Longitudinal Invariance Testing Of The Knee Injury Osteoarthritis Outcome Score For Joint Replacement Scale (KOOS-JR)
# Background The Knee Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR) is a seven-item patient reported outcome measure used to assess perceived knee health. Though commonly used, the longitudinal psychometric properties of the KOOS-JR have not been established and further characterizat...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
North American Sports Medicine Institute
2023-10-01
|
| Series: | International Journal of Sports Physical Therapy |
| Online Access: | https://doi.org/10.26603/001c.86129 |
| _version_ | 1797341534144692224 |
|---|---|
| author | Alexandra Dluzniewski Caleb Allred Madeline P Casanova Jonathan D Moore Adam C Cady Russell T Baker |
| author_facet | Alexandra Dluzniewski Caleb Allred Madeline P Casanova Jonathan D Moore Adam C Cady Russell T Baker |
| author_sort | Alexandra Dluzniewski |
| collection | DOAJ |
| description | # Background
The Knee Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR) is a seven-item patient reported outcome measure used to assess perceived knee health. Though commonly used, the longitudinal psychometric properties of the KOOS-JR have not been established and further characterization of its structural validity and multi-group invariance properties is warranted.
# Purpose
The purpose of this study was to evaluate psychometric properties of the KOOS-JR in a large sample of patients who received care for knee pathology.
# Study Design
Original research.
# Methods
Longitudinal data extracted from the Surgical Outcome System (SOS) database of 13,470 knee pathology patients who completed the KOOS-JR at baseline, three-months, six- months, and one-year. Scale structure was assessed with confirmatory factor analysis (CFA), while multi-group and longitudinal invariance properties were assessed with CFA-based procedures. Latent group means were compared with statistical significance set at α ≤ .05 and Cohen’s d effect size as d = 0.2 (small), d = 0.5 (medium), and d = 0.8 (large).
# Results
CFA results exceeded goodness-of-fit indices at all timepoints. Multi-group invariance properties passed test requirements. Longitudinal analysis identified a biased item resulting in removal of item #1; the retained six-item model (KOOS-JR-6) passed longitudinal invariance requirements. KOOS-JR-6 scores significantly changed over time (p ≤ .001, Mdiff = 1.08, Cohen’s d = 0.57): the highest scores were at baseline examination and the lowest at 12-month assessment.
# Conclusions
The KOOS-JR can be used to assess baseline differences between males and females, middle and older aged adults, and patients receiving total knee arthroplasty or non-operative care. Caution is warranted if the KOOS-JR is used longitudinally due to potential measurement error associated with item #1. The KOOS-JR-6 may be a more viable option to assess change over time; however, more research is warranted.
# Level of Evidence
3
© The Author(s) |
| first_indexed | 2024-03-08T10:19:31Z |
| format | Article |
| id | doaj.art-2ed28f87831a4de1a16841511b0fb672 |
| institution | Directory Open Access Journal |
| issn | 2159-2896 |
| language | English |
| last_indexed | 2024-03-08T10:19:31Z |
| publishDate | 2023-10-01 |
| publisher | North American Sports Medicine Institute |
| record_format | Article |
| series | International Journal of Sports Physical Therapy |
| spelling | doaj.art-2ed28f87831a4de1a16841511b0fb6722024-01-28T01:20:06ZengNorth American Sports Medicine InstituteInternational Journal of Sports Physical Therapy2159-28962023-10-01185Longitudinal Invariance Testing Of The Knee Injury Osteoarthritis Outcome Score For Joint Replacement Scale (KOOS-JR)Alexandra DluzniewskiCaleb AllredMadeline P CasanovaJonathan D MooreAdam C CadyRussell T Baker# Background The Knee Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR) is a seven-item patient reported outcome measure used to assess perceived knee health. Though commonly used, the longitudinal psychometric properties of the KOOS-JR have not been established and further characterization of its structural validity and multi-group invariance properties is warranted. # Purpose The purpose of this study was to evaluate psychometric properties of the KOOS-JR in a large sample of patients who received care for knee pathology. # Study Design Original research. # Methods Longitudinal data extracted from the Surgical Outcome System (SOS) database of 13,470 knee pathology patients who completed the KOOS-JR at baseline, three-months, six- months, and one-year. Scale structure was assessed with confirmatory factor analysis (CFA), while multi-group and longitudinal invariance properties were assessed with CFA-based procedures. Latent group means were compared with statistical significance set at α ≤ .05 and Cohen’s d effect size as d = 0.2 (small), d = 0.5 (medium), and d = 0.8 (large). # Results CFA results exceeded goodness-of-fit indices at all timepoints. Multi-group invariance properties passed test requirements. Longitudinal analysis identified a biased item resulting in removal of item #1; the retained six-item model (KOOS-JR-6) passed longitudinal invariance requirements. KOOS-JR-6 scores significantly changed over time (p ≤ .001, Mdiff = 1.08, Cohen’s d = 0.57): the highest scores were at baseline examination and the lowest at 12-month assessment. # Conclusions The KOOS-JR can be used to assess baseline differences between males and females, middle and older aged adults, and patients receiving total knee arthroplasty or non-operative care. Caution is warranted if the KOOS-JR is used longitudinally due to potential measurement error associated with item #1. The KOOS-JR-6 may be a more viable option to assess change over time; however, more research is warranted. # Level of Evidence 3 © The Author(s)https://doi.org/10.26603/001c.86129 |
| spellingShingle | Alexandra Dluzniewski Caleb Allred Madeline P Casanova Jonathan D Moore Adam C Cady Russell T Baker Longitudinal Invariance Testing Of The Knee Injury Osteoarthritis Outcome Score For Joint Replacement Scale (KOOS-JR) International Journal of Sports Physical Therapy |
| title | Longitudinal Invariance Testing Of The Knee Injury Osteoarthritis Outcome Score For Joint Replacement Scale (KOOS-JR) |
| title_full | Longitudinal Invariance Testing Of The Knee Injury Osteoarthritis Outcome Score For Joint Replacement Scale (KOOS-JR) |
| title_fullStr | Longitudinal Invariance Testing Of The Knee Injury Osteoarthritis Outcome Score For Joint Replacement Scale (KOOS-JR) |
| title_full_unstemmed | Longitudinal Invariance Testing Of The Knee Injury Osteoarthritis Outcome Score For Joint Replacement Scale (KOOS-JR) |
| title_short | Longitudinal Invariance Testing Of The Knee Injury Osteoarthritis Outcome Score For Joint Replacement Scale (KOOS-JR) |
| title_sort | longitudinal invariance testing of the knee injury osteoarthritis outcome score for joint replacement scale koos jr |
| url | https://doi.org/10.26603/001c.86129 |
| work_keys_str_mv | AT alexandradluzniewski longitudinalinvariancetestingofthekneeinjuryosteoarthritisoutcomescoreforjointreplacementscalekoosjr AT caleballred longitudinalinvariancetestingofthekneeinjuryosteoarthritisoutcomescoreforjointreplacementscalekoosjr AT madelinepcasanova longitudinalinvariancetestingofthekneeinjuryosteoarthritisoutcomescoreforjointreplacementscalekoosjr AT jonathandmoore longitudinalinvariancetestingofthekneeinjuryosteoarthritisoutcomescoreforjointreplacementscalekoosjr AT adamccady longitudinalinvariancetestingofthekneeinjuryosteoarthritisoutcomescoreforjointreplacementscalekoosjr AT russelltbaker longitudinalinvariancetestingofthekneeinjuryosteoarthritisoutcomescoreforjointreplacementscalekoosjr |