliable and valid alternative to KOOS in TKR patients with moderate to severe OA and provided three domain-specific and summary knee impact scores with substantially reduced respondent burden.

AB - Objective: To evaluate reliability, validity and responsiveness of KOOS-12, a 12-item short form of the 42-item Knee injury and Osteoarthritis Outcome Score (KOOS) that provides Pain, Function and Quality of Life (QOL) scale scores and a summary knee impact score. Design: Data from 1,392 knee osteoarthritis (OA) patients from the FORCE-TJR research cohort who completed KOOS before and 6 and 12 months after total knee replacement (TKR) were analyzed. KOOS-12 includes a pain frequency item and three items measuring pain during increasingly difficult (sitting/lying, walking, stairs) activities; function items about standing, rising from sitting, getting in/out of a car, and twisting/pivoting; and the 4-item KOOS QOL scale. Percent computable scale scores, floor and ceiling effects, internal consistency reliability, validity (scale correlations, tests of known groups validity using one-way analysis of variance (ANOVA)) and responsiveness (effect sizes, standardized response means) were compared for the KOOS-12, full-length KOOS, KOOS-PS and KOOS, JR. Results: Internal consistency reliability was above 0.70 for all KOOS-12 scales and ≥0.90 for the KOOS-12 Summary score. Validity and responsiveness of KOOS-12 Pain, Function and QOL scales was satisfactory and reached similar conclusions as comparable full-length KOOS scales. The KOOS-12 Summary score was most responsive in discriminating between groups who differed in global ratings of post-TKR change in physical capabilities and had the highest effect sizes and standardized response means. Conclusions: KOOS-12 was a reliable and valid alternative to KOOS in TKR patients with moderate to severe OA and provided three domain-specific and summary knee impact scores with substantially reduced respondent burden.

KW - KOOS

KW - Knee

KW - Osteoarthritis

KW - Patient-reported outcome measures

KW - Psychometrics

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A 12-item short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-12): tests of reliability, validity and responsiveness

Abstract

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