Kearney, Rebecca S., Achten, Juul, Lamb, S. E. (Sallie E.), Parsons, Nicholas R. and Costa, Matthew L. (2012) The Achilles tendon total rupture score : a study of responsiveness, internal consistency and convergent validity on patients with acute Achilles tendon ruptures. Health and Quality of Life Outcomes, Vol.10 (No.1). p. 24. doi:10.1186/1477-7525-10-24

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Abstract

Background
The Achilles tendon Total Rupture Score was developed by a research group in 2007 in response to the need for a patient reported outcome measure for this patient population. Beyond this original development paper, no further validation studies have been published.

Consequently the purpose of this study was to evaluate internal consistency, convergent validity and responsiveness of this newly developed patient reported outcome measure within patients who have sustained an isolated acute Achilles tendon rupture.

Methods
Sixty-four eligible patients with an acute rupture of their Achilles tendon completed the Achilles tendon Total Rupture Score alongside two further patient reported outcome measures (Disability Rating Index and EQ 5D). These were completed at baseline, six weeks, three months, six months and nine months post injury. The Achilles tendon Total Rupture Score was evaluated for internal consistency, using Cronbach's alpha, convergent validity, through correlation analysis and responsiveness, by analysing floor and ceiling effects and calculating its relative efficiency in comparison to the Disability Rating Index and EQ 5D scores.

Results
The Achilles tendon Total Rupture Score demonstrated high internal consistency (Cronbachs alpha > 0.8) and correlated significantly (p < 0.001) with the Disability Rating Index at five time points (pre-injury, six weeks, three, six and nine months) with correlation coefficients between -0.5 and -0.9. However, the confidence intervals were wide. Furthermore, the ability of the new score to detect clinically important changes over time (responsiveness) was shown to be greater than the Disability Rating Index and EQ 5D.

Conclusions
A universally accepted outcome measure is imperative to allow comparisons to be made across practice. This is the first study to evaluate aspects of validity of this newly developed outcome measure, outside of the developing centre. The ATRS demonstrated high internal consistency and responsiveness, with limited convergent validity. This research provides further support for the use of this outcome measure, however further research is required to advocate its universal use in patients with acute Achilles tendon ruptures. Such areas include inter-rater reliability and research to determine the minimally clinically important difference between scores.

Item Type:	Journal Article
Subjects:	R Medicine > R Medicine (General)
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit
Library of Congress Subject Headings (LCSH):	Achilles tendon -- Wounds and injuries, Outcome assessment (Medical care), Clinical trials
Journal or Publication Title:	Health and Quality of Life Outcomes
Publisher:	Bio Med Central
ISSN:	1477-7525
Official Date:	29 February 2012
Dates:	Date Event 29 February 2012 Published
Date of first compliant deposit:	20 December 2015
Volume:	Vol.10
Number:	No.1
Page Range:	p. 24
DOI:	10.1186/1477-7525-10-24
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access
Funder:	Arthritis Research UK

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