The Popularity of Outcome Measures Used in the Foot and Ankle Literature.

BACKGROUND: Outcome measures are frequently employed in clinical studies to determine the efficacy of orthopaedic surgical procedures. However, substantial variability exists among the outcome instruments utilized in foot and ankle (F&A) literature. The purpose of this study is to determine the number of outcome measures reported in F&A literature recently published in major orthopaedic journals and the association between study characteristics and the use of particular outcome measurement categories.

METHODS: All manuscripts published in 6 major orthopaedic journals between 2013-2017 reporting at least one clinical outcome measure were collected. For each manuscript, the journal, title, authors, country/region of origin, level of evidence, topic, and anatomic location were recorded. Outcome measures were characterized as generic, F&A specific, and disease specific. Poisson regression with robust error variance was used to test for association between study characteristics and outcome measure categories.

RESULTS: A total of 541 F&A articles were included with fifty-two different outcome measures reported. The most popular tool was the American Orthopaedic Foot and Ankle Score (AOFAS) (56.9%). Generic outcome measures were used in 331 (61.1%) studies, while 440 (81.3%) studies used F&A specific measures and 64 (11.8%) used disease-specific measures. The use of generic and disease-specific outcome measures was associated with a higher level of evidence (p < 0.001).

CONCLUSION: AA substantial variety of outcome measures are employed among recent published studies, with many studies utilizing non-validated measures. Reporting a combination of validated and focused outcome measures is necessary to improve the quality and generalizability of published studies in foot and ankle literature.

LEVELS OF EVIDENCE: Level II: Systematic review.