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Outcome Instruments: Rationale for Their Use

Poolman, Rudolf W. MD, PhD1; Swiontkowski, Marc F. MD2; Fairbank, Jeremy C.T. MD, FRCS3; Schemitsch, Emil H. MD, FRCSC4; Sprague, Sheila MSc5; de Vet, Henrica C.W. PhD6

doi: 10.2106/JBJS.H.01551
Design, Conduct, and Interpretation of Nonrandomized Orthopaedic Studies--A Practical Approach

The number of outcome instruments available for use in orthopaedic observational studies has increased dramatically in recent years. Properly developed and tested outcome instruments provide a very useful tool for orthopaedic research. Criteria have been proposed to assess the measurement properties and quality of health-status instruments. Unfortunately, not all instruments are developed with use of strict quality criteria. In this article, we discuss these quality criteria and provide the reader with a tool to help select the most appropriate instrument for use in an observational study. We also review the steps for future use of outcome instruments, including the standardization of their use in orthopaedic research.

1Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, Postbus 95500, 1090 HM Amsterdam, The Netherlands. E-mail address:

2Department of Orthopaedic Surgery, University of Minnesota Medical Center, 2450 Riverside Avenue South, Minneapolis, MN 55454

3Department of Orthopaedic Surgery, Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX3 7LD, United Kingdom

4Division of Orthopaedics, Department of Surgery, St. Michael's Hospital, 55 Queen Street East, Suite 800, Toronto, ON M5C 1R6, Canada

5Department of Clinical Epidemiology and Biostatistics, McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON L8L 8E7, Canada

6EMGO Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands

Copyright © 2009 by The Journal of Bone and Joint Surgery, Incorporated
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