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Article ; Online: 30 years with the Knee injury and Osteoarthritis Outcome Score (KOOS).

Roos, Ewa M

2023 Volume 32, Issue 4, Page(s) 421–429

Abstract: This narrative review describes the development and use of patient-reported outcomes over 30 years, focusing on the Knee injury and Osteoarthritis Outcome Score (KOOS). KOOS is a five-subscale patient-reported instrument intended for use from the time of ...

Abstract	This narrative review describes the development and use of patient-reported outcomes over 30 years, focusing on the Knee injury and Osteoarthritis Outcome Score (KOOS). KOOS is a five-subscale patient-reported instrument intended for use from the time of knee injury to the development of osteoarthritis. Numerous studies have confirmed that the psychometric properties of the KOOS and its short-form KOOS-12 are acceptable. More recent research has focused on the use and interpretation of KOOS scores in clinical trials using thresholds, such as minimal important differences, patient-acceptable symptom states, and treatment failure. As an indication of KOOS's popularity, the total 3854 PubMed results for KOOS have increased exponentially since the first KOOS paper was published 25 years ago and now seem to have plateaued at around 650 annually. The selected articles are not based on a systematic search, but on the author's own publications, reading, and literature search that grew organically from that.
MeSH term(s)	Humans ; Osteoarthritis, Knee/diagnosis ; Knee Injuries/diagnosis ; Treatment Failure ; Patient Reported Outcome Measures ; Psychometrics ; Quality of Life ; Treatment Outcome
Language	English
Publishing date	2023-10-12
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1167809-4
ISSN	1522-9653 ; 1063-4584
ISSN (online)	1522-9653
ISSN	1063-4584
DOI	10.1016/j.joca.2023.10.002
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Article ; Online: 3 steps to improve reporting and interpretation of patient-reported outcome scores in orthopedic studies.

Roos, Ewa M

Acta orthopaedica

2018 Volume 89, Issue 1, Page(s) 1–2

MeSH term(s)	Confidence Intervals ; Humans ; Knee Injuries/therapy ; Orthopedic Procedures/methods ; Orthopedic Procedures/standards ; Patient Reported Outcome Measures ; Quality Improvement ; Surveys and Questionnaires ; Treatment Outcome
Language	English
Publishing date	2018
Publishing country	England
Document type	Journal Article
ZDB-ID	2180677-9
ISSN	1745-3682 ; 1745-3674
ISSN (online)	1745-3682
ISSN	1745-3674
DOI	10.1080/17453674.2017.1407058
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Article: Calculate Patient-Reported Scores as Recommended so as Not to Threaten the Validity of the Measure: Letter to the Editor.

Roos, Ewa M

Orthopaedic journal of sports medicine

2018 Volume 6, Issue 12, Page(s) 2325967118816987

Language	English
Publishing date	2018-12-31
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	2706251-X
ISSN	2325-9671
ISSN	2325-9671
DOI	10.1177/2325967118816987
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Article ; Online: Do self-reported knee instability, difficulty twisting, and knee confidence change after exercise and education in patients with knee osteoarthritis?

Selçuk, Halit / Roos, Ewa M / Grønne, Dorte T / Thorlund, Jonas B / Sarı, Zübeyir / Skou, Søren T

Musculoskeletal care

2024 Volume 22, Issue 2, Page(s) e1884

MeSH term(s)	Humans ; Osteoarthritis, Knee/therapy ; Self Report ; Knee Joint ; Exercise ; Joint Instability ; Exercise Therapy
Language	English
Publishing date	2024-04-18
Publishing country	England
Document type	Journal Article
ZDB-ID	2171452-6
ISSN	1557-0681 ; 1478-2189
ISSN (online)	1557-0681
ISSN	1478-2189
DOI	10.1002/msc.1884
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Article ; Online: Treatment for Acute Anterior Cruciate Ligament Tear in Young Active Adults.

Lohmander, L Stefan / Roemer, Frank W / Frobell, Richard B / Roos, Ewa M

NEJM evidence

2023 Volume 2, Issue 8, Page(s) EVIDoa2200287

Abstract: KANON Follow-up AnalysisThis was an extended follow-up analysis from the KANON trial examining the management of acute ACL tears in young active adults. There was no difference in patient-reported outcomes at the 11-year follow-up among patients treated ... ...

Abstract	KANON Follow-up AnalysisThis was an extended follow-up analysis from the KANON trial examining the management of acute ACL tears in young active adults. There was no difference in patient-reported outcomes at the 11-year follow-up among patients treated with early surgery versus an initial nonsurgical approach.
MeSH term(s)	Adult ; Humans ; Anterior Cruciate Ligament Injuries/surgery ; Anterior Cruciate Ligament/surgery ; Anterior Cruciate Ligament Reconstruction
Language	English
Publishing date	2023-06-26
Publishing country	United States
Document type	Journal Article
ISSN	2766-5526
ISSN (online)	2766-5526
DOI	10.1056/EVIDoa2200287
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Article ; Online: Foot and Ankle Outcome Score (FAOS): Reference Values From a National Representative Sample.

Larsen, Peter / Rathleff, Michael S / Roos, Ewa M / Elsoe, Rasmus

Foot & ankle orthopaedics

2023 Volume 8, Issue 4, Page(s) 24730114231213369

Abstract: Background: The Foot and Ankle Outcome Score (FAOS) is widely used in clinical practice and research. However, FAOS reference values are missing to aid interpretation. This study aimed to establish national record-based reference values for the FAOS.: ...

Abstract	Background: The Foot and Ankle Outcome Score (FAOS) is widely used in clinical practice and research. However, FAOS reference values are missing to aid interpretation. This study aimed to establish national record-based reference values for the FAOS. Methods: A national representative sample of 9996 adult Danish citizens was derived from the Danish Civil Registration System. The FAOS questionnaire was sent to all participants, including 2 supplemental questions regarding previous foot and ankle problems and body mass index (BMI). A threshold of 10 FAOS points was predefined as a clinically relevant difference across all 5 subscales. Results: A total of 2759 participants completed the FAOS. Mean age of participants was 60.5 years, and 51% were women. The mean FAOS subscale scores were as follows: pain, 87.1 (95% CI 86.4-87.8); symptoms, 85.1 (95% CI 84.5-85.8); activity of daily living (ADL), 88.9 (95% CI 88.2-89.6); sport and recreation function 78.5 (95% CI 77.4-79.6); and quality of life (QOL), 79.9 (95% CI 79.0-80.9). The mean difference between men and women was small and not clinically relevant (ranged from 0.9 in ADL to 3.4 in QOL). The largest differences in mean scores between age groups ranged from 4.3 in symptoms to 16.4 in sport/rec. Except for the subscale sport/rec, all age-related differences were below the predefined threshold of 10 for clinical relevance. The difference in mean subscale scores between the lowest BMI group (<24.7) and the obese group (>30) ranged from 19.6 in ADL to 39.1 in sport/rec. Conclusion: We found in our population that BMI severely impacted FAOS scores. We recommend using BMI-specific reference FAOS values. Separate FAOS reference values for men and women appear not needed. Stratifying reference values for age is likely not needed except for the subscale sport and recreation function. Level of evidence: Level III, cohort study.
Language	English
Publishing date	2023-12-04
Publishing country	United States
Document type	Journal Article
ISSN	2473-0114
ISSN (online)	2473-0114
DOI	10.1177/24730114231213369
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Article ; Online: National population-based reference data for the Hip Disability and Osteoarthritis Outcome Score (HOOS).

Larsen, Peter / Rathleff, Michael S / Roos, Ewa M / Elsoe, Rasmus

Archives of orthopaedic and trauma surgery

2023 Volume 143, Issue 11, Page(s) 6865–6874

Abstract: Introduction: Interpretation of patient-reported outcome scores such as the Hip Disability and Osteoarthritis Outcome Score (HOOS) can be improved with use of reference values. The aim of the study was to establish population-based reference values for ... ...

Abstract	Introduction: Interpretation of patient-reported outcome scores such as the Hip Disability and Osteoarthritis Outcome Score (HOOS) can be improved with use of reference values. The aim of the study was to establish population-based reference values for the HOOS' five subscales and its short-form HOOS-12. Materials and methods: A representative sample of 9997 Danish citizens 18 years and older were identified. The population record-based sample was based on seven predefined age groups and an equal sex distribution within each age group. A national secure electronic system was used to send the HOOS questionnaire and one supplementary question regarding previous hip complaints to all participants. Results: 2277 participants completed the HOOS, 947 women (42%) and 1330 men (58%). The mean HOOS subscale scores were: pain 86.9 (95% CI 86.1-87.7), symptoms 83.7 (95% CI 82.9-84.5), ADL 88.2 (95% CI 87.5-89.0), sport and recreation function 83.1 (95% CI 82.0-84.1), QOL 82.7 (95% CI 81.8-83.6). The youngest age group reported better mean scores in four subscales compared to the oldest age group (pain 91.7 vs. 84.5, mean difference 7.2 95% CI 0.4-14.0), (ADL 94.6 points vs. 83.2, mean difference 11.4 95% CI 4.9-17.8), (sport and recreation function 91.5 points vs. 73.8 points, mean difference 17.7 95% CI 9.0-26.4), (QOL 88.9 points vs. 78.8, mean difference 10.1 points 95% CI 2.0-18.2). Participants with a self-reported hip complaint had worse HOOS scores across all subscales (mean difference range 22.1-34.6). Super obese patients (BMI > 40) had > 12.5 points worse scores across the five HOOS subscales. Results were similar for the HOOS-12. Conclusion: This study provides reference values for the HOOS and its short form HOOS-12. Results show that older patients and patients with a BMI over 40 have worse HOOS and HOOS-12 scores that may be of clinical importance in the interpretation of scores both when evaluating potential for improvement and post-treatment results.
MeSH term(s)	Male ; Humans ; Female ; Osteoarthritis, Hip/surgery ; Quality of Life ; Pain ; Surveys and Questionnaires ; Patient Reported Outcome Measures ; Arthroplasty, Replacement, Hip/methods
Language	English
Publishing date	2023-06-06
Publishing country	Germany
Document type	Journal Article
ZDB-ID	80407-1
ISSN	1434-3916 ; 0003-9330 ; 0344-8444
ISSN (online)	1434-3916
ISSN	0003-9330 ; 0344-8444
DOI	10.1007/s00402-023-04915-w
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Article ; Online: Knee injury and osteoarthritis outcome score (KOOS) - National record-based reference values.

Larsen, Peter / Rathleff, Michael S / Roos, Ewa M / Elsoe, Rasmus

The Knee

2023 Volume 43, Page(s) 144–152

Abstract: Background: Knee Injury and Osteoarthritis Outcome Score (KOOS) and the short form KOOS-12 are commonly used in clinical practice and research but there are no national record-based reference values to aid interpretation. The aim of this study was to ... ...

Abstract	Background: Knee Injury and Osteoarthritis Outcome Score (KOOS) and the short form KOOS-12 are commonly used in clinical practice and research but there are no national record-based reference values to aid interpretation. The aim of this study was to establish national record-based reference values for the KOOS and its short form KOOS-12. Patients and methods: A national record-based representative sample of 9996 adult citizens were derived from the Danish Civil Registration System. The selection of citizens was based on seven predefined age groups with an equal sex distribution across each age strata. The KOOS questionnaire was sent to all participants, together with two supplemental questions regarding previous knee problems and body mass index (BMI). Results: A total of 2842 participants completed the KOOS, 1463 women (51.4%) and 1379 men (48.6%). The mean KOOS subscale scores were: pain 85.3 (95% confidence interval (CI): 84.6-85.9), symptoms 85.1 (95% CI: 84.5-85.8), activities of daily living (ADL) 86.7 (95% CI: 86.0-87.3), sport and recreation function 70.9 (95% CI: 69.8-72.0), quality of life (QOL) 74.9 (95% CI: 73.9-75.8).Age- and sex-specific reference values showed small differences in mean scores between the five KOOS subscales and all were below the threshold for clinically relevant improvement (10 points).Knee problems were associated with worse KOOS scores across all subscales. The difference in the mean subscale scores between the lowest (<24.9) and highest (>40) BMI groups ranged from 12.9 to 24.1. Comparable results were observed for KOOS-12. Conclusion: KOOS and KOOS-12 reference values can, in most situations, be used without stratification for age and sex. Sport/recreation reference values stratified for age and BMI may be of importance.
MeSH term(s)	Adult ; Male ; Humans ; Female ; Quality of Life ; Osteoarthritis, Knee/diagnosis ; Osteoarthritis, Knee/epidemiology ; Activities of Daily Living ; Reference Values ; Knee Injuries/diagnosis ; Knee Injuries/epidemiology
Language	English
Publishing date	2023-07-04
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1200476-5
ISSN	1873-5800 ; 0968-0160
ISSN (online)	1873-5800
ISSN	0968-0160
DOI	10.1016/j.knee.2023.06.004
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Article ; Online: Online and onsite supervised exercise therapy and education for individuals with knee osteoarthritis - A before and after comparison of two different care delivery models.

Holm, Paetur M / Roos, Ewa M / Grønne, Dorte T / Skou, Søren T

Musculoskeletal care

2023 Volume 21, Issue 3, Page(s) 878–889

Abstract: Objective: To compare the 3 and 12-month changes on pain, function and quality of life between online and onsite delivery of Good Life with Osteoarthritis in Denmark (GLA:D: Design: Non-inferior comparison of individuals with knee OA receiving ... ...

Abstract	Objective: To compare the 3 and 12-month changes on pain, function and quality of life between online and onsite delivery of Good Life with Osteoarthritis in Denmark (GLA:D Design: Non-inferior comparison of individuals with knee OA receiving physiotherapist-supervised online (TeleGLA:D) or onsite (GLA:D®) (12 exercise and 2 education sessions). The primary outcome was the baseline-to-3-month change on KOOS-12 summary score. Secondary outcomes were changes in KOOS-12 subscales pain, function and quality of life and pain intensity (Visual Analog Scale (VAS 0-100)) at 3 and 12 months; 40 m fast-paced walk and 30 s chair-stand at 3 months. Using mixed linear regressions, comparisons were adjusted for age, sex, BMI, comorbidities and number of knees and hips with OA. Results: Over a 1-year period (May 2020-May 2021), we included data from 3789 participants (3701 GLA:D®; 88 TeleGLA:D). At 3 months, TeleGLA:D showed non-inferior change-scores to GLA:D® on KOOS-12 summary score; adjusted mean difference (90% Confidence Intervals (CI)) -2.40 (-5.55 to 0.75). For secondary outcomes, there was a statistically significant difference in change-scores, favouring TeleGLA:D in gait speed; adjusted mean difference (90%CI) 0.23 m/s (0.18-0.27). TeleGLA:D remained non-inferior to GLA:D® at 12 months. Conclusions: Online delivery of physiotherapist-supervised neuromuscular exercise and education for individuals with knee OA may be non-inferior to traditional onsite delivery in reducing pain and improving function and quality of life. The wide confidence intervals, baseline imbalance, loss to follow-up and the non-randomized design highlight the need for a confirmatory randomized controlled trial.
MeSH term(s)	Humans ; Osteoarthritis, Knee/therapy ; Quality of Life ; Exercise Therapy ; Exercise ; Pain
Language	English
Publishing date	2023-04-04
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2171452-6
ISSN	1557-0681 ; 1478-2189
ISSN (online)	1557-0681
ISSN	1478-2189
DOI	10.1002/msc.1765
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Article: Physical therapy for patients with knee and hip osteoarthritis: supervised, active treatment is current best practice study.

Skou, Søren T / Roos, Ewa M

Clinical and experimental rheumatology

2020 Volume 38, Issue 5, Page(s) 1036

Language	English
Publishing date	2020-10-02
Publishing country	Italy
Document type	Journal Article ; Published Erratum
ZDB-ID	605886-3
ISSN	1593-098X ; 0392-856X
ISSN (online)	1593-098X
ISSN	0392-856X
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