American Orthopedic Foot-and-Ankle Society Score, Where Are We Now? – A Narrative Review of Quality of Life Measures in Foot-and-Ankle Surgery

Jonathan James D'souza

doi:10.3889/oamjms.2020.3914

Authors

Jonathan James D'souza Warrington and Halton NHS Trust, Lovely Ln, Warrington WA5 1QG, United Kingdom

DOI:

https://doi.org/10.3889/oamjms.2020.3914

Keywords:

AOFAS, QOL

Abstract

BACKGROUND: The American Orthopedic Foot and Ankle Society (AOFAS) score is the mostly widely used quality of life index for foot-and-ankle pathologies. However, there are many shortcomings of the QOL index with respect to validity, reliability, and responsiveness.

AIM: The narrative review will examine the AOFAS scoring system and review the outcome measure using the GRADE tool for quality of outcome measure.

CONCLUSIONS: Clinicians and researchers should cease using the AOFAS score as it is not a reliable tool. However, the recommendations suggested in this article can be used to upgrade the quality of the scoring system.

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References

Sackett DL. Rules of evidence and clinical recommendations on the use of antithrombotic agents.Chest.1989;95(2):2S-4S. https://doi.org/10.1378/chest.95.2_supplement.2s PMid:2914516

Thornton J, Alderson P, Tan T, Turner C, Latchem S, Shaw E, et al. Introducing GRADE across the NICE clinical guideline program. J Clin Epidemiol. 2013;66(2):124-31.https://doi. org/10.1016/j.jclinepi.2011.12.007 PMid:22406196

Burns PB, Rohrich RJ, Chung KC. The levels of evidence and their role in evidence-based medicine. Plast Reconstr Surg. 2011;128(1):305-10. PMid:21701348

Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, AlonsoCoello P, et al. GRADE: An emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924-6.https://doi.org/10.1136/bmj.39489. 470347.ad PMid:18436948

Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64(4):383- 94.https://doi.org/10.1016/j.jclinepi.2010.04.026 PMid:21195583

Malviya A, Makwana N, Laing P. Correlation of the AOFAS scores with a generic health QUALY score in foot and ankle surgery. Foot Ankle Int. 2007;28(4):494-8.https://doi.org/10.3113/fai.2007.0494 PMid:17475146

Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994;15(7):349- 53.https://doi.org/10.1177/107110079401500701 PMid:7951968

Ibrahim T, Beiri A, Azzabi M, Best AJ, Taylor GJ, Menon DK. Reliability and validity of the subjective component of the American orthopaedic foot and ankle society clinical rating scales. J Foot Ankle Surg. 2007;46(2):65-74.https://doi. org/10.1053/j.jfas.2006.12.002 PMid:17331864

Revell M, Pynsent P, Abudu A, Fairbank J. Trauma scores and trauma outcome measures. Trauma. 2003;5(1):61-70.https:// doi.org/10.1191/1460408603ta268oa

Guyton GP. Theoretical limitations of the AOFAS scoring systems: An analysis using Monte Carlo modeling. Foot Ankle Int. 2001;22(10):779-87.https://doi. org/10.1177/107110070102201003 PMid:11642529

Naal FD, Impellizzeri FM, Rippstein PF. Which are the most frequently used outcome instruments in studies on total ankle arthroplasty? Clin Orthop Relat Res. 2010;468(3):815-26. https://doi.org/10.1007/s11999-009-1036-y PMid:19672670

WareJE Jr., Sherbourne CD. The MOS 36-item shortform health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473-83.https://doi. org/10.1097/00005650-199206000-00002 PMid:1593914

Martin DP, Engelberg R, Agel J, Snapp D, Swiontkowski MF. Development of a musculoskeletal extremity health status instrument: The musculoskeletal function assessment instrument. J Orthop Res. 1996;14(2):173-81.https://doi. org/10.1002/jor.1100140203 PMid:8648493

Pena F, Agel J, Coetzee JC. Comparison of the MFA to the AOFAS outcome tool in a population undergoing total ankle replacement. Foot Ankle Int. 2007;28(7):788-93.https://doi. org/10.3113/fai.2006.0788 PMid:17666170

SooHoo NF, Shuler M, Fleming LL, American Orthopaedic Foot and Ankle Society. Evaluation of the validity of the AOFAS clinical rating systems by correlation to the SF-36. Foot Ankle Int. 2003;24(1):50-5.https://doi.org/10.1177/107110070302400108 PMid:12540082

Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: Atool for assessing risk of bias in non-randomised studies of interventions. BMJ.2016;355:i4919. PMid:27733354

Guyatt GH, Oxman AD, Kunz R, Woodcock J, Brozek J, Helfand M, et al. GRADE guidelines: 8. Rating the quality of evidence-indirectness. J Clin Epidemiol. 2011;64(12):1303-10. https://doi.org/10.1016/j.jclinepi.2011.04.014 PMid:21802903

Button G, Pinney S. A meta-analysis of outcome rating scales in foot and ankle surgery: Is there a valid, reliable, and responsive system? Foot Ankle Int. 2004;25(8):521-5.https:// doi.org/10.1177/107110070402500802 PMid:15363371

Shazadeh Safavi P, Janney C, Jupiter D, Kunzler D, Bui R, Panchbhavi VK. A systematic review of the outcome evaluation tools for the foot and ankle. Foot Ankle Spec. 2019;12(5):461- 70.https://doi.org/10.1177/1938640018803747 PMid:30338697

Guyatt GH, Oxman AD, Sultan S, Glasziou P, Akl EA, AlonsoCoello P, et al. GRADE guidelines: 9. Rating up the quality of evidence. J Clin Epidemiol. 2011;64(12):1311-6.https://doi. org/10.1016/j.jclinepi.2011.06.004 PMid:21802902

Pinsker E, Daniels TR. AOFAS position statement regarding the future of the AOFAS clinical rating systems. Foot Ankle Int. 2011;32(9):841-2.https://doi.org/10.3113/fai.2011.0841 PMid:22097157

Van Lieshout E, De Boer A, Meuffels D, Den Hoed P, Van der Vlies C, Tuinebreijer W, et al. American orthopaedic foot and ankle society (AOFAS) ankle-hindfoot score: A study protocol for the translation and validation of the Dutch language version. BMJ Open. 2017;7(2):e012884.https://doi.org/10.1136/ bmjopen-2016-012884