| 1. |
- Cöster, Maria, et al.
(författare)
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Baseline and 1-Year Follow-Up Data of Patients with End-Stage Hallux Rigidus Treated with an Arthrodesis Reported to Swefoot
- 2023
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Ingår i: Medical Research Archives. - 2375-1916. ; 11:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Hallux rigidus (HR) affects the first metatarsophalangeal joint and is the most common osteoarthritic condition in the foot. The most used surgical treatment for severe cases of HR is an arthrodesis. The aim of this study is to describe patient characteristics, surgical treatment and the patient-reported outcomes for patients treated with arthrodesis for HR using data from Swefoot, the Swedish quality register for foot and ankle surgery.Methods: From Swefoot we extracted data on patients who underwent surgery for HR between January 2014 and December 2019. We included 419 patients with end-stage HR, who had not previously been treated surgically for HR on the same side.The outcome was measured with the Self-reported Foot and Ankle Score (SEFAS) (summary score 0-48) and EuroQol 5 Dimensions (EQ5D) (index 0-1) together with questions regarding appearance, shoe wear and satisfaction. We extracted surgical and patient-reported data preoperatively and 1 year postoperatively.Results: Our patient-population is predominantly female, around 61 years old, and slightly overweight. The arthrodeses are most often fixated with screws and most of the patients are allowed to bear weight immediately after surgery. The mean SEFAS score is 22 preoperatively and 38 postoperatively, the corresponding values for EQ5D index are 0.56 and 0.81 which means that the health-related quality of life (HrQoL) improves significantly after surgery.Conclusion: Patients with severe HR treated with an arthrodesis have reduced pain, improved function and HrQoL according to the patient-reported outcome measures SEFAS and EQ5D. The mean postoperative SEFAS value was close to the mean SEFAS value of the Swedish general population in the same age category. Fixation techniques and postoperative regimen differ among surgeons in the country. This is the first report from Swefoot regarding this patient population.
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| 2. |
- Cöster, Maria C., et al.
(författare)
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Hallux rigidus – Osteoarthritis of the first MTP-joint. Surgical and patient-reported results from Swefoot
- 2021
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Ingår i: Foot and Ankle Surgery. - : Elsevier BV. - 1268-7731. ; 27:5, s. 555-558
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Tidskriftsartikel (refereegranskat)abstract
- Background: Swefoot is a Swedish national registry, that covers surgery in the foot and ankle. Surgical treatment of hallux rigidus (HR) vary within and between countries. The aim of this study was to report baseline variables for patients with HR. Methods: We extracted baseline characteristics, surgical procedures and patient-reported data for patients with HR entered in the registry during the period January 2014 to August 2019. Results: By August 2019, 1818 patients were reported in the registry. 68.9% of the patients were women, the average age was 58 years, the mean BMI was 26.4 kg/m2. 41.9% of the patients underwent a cheilectomy,19.8% a metatarsal osteotomy, 34.3% a fusion, 0.2% an arthroplasty, 0.3% Keller's procedure and 3.5% other methods. The preoperative summary score for SEFAS (Self-reported Foot and Ankle Score) was 26 and for EQ-5D (Euroqol-5 Dimension) 0.60. Conclusion: This study is the first report from Swefoot regarding HR.
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| 3. |
- Cöster, Maria C., et al.
(författare)
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Swefoot : The Swedish national quality register for foot and ankle surgery
- 2022
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Ingår i: Foot and Ankle Surgery. - : Elsevier. - 1268-7731 .- 1460-9584. ; 28:8, s. 1404-1410
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPopulation-based register data could be used to improve our knowledge of patients surgically treated for foot and ankle disorders. The quality register Swefoot was recently created to collect surgical and patient-reported data of foot and ankle surgery. This manuscript aims to describe the development and current use of the register.MethodsThe development of Swefoot started in 2014 and currently, data on 16 different diagnoses are collected in 49 units performing foot and ankle surgery. Registrations are performed by the surgeon and the patient.ResultsBetween 2014 and 2020 approximately 20,000 surgical procedures have been registered. 75.1% of the registered patients were women, 9.3% were smokers, 9.3% had a concomitant rheumatoid disease, and 18.4% a BMI larger than 30 kg/m2.ConclusionsThe Swefoot is a unique national register for foot and ankle surgery. It is by now possible to present demographic, surgical, and outcome parameters based on Swefoot.
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| 4. |
- Cöster, Marcus E., et al.
(författare)
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Patient-reported outcomes of joint-preserving surgery for moderate hallux rigidus : a 1-year follow-up of 296 patients from Swefoot
- 2021
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 92:1, s. 109-113
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose — Hallux rigidus (HR) may cause decreased range of motion, joint pain, and gait disturbances. There is a lack of evidence regarding the outcome of different surgical procedures for moderate HR. We report patient-reported outcomes after joint-preserving surgical procedures for moderate HR. Patients and methods — We included 296 patients registered in Swefoot (Swedish national registry of foot and ankle surgery) who underwent primary surgery for moderate HR 2014 through 2018. We extracted information on anthropometrics, grading of HR, chosen surgical procedure, and patient-reported data including the PROMs SEFAS (summary score 0–48) and EQ-5D-3L (index 0–1) preoperatively and 1 year postoperatively. Results — 115 patients underwent metatarsal decompression (i.e., Youngswick) osteotomy (YOT) and 181 underwent cheilectomy. The mean improvement in SEFAS score 1 year after surgery was 12 points (95% CI 10 − 13) for YOT and 10 points (CI 9 − 12) for cheilectomy. Also, EQ-5D improved in both groups. Patients who underwent YOT were more satisfied with the procedure (84% vs. 70% for cheilectomy, p = 0.02). Interpretation — Surgically treated patients with moderate HR improved after both YOT and cheilectomy, according to patient-reported data from Swefoot. Patients who underwent a YOT were more satisfied with their procedure. One possible explanation may be that more patients in the YOT group had a concomitant hallux valgus; however, we have no information on this.
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| 5. |
- Carlsson, Bo, et al.
(författare)
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European industrial transformation : the effects of digitization
- 2011
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Ingår i: Proceedings of the 13th Swedish network for European studies in economics and business conference. ; , s. 1-41
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- This paper reviews the impact of digitization and information technology over several decades in four industries representing a cross-section of the entire economy. It is based on in-depth studies of the raw material production, manufacturing, retailing, and public service sectors in Sweden. The focus is on the content of industrial transformation in the form of new and improved products, improved processes, changed organizational structures, and redefined industry boundaries. Some of these changes are measurable in terms of their economic impact, but most are not. We find that digitization has been a gradual and iterative process involving interrelated technological and organizational changes. This confirms the findings in previous studies that Sweden is the leading country in Europe in adopting IT and may help to explain Sweden’s successful economic performance over the last decade or so.
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| 6. |
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| 7. |
- Cöster, Maria C, et al.
(författare)
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Age- and Gender-Specific Normative Values for the Self-Reported Foot and Ankle Score (SEFAS)
- 2018
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Ingår i: Foot & Ankle International. - : SAGE Publications. - 1944-7876 .- 1071-1007. ; 39:11, s. 1328-1334
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Self-Reported Foot and Ankle Score (SEFAS) is a foot- and ankle-specific patient-reported outcome measurement (PROM) score that has been validated with good results for a variety of foot and ankle disorders. SEFAS is sensitive detecting improvement or deterioration after surgery. However, normative values, required to put a specific patient's summary score into perspective, are lacking.METHODS: In this report, we included 396 population-based men and 383 women (43% of the invited individuals), age 20-89 years, who had completed the SEFAS questionnaire and questions regarding anthropometrics and health. We used Mann-Whitney U test to test gender differences and Spearman correlation coefficients to determine any association between SEFAS score and age. We present gender-specific median SEFAS scores with range and 5th to 95th percentiles and mean with standard deviation.RESULTS: The SEFAS normative values were median 48 in men (range 11-48), 5th to 95th percentiles 31 to 48 and mean 45 ± 6, and in women, median 47 (range 6-48), 5th to 95th percentiles 23 to 48 and mean 43 ± 8 (gender comparison P < .001). SEFAS normative values correlated inversely with age (r = -0.12, P < .001).CONCLUSION: In the general population, older age was associated with lower SEFAS value, and men had higher values than women. The population-based normative SEFAS values provided in this study can facilitate quantification of disability related to foot and ankle with and without surgery in the foot and ankle.LEVEL OF EVIDENCE: Level II, prospective comparative study.
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| 8. |
- CöSter, Maria C., et al.
(författare)
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Minimally important change, measurement error, and responsiveness for the Self-Reported Foot and Ankle Score
- 2017
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Ingår i: Acta Orthopaedica. - Abingdon : TAYLOR & FRANCIS LTD. - 1745-3674 .- 1745-3682. ; 88:3, s. 300-304
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Patient-reported outcome measures (PROMs) are increasingly used to evaluate results in orthopedic surgery. To enhance good responsiveness with a PROM, the minimally important change (MIC) should be established. MIC reflects the smallest measured change in score that is perceived as being relevant by the patients. We assessed MIC for the Self-reported Foot and Ankle Score (SEFAS) used in Swedish national registries. Patients and methods - Patients with forefoot disorders (n = 83) or hindfoot/ankle disorders (n = 80) completed the SEFAS before surgery and 6 months after surgery. At 6 months also, a patient global assessment (PGA) scaleas external criterionwas completed. Measurement error was expressed as the standard error of a single determination. MIC was calculated by (1) median change scores in improved patients on the PGA scale, and (2) the best cutoff point (BCP) and area under the curve (AUC) using analysis of receiver operating characteristic curves (ROCs). Results - The change in mean summary score was the same, 9 (SD 9), in patients with forefoot disorders and in patients with hindfoot/ankle disorders. MIC for SEFAS in the total sample was 5 score points (IQR: 2-8) and the measurement error was 2.4. BCP was 5 and AUC was 0.8 (95% CI: 0.7-0.9). Interpretation - As previously shown, SEFAS has good responsiveness. The score change in SEFAS 6 months after surgery should exceed 5 score points in both forefoot patients and hindfoot/ankle patients to be considered as being clinically relevant.
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| 9. |
- Cöster, Maria C., et al.
(författare)
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Patient-reported outcome for 17,648 patients in 5 different Swedish orthopaedic quality registers before and 1 year after surgery: an observational study
- 2023
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 94, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose — The EQ-5D is a patient-reported outcome measure (PROM). To make priorities and allocate resources between patients and surgical procedures it is necessary to evaluate outcome differences, which is why comparing PROMs between registers is important. We compared EQ-5D data and the follow-up rate for selected diag-noses reported to Swedish orthopedic registers before and 1 year after surgery. Patients and methods — Patients from 5 orthopedic registers (Swespine, Swedish Hip Arthroplasty Register, Swedish Knee Arthroplasty Register, Swedankle, and Swe-foot) who, in 2014–2018, underwent surgery in southern Sweden were included in the study. Data on the EQ-5D index, individual questions, and the EQ-VAS at baseline and at the 1-year follow-up was compared. Results — 17,648 patients had completed the EQ-5D pre-and 1-year postoperatively. The follow-up rate ranged from 32% to 88%. All registers showed a statistical and clinically relevant improvement in the EQ-5D index (mean improvement 0.29–0.39), where patients who underwent hip arthro-plasties experienced the largest improvement. The EQ-5D index improvements in patients with foot and ankle surgeries were larger than for patients with knee arthroplasties and spinal surgeries. The dimensions “self-care” and “usual activities” had the largest change in patients reporting “some problems.” Conclusion — All 5 registers showed a clinically relevant improvement 1 year postoperatively regarding the EQ-5D index, supporting continuous resource allocation to these groups of patients and surgical procedures. However, using PROM data to present register differences was chal-lenged by the high number of non-responders.
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| 10. |
- Cöster, Maria C., et al.
(författare)
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Validation of Two Foot and Ankle Scores – SEFAS (Self-reported Foot And Ankle Score) and AOFAS
- 2014
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Konferensbidrag (refereegranskat)abstract
- INTRODUCTION: The American Orthopedic Foot and Ankle Score (AOFAS) is for many foot and ankle surgeons the gold standard for evaluation of foot and ankle disorders. The score comprises of four different questionnaires depending on which region is evaluated, and covers three different constructs; pain, function and range of motion and alignment. AOFAS however, requires clinical examination, and can therefore not be used as a patient-reported outcome measure (PROM). In contrast, the Self-Reported Foot and Ankle Score (SEFAS) is a PROM that recently has been validated with good results in patients with foot and ankle disorders. The SEFAS contains 12 questions and covers different constructs such as pain, function and limitation of function. The aim of this study was to compare the SEFAS and AOFAS in patients with disorders in the great toe, the hindfoot and ankle, taking psychometric properties for scores into account.PATIENTS AND METHODS: The SEFAS and AOFAS scores were completed by 73 patients with disorders in the great toe and by 89 patients with disorders in the hindfoot or ankle. The time it took to complete the questionnaire was measured in 17 patients. In all patients, construct validity for SEFAS versus AOFAS was estimated by Spearman´s correlation coefficient and we also evaluated if there were any floor and ceiling effects. Test-retest reliability (intra-observer reliability) was measured for SEFAS in 68 patients and for AOFAS in 33 patients with intra-class correlation coefficient (ICC). Inter-observer reliability was calculated in nine patients for AOFAS using ICC. Responsiveness, i.e. the ability of a score to detect changes after a surgical intervention, was estimated by effect size (ES) and standardized response mean (SRM) in 120 patients for SEFAS and in 112 patients for AOFAS.RESULTS: The SEFAS was completed more than three times faster than AOFAS (165 seconds versus 515 seconds). SEFAS had good convergent validity (strong correlation) with AOFAS with a Spearman´s correlation coefficient of 0.64 in patients with great toe disorders and 0.65 in patients with hind foot/ankle disorders. There were no floor or ceiling effects in either of the scores. ICC was in patients with great toe disorders 0.94 (95% CI: 0.87-0.97) for SEFAS and 0.77 (95% CI: 0.39-0.93) for AOFAS, and in patients with hindfoot/ankle disorders 0.92 (95%CI: 0.85-0.95) for SEFAS and 0.52 (95%CI: 0.13-0.77) for AOFAS. ES was 1.4 for SEFAS and 1.8 for AOFAS and SRM 1.4 for SEFAS and 1.6 for AOFAS in patients with great toe disorders. ES was 1.2 for SEFAS and 1.1 for AOFAS and SRM 1.1 for SEFAS and 0.9 for AOFAS in patients with hindfoot/ ankle disorders. Inter-observer reliability was 0.43 (95% CI: 0.0-0.84) for AOFAS.DISCUSSION AND CONCLUSION: In this study there was a strong correlation between SEFAS and AOFAS indicating good construct validity for SEFAS. Both scores had good responsiveness and no floor or ceiling effects. The test-retest reliability was better for SEFAS than AOFAS while the inter-observer reliability was low for AOFAS. Finally, SEFAS was completed three times faster than AOFAS. In conclusion we consider SEFAS at least equal to AOFAS for evaluation of patients with foot and ankle disorders, and as no clinical examination is demanded in SEFAS, it is an ideal instrument for evaluation of clinical patient outcome in national registers.
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| 11. |
- Cöster, Maria, et al.
(författare)
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Comparison of the Self-Reported Foot and Ankle Score (SEFAS) and the American Orthopedic Foot and Ankle Society Score (AOFAS)
- 2014
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Ingår i: Foot & ankle international. - Thousand Oaks, CA : SAGE Publications (UK and US): 12 month Embargo. - 1071-1007 .- 1944-7876. ; 35:10, s. 1031-1036
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Self-reported Foot and Ankle Score (SEFAS) is a patient-reported outcome measure, while the American Orthopedic Foot and Ankle Society Score (AOFAS) is a clinician-based score, both used for evaluation of foot and ankle disorders. The purpose of this study was to compare the psychometric properties of these 2 scoring systems. Methods: A total of 95 patients with great toe disorders and 111 patients with ankle or hindfoot disorders completed the 2 scores before and after surgery. We evaluated time to complete the scores in seconds, correlations between scores with Spearmans correlation coefficient (r(s)), floor and ceiling effects by proportion of individuals who reached the minimum or maximum values, test-retest reliability and interobserver reliability by intraclass correlation coefficient (ICC), internal consistency by Cronbachs coefficient alpha (CA), and responsiveness by effect size (ES). Data are provided as correlation coefficients, means, and standard deviations. Results: SEFAS was completed 3 times faster than AOFAS. The scores correlated with an r(s) of .49 for great toe disorders and .67 for ankle/hindfoot disorders (both P less than .001). None of the scores had any floor or ceiling effect. SEFAS test-retest ICC values measured 1 week apart were .89 for great toe and .92 for ankle/hindfoot disorders, while the corresponding ICC values for AOFAS were .57 and .75. AOFAS interobserver reliability ICC values were .70 for great toe and .81 for ankle/hindfoot disorders. SEFAS CA values were .85 for great toe and .86 for ankle/hindfoot disorders, while the corresponding CA values for AOFAS were .15 and .42. SEFAS ES values were 1.15 for great toe and 1.39 for ankle/hindfoot disorders, while the corresponding ES values for AOFAS were 1.05 and 1.73. Conclusion: As SEFAS showed similar or better outcome in our tests and was completed 3 times faster than AOFAS, we recommend SEFAS for evaluation of patients with foot and ankle disorders.
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| 12. |
- Cöster, Maria, et al.
(författare)
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Enkel senförflyttning kan ge ökad funktion vid droppfot efter stroke
- 2021
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Ingår i: Lakartidningen. - : Läkartidningen Förlag AB. - 0023-7205 .- 1652-7518. ; 118
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Tidskriftsartikel (refereegranskat)abstract
- Foot drop (FD) can be caused by a variety of diseases and injuries. FD leads to walking difficulties and reduced balance which also can lead to a higher risk of falling. Patient with a stroke often have an equinovarus deformity of the foot together with the DF. There is a need to optimize and standardize the treatment for patients with FD across different medical specialities. Surgical interventions, with goals of producing a balanced functional foot, have been shown to improve the function and quality of life and decrease the use of braces and walking aids in patients with FD after a CVI. In Sweden data regarding FD surgery is collected in the National Quality Registry for Foot and Ankle Surgery (Riksfot), but there is also an ongoing multicentre study, investigating the patient-reported and functional results of surgery due to FD caused by a CVI.
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| 13. |
- Cöster, Maria, et al.
(författare)
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Patientrapporterade SEFAS : Frågeformulär bra utvärderingsmetod vid fot- och fotledsbesvär
- 2015
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Ingår i: Läkartidningen. - 0023-7205. ; 112:7
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Tidskriftsartikel (refereegranskat)abstract
- There is need for structured evaluation of disability before and after surgery. The patients' subjective aspects of their symptoms should be one part of this evaluation, preferably captured by patient-reported outcome measures (PROMs). There are several PROMs, either generic or region-specific questionnaires, but no » gold standard « for foot or ankle evaluation. We translated the Self-reported Foot and Ankle Score (SEFAS) and evaluated the psychometric properties of the score in terms of reliability, validity and responsiveness in patients with a variety of foot and ankle disorders. In this report we recommend a validation process for PROMs and report that SEFAS shows good results when doing this. As SEFAS is a PROM, the instrument seems suitable for use in national registers.
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| 14. |
- Cöster, Maria
(författare)
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SEFAS The Self-Reported Foot and Ankle Score
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Patient-reported outcome (PRO) instruments are used in all medical disciplines to evaluate patients with different diseases and also to follow results after treatments such as surgery. Currently there is no generally accepted and fully validated PRO instrument for the foot and ankle. Aims: To translate the New Zealand Ankle Questionnaire into a Swedish version, [the Self-Reported Foot and Ankle Score (SEFAS)] and to evaluate the validity, reliability and responsiveness of SEFAS in patients with disabilities in the foot and/or ankle. The second aim was to compare SEFAS with four other PRO instruments: EQ-5D, SF-36, Foot and Ankle Outcome Score (FAOS) and American Orhopaedic Foot and Ankle Society (AOFAS) score. Methods: In study I, we translated SEFAS into Swedish. We then included 135 patients registered in the Swedish Ankle Registry with osteoarthritis or inflammatory arthritis in the ankle joint. These patients completed SEFAS, FAOS, EQ-5D and SF-36. In study II we included 224 patients scheduled for surgery with a variety of foot and ankle disabilities who completed the same PRO instruments as in study I. In study III we included 206 patients scheduled for surgery with a variety of foot and ankle disabilities who completed SEFAS and AOFAS. Validity, reliability and responsiveness in addition to time to complete the instruments were then evaluated in studies I–III. In study IV we included 21 patients scheduled for surgery due to a flatfoot deformity. These patients completed SEFAS, EQ-5D and SF-36 before surgery and 6 and 24 months after surgery. Results: In studies I-III we found good validity, reliability and responsiveness for SEFAS in patients with disorders in the forefoot, hindfoot and ankle. The results for SEFAS were better than or comparable to EQ-5D, SF-36, FAOS and AOFAS. In study IV we found that SEFAS was able to capture an improvement by surgery in patients with flatfoot deformity and that the improvement continued up to 24 months after surgery. Conclusion: SEFAS is a PRO instrument with good validity, reliability and responsiveness. We recommend SEFAS as a PRO instrument when evaluating surgery in the foot and ankle, also in national registries.
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| 15. |
- Cöster, Maria, et al.
(författare)
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Surgery for adult acquired flatfoot due to posterior tibial tendon dysfunction reduces pain, improves function and health related quality of life
- 2015
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Ingår i: Foot and Ankle Surgery. - London : Elsevier. - 1268-7731 .- 1460-9584. ; 21:4, s. 286-289
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Patients with adult acquired flatfoot deformity (AAFD) due to posterior tibial tendon dysfunction (PTTD) may require surgery but few reports have evaluated the outcome.METHODS: We evaluated 21 patients with a median age of 60 (range 37-72) years who underwent different surgical reconstructions due to stage II AAFD before and 6 and 24 months after surgery by the validated Self-Reported Foot and Ankle Score (SEFAS), Short Form 36 (SF-36) and Euroquol 5 Dimensions (EQ-5D).RESULTS: The improvement from before to 24 months after surgery was in SEFAS mean 12 (95% confidence interval 8-15), SF-36 physical function 21 (10-22), SF-36 bodily pain 28 (17-38), EQ-5D 0.2 (0.1-0.3) and EQ-VAS 11 (2-21).CONCLUSION: Surgery for AFFD due to PTTD results in reduced pain and improved function and health related quality of life. The outcome scores have been demonstrated as useful. It has also been shown, since there is a further improvement between 6 and 24 months after surgery, that a minimum follow-up of 2 years is needed.LEVEL OF CLINICAL EVIDENCE: III - prospective observational cohort study.2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.
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| 16. |
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| 17. |
- Cöster, Maria, et al.
(författare)
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Validity, reliability, and responsiveness of a self-reported foot and ankle score (SEFAS)
- 2012
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 83:2, s. 197-203
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose A questionnaire was introduced by the New Zealand Arthroplasty Registry for use when evaluating the outcome of total ankle replacement surgery. We evaluated the reliability, validity, and responsiveness of the modified Swedish version of the questionnaire (SEFAS) in patients with osteoarthritis or inflammatory arthritis before and/or after their ankle was replaced or fused. Patients and methods The questionnaire was translated into Swedish and cross-culturally adapted according to a standardized procedure. It was sent to 135 patients with ankle arthritis who were scheduled for or had undergone surgery, together with the foot and ankle outcome score (FAOS), the short form 36 (SF-36) score, and the EuroQol (EQ-5D) score. Construct validity was evaluated with Spearman's correlation coefficient when comparing SEFAS with FAOS, SF-36, and EQ-5D, content validity by calculating floor and ceiling effects, test-retest reliability with intraclass correlation coefficient (ICC), internal consistency with Cronbach's alpha (n = 62), agreement by Bland-Altman plot, and responsiveness by effect size and standardized response mean (n = 37). Results For construct validity, we correlated SEFAS with the other scores and 70% or more of our predefined hypotheses concerning correlations could be confirmed. There were no floor or ceiling effects. ICC was 0.92 (CI 95%: 0.88-0.95), Cronbach's alpha 0.96, effect size was 1.44, and the standardized response mean was 1.00. Interpretation SEFAS is a self-reported foot and ankle score with good validity, reliability and responsiveness, indicating that the score can be used to evaluate patients with osteoarthritis or inflammatory arthritis of the ankle and outcome of surgery.
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| 18. |
- Cöster, Maria, et al.
(författare)
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Validity, reliability, and responsiveness of the Self-reported Foot and Ankle Score (SEFAS) in forefoot, hindfoot, and ankle disorders
- 2014
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Ingår i: Acta Orthopaedica. - London : Informa Healthcare. - 1745-3674 .- 1745-3682. ; 85:2, s. 187-194
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: The self-reported foot and ankle score (SEFAS) is a questionnaire designed to evaluate disorders of the foot and ankle, but it is only validated for arthritis in the ankle. We validated SEFAS in patients with forefoot, midfoot, hindfoot, and ankle disorders.PATIENTS AND METHODS: 118 patients with forefoot disorders and 106 patients with hindfoot or ankle disorders completed the SEFAS, the foot and ankle outcome score (FAOS), SF-36, and EQ-5D before surgery. We evaluated construct validity for SEFAS versus FAOS, SF-36, and EQ-5D; floor and ceiling effects; test-retest reliability (ICC); internal consistency; and agreement. Responsiveness was evaluated by effect size (ES) and standardized response mean (SRM) 6 months after surgery. The analyses were done separately in patients with forefoot disorders and hindfoot/ankle disorders.RESULTS: Comparing SEFAS to the other scores, convergent validity (when correlating foot-specific questions) and divergent validity (when correlating foot-specific and general questions) were confirmed. SEFAS had no floor and ceiling effects. In patients with forefoot disorders, ICC was 0.92 (CI: 0.85-0.96), Cronbach's α was 0.84, ES was 1.29, and SRM was 1.27. In patients with hindfoot or ankle disorders, ICC was 0.93 (CI: 0.88-0.96), Cronbach's α was 0.86, ES was 1.05, and SRM was 0.99.INTERPRETATION: SEFAS has acceptable validity, reliability, and responsiveness in patients with various forefoot, hindfoot, and ankle disorders. SEFAS is therefore an appropriate patient- reported outcome measure (PROM) for these patients, even in national registries.
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| 19. |
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| 20. |
- Djukanovic, Ingrid, et al.
(författare)
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Health-related quality of life in patients before and after planned orthopedic surgery : a prospective follow-up study
- 2011
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Ingår i: International Journal of Orthopaedic and Trauma Nursing. - : Elsevier. - 1878-1241 .- 1878-1292. ; 15:4, s. 185-195
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThere are increasing demands on health care for both results and quality. Treatment outcome from the patient’s perspective is essential but not often demanded. The aim of the study was to assess Health Related Quality of Life (HRQoL) prior to and one year after an elective orthopedic intervention.MethodsHRQoL was evaluated by the 5-dimensional scale of the EuroQoL (EQ5D) with two additional scales, EQVAS and PainVAS in 676 consecutive patients undergoing 120 different elective orthopedic interventions. Descriptive statistics were used.ResultsResults showed patients treated for arthrosis with total hip and knee replacement had the greatest improvement in HRQoL. Patients that underwent spinal, upper arm and arthroscopic knee surgery showed considerable improvement. All patients experienced pain relief one year after surgery. Changes in the three effect variables EQ5D, EQVAS and PainVAS correlated significantly with each other.ConclusionsThe study provides an overview of patient assessment of HRQoL before and after some of the most common elective orthopedic interventions. Knowledge obtained from patient groups should help improve and individualize care both from a nursing and surgical perspective.
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| 21. |
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| 22. |
- Karlsson, Magnus, et al.
(författare)
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International and ethnic variability of falls in older men
- 2014
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 42:2, s. 194-200
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Fallers and especially recurrent fallers are at high risk for injuries. The aim of this study was to evaluate fall epidemiology in older men with special attention to the influence of age, ethnicity and country of residence. Methods: 10,998 men aged 65 years or above recruited in Hong Kong, the United States (US) and Sweden were evaluated in a cross-sectional retrospective study design. Self-reported falls and fractures for the preceding 12 months were registered through questionnaires. Group comparisons were done by chi-square test or logistic regression. Results: The proportion of fallers among the total population was 16.5% in ages 65-69, 24.8% in ages 80-84 and 43.2% in ages above 90 (P <0.001). The corresponding proportions of recurrent fallers in the same age groups were 6.3%, 10.1% and 18.2%, respectively (P <0.001), and fallers with fractures 1.0%, 2.3% and 9.1%, respectively (P <0.001). The proportion of fallers was highest in the US, intermediate in Sweden and lowest in Hong Kong (in most age groups P <0.05). The proportion of fallers among white men in the US was higher than in white men in Sweden (all comparable age groups P <0.01) but there were no differences in the proportion of fallers in US men with different ethnicity. Conclusions: The proportion of fallers in older men is different in different countries, and data in this study corroborate with the view that society of residence influences fall prevalence more than ethnicity.
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| 23. |
- Karlsson, Magnus K., et al.
(författare)
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Prevention of falls in old people-a review
- 2013
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Ingår i: Reviews in Clinical Gerontology. - 0959-2598. ; 23:3, s. 206-222
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Forskningsöversikt (refereegranskat)abstract
- Physical training, if including specific different training modalities, reduces the fall risk in healthy community-dwelling older people, as does a home hazards modification programme. Vitamin D supplementation in older individuals with low levels of vitamin D, adjustment of psychotropic medication, and structured modification of multi-pharmacy are all drug-focused programmes that reduce the number of falls. Anti-slip shoe devices during icy conditions for older people who walk outdoors and multifaceted podiatry in patients with specific foot disability reduce the fall risk. First eye cataract surgery and pacemakers in patients with cardio-inhibitory carotid sinus hypersensitivity are surgical interventions that reduce the fall risk. Multi-factorial preventive programmes that include training, both individually designed and generally prescribed, also reduce the fall frequency. With this in mind, we ought to initiate fall preventive programmes in older people, especially in high-risk groups, to reduce the number of falls and fallers in society.
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| 24. |
- Karlsson, Magnus, et al.
(författare)
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Patients With Hip Osteoarthritis Have a Phenotype With High Bone Mass and Low Lean Body Mass.
- 2014
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Ingår i: Clinical Orthopaedics and Related Research. - : Ovid Technologies (Wolters Kluwer Health). - 0009-921X. ; 472:4, s. 1224-1229
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Tidskriftsartikel (refereegranskat)abstract
- Although hip osteoarthritis (OA) is common, its etiology is poorly understood. Specifically, it is not known whether hip OA is associated with abnormal relationships among the anthropometric and musculoskeletal characteristics that are associated with OA in general.
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| 25. |
- Karlsson, Magnus, et al.
(författare)
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Patients With Knee Osteoarthritis Have a Phenotype With Higher Bone Mass, Higher Fat Mass, and Lower Lean Body Mass.
- 2015
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Ingår i: Clinical Orthopaedics and Related Research. - : Ovid Technologies (Wolters Kluwer Health). - 0009-921X. ; 473:1, s. 258-264
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Tidskriftsartikel (refereegranskat)abstract
- Although knee osteoarthritis (OA) is common, its etiology is poorly understood. Specifically, it is not known whether knee OA is associated with abnormal anthropometric and musculoskeletal characteristics known to be associated with OA in general. We recently studied this topic for patients with hip arthritis; however, it is important to evaluate it for knee OA separately, because there are reports indicating that patients with primary OA in different joints may have a different phenotype.
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