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Topic:

Limb Deformity

Issue:

​

Category:

​

Title:

Prospective Multicenter Preliminary Validation of Limb Deformity–modified Scoliosis Instruments in Pediatric Patients With Limb Deformity

Author:

Moon, Tyler James MD; Canitia, Emily CNP; Amakoutou, Kouami MD; Jasty, Naveen MD; Sachwani, Numera MS; Flanagan, Jill C. MD; Liu, Raymond W. MD

Journal:

Journal of Pediatric Orthopaedics

Date:

March 2024

Reference:

44(3): p e260-e266, DOI: 10.1097/BPO.0000000000002605

Level Of Evidence:

II

# of Patients:

34 patients completed the LD-EOSQ (ages 10 and younger).
30 patients completed the LD-SRS (ages 11 to 18).

Study Type:

Diagnostic, prospective cross-sectional cohort design

Location:

Not specified

Summary:

This study aimed to validate two disease-specific patient-reported outcome measures (PROMs) for pediatric limb deformity (LD) patients, specifically modifying the Early Onset Scoliosis Questionnaire (EOSQ) and the Scoliosis Research Society (SRS) survey for limb deformity.

Methods:

Intervention: The EOSQ and SRS surveys were modified by substituting the word "limb" for "back," creating the LD-EOSQ and LD-SRS instruments, respectively. Outcome Measures: Convergent and discriminant validity. Floor and ceiling effects. Content validity. Minimal clinically important difference (MCID). Patients were administered the modified PROMs along with the Pediatric Outcomes Data Collection Instrument (PODCI) as a comparative measure.

Exclusions:

Not specified

Results:

Both the LD-EOSQ and LD-SRS showed excellent convergent validity when compared with the PODCI domains and discriminant validity with demographic and deformity data, including LLRS-AIM scores. Minimal floor or ceiling effects were observed for both instruments. Content validity was achieved in 100% of LD-EOSQ surveys and over 80% of LD-SRS surveys. The minimal clinically important difference was 0.4 for LD-EOSQ and 0.3 for LD-SRS.

Conclusions:

The LD-EOSQ (for patients aged 10 and under) and the LD-SRS (for patients aged 11 to 18) demonstrated preliminary validity and reliability in pediatric patients with limb deformity. These modified instruments provide more relevant information regarding familial impact for younger children and self-image/mental health for adolescents, as compared to the generic PODCI. Further evaluation is needed for these instruments to confirm their utility in clinical practice for children with limb deformities.

Relevance:

Limitations:

Perspective:

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