Validity, reliability, and responsiveness of a self-reported foot and ankle score (SEFAS)

Figures & data

Table 1. Validity, reliability, and measurement errors of the different scores. Correlation analyses comparing SEFAS and the other scores. Data are presented as mean with 95% CI or standard deviation (SD), and as proportions (%)

	Validity		Reliability				Agreement
Questionnaire	Spearman Rho – SEFAS versus (95% CI)	Floor and ceiling effects (%)	Test mean (SD)	Retest mean (SD)	Intraclass correlation coefficient (ICC) (95%CI)	Cronbach’s α	Smethod
Number	135	135	62	62	62	62	62
SEFAS	1	0	29 (9.6)	29 (9.9)	0.92 (0.87–0.95)	0.96	2.7 (15%)
FAOS			–	–	–	–
Pain	0.82 (0.76–0.88)	4.4	71 (21)	69 (22)	0.89 (0.82–0.93)	0.94	7.4 (11%)
Symptom	0.50 (0.37–0.63)	0	60 (16)	62 (15)	0.84 (0.75–0.90)	0.92	6.1 (10%)
ADL	0.77 (0.70–0.83)	1.5	77 (19)	77 (19)	0.96 (0.94–0.98)	0.98	3.7 (5%)
Sport/Recreation	0.42 (0.27–0.56)	34	24 (26)	24 (25)	0.78 (0.66–0.86)	0.88	12 (49%)
Quality of life	0.82 (0.76–0.88)	8.2	51 (25)	53 (25)	0.92 (0.87–0.95)	0.96	7.1 (14%)
EQ–5D	0.76 (0.68–0.83)	8.1	0.72 (0.22)	0.67 (0.24)	0.80 (0.68–0.87)	0.89	0.1 (16%)
Visual analog scale (VAS)	0.65 (0.53–0.75)	1.5	69 (19)	69 (20)	0.96 (0.94–0.98)	0.98	9.1 (13%)
SF–36			–	–	–	–
Physical functioning (PF)	0.64 (0.53–0.74)	1.4	54 (23)	53 (23)	0.92 (0.88–0.95)	0.96	6.4 (12%)
Role limitations, physical (RP)	0.30 (0.14–0.46)	62	40 (43)	40 (43)	0.89 (0.82–0.93)	0.94	13 (32%)
Bodily pain (BP)	0.76 (0.68–0.83)	4.4	57 (24)	54 (23)	0.87 (0.79–0.92)	0.93	8.5 (15%)
General health (GH)	0.17 (0.00–0.34)	3	67 (22)	67 (23)	0.93 (0.89–0.96)	0.97	5.9 (9%)
Vitality (VT)	0.46 (0.31–0.59)	1.5	61 (21)	61 (24)	0.88 (0.80–0.92)	0.93	8.0 (13%)
Social functioning (SF)	0.42 (0.28–0.57)	33	82 (23)	82 (22)	0.72 (0.57–0.82)	0.84	12 (14%)
Role limitation, emotional (RE)	0.31 (0.15–0.46)	76	68 (43)	69 (42)	0.76 (0.64–0.85)	0.87	17 (25%)
Mental health (MH)	0.38 (0.22–0.52)	8.9	80 (17)	81 (16)	0.83 (0.74–0.90)	0.91	6.1 (12%)
Physical	0.51 (0.37–0.64)	–	38 (11)	37 (11)	0.88 (0.80–0.92)	0.93	3.8 (10%)
Mental	0.30 (0.13–0.45)	–	53 (14)	54 (13)	0.77 (0.64–0.86)	0.87	6.4 (12%)

Agreement in 62 patients for the SEFAS, FAOS_total, EQ-5D, VAS, and SF-36 Physical and Mental, presented as Bland-Altman plots (Bland and Altman 1986).

Table 2. Responsiveness expressed as effect size (ES) and standard response mean (SRM) calculated for 37 patients before and 6 months after ankle arthroplasty operation. Due to missing answers, numbers are also shown

	n	Preoperatively (mean)	Postoperatively (mean)	Effect size (ES)	Standard response mean (SRM)
SEFAS	35	17	27	1.44	1
FAOS
Pain	19	43	68	1.78	0.94
Symptom	20	46	52	0.47	0.55
ADL	19	53	73	1.36	0.89
Sport/Recreation	20	17	24	0.37	0.26
Quality of life	20	27	48	1.38	0.79
EQ-5D	36	0.4	0.6	0.93	0.81
VAS	29	50	67	0.65	0.53
SF-36
Physical functioning (PF)	36	36	50	0.67	0.6
Role limitation, physical (RP)	35	28	36	0.23	0.15
Bodily pain (BP)	34	30	54	1.25	0.68
General health (GH)	33	70	69	–0.04	–0.06
Vitality (VT)	34	53	57	0.14	0.13
Social functioning (SF)	33	75	82	0.31	0.28
Role limitation, emotional (RE)	32	53	72	0.44	0.33
Mental health (MH)	34	79	80	0.07	0.08
Physical	30	31	36	0.66	0.49
Mental	30	51	54	0.26	0.23

Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1 (8476): 307-10.

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