Objective: The purpose is to provide more validity, reliability, and responsiveness testing of the anterior cruciate ligament–quality of life instrument (ACL-QOL), particularly in light of consensus-based standards for the selection of health status measurement instruments (COSMIN) guidelines.
Design: Prospective case series.
Setting: An orthopedic surgical practice for consultation.
Patients: A convenience sample of 579 ACL-deficient patients.
Intervention: Anterior cruciate ligament reconstructive surgery.
Main Outcome Measures: Patients completed the ACL-QOL at initial visit and underwent reconstructive surgery. Patients were followed at 6, 12, and 24 months using the ACL-QOL to determine its validity and responsiveness. Cronbach's alpha was used to determine the unidimensionality of the ACL-QOL. A subset of patients took the ACL-QOL twice in a test–retest reliability analysis (intraclass correlation coefficient or ICC 2,k). Another subset of 24-month postsurgical patients measured the success of their surgery using a 7-point global rating scale of improvement as an anchor-based method of responsiveness.
Results: Cronbach's alpha coefficients = 0.93, 0.95, 0.96, and 0.98 at 6, 12, and 24 months, respectively. Intraclass correlation coefficient = 0.60, SEM = 6.16, and confidence interval of 12.1 (CI 95%). Responsiveness was measured by comparing the 4 serial time periods. Patients improved significantly at each time period (P < 0.05, ETA squared 0.61). A 24-month ACL-QOL was significantly correlated (P > 0.05) to being “significantly better” or “somewhat better.”
Conclusions: The results of this study added more validity, reliability, and responsiveness for the ACL-QOL. The ACL-QOL has completed 8 of 9 COSMIN criteria.
*Mount Royal University, Calgary, Alberta, Canada; and
†Banff Sport Medicine, Banff, Alberta, Canada.
Corresponding Author: Mark R. Lafave, PhD, Mount Royal University, 4825 Mount Royal Gate SW, Calgary, AB, T3E 6K6 (email@example.com).
The authors report no conflicts of interest.
Received May 24, 2015
Accepted September 23, 2015