Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Apr;35(4):1137-1144.
doi: 10.1016/j.arth.2019.10.058. Epub 2019 Nov 5.

Determining the Validity, Reliability, and Utility of the Forgotten Joint Score: A Systematic Review

Marco Adriani  1 , Michael-Alexander Malahias  1 , Alex Gu  1 , Cynthia A Kahlenberg  2 , Michael P Ast  2 , Peter K Sculco  1
Affiliations

Determining the Validity, Reliability, and Utility of the Forgotten Joint Score: A Systematic Review

Marco Adriani et al. J Arthroplasty. 2020 Apr.

Abstract

Background: With improving patient outcome after total hip and total knee arthroplasty, patient-reported outcome measures (PROMs) have seen a parallel rise in average scores and ceiling effects. The Forgotten Joint Score (FJS) is a PROM that has been previously proposed to reduce this observed ceiling effect. However, the validity and reliability of the FJS has not been well analyzed.

Methods: The US National Library of Medicine (PubMed/MEDLINE), EMBASE, and the Cochrane Database of Systematic Reviews were queried using keywords pertinent to FJS, validity, reliability, measurement properties, and PROM. The methodological quality of measurement properties was evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist.

Results: In total, 13 articles met the inclusion criteria and were included in this analysis. Internal consistency was consistently high (Cronbach alpha >0.9). Test-retest reliability was good or excellent (interclass correlation coefficient ≥0.8) in all studies. As for construct validity, all the articles reported a positive rating. Floor and ceiling effects overall were low (<15%). Conflicting results were found for responsiveness and measurement error.

Conclusion: There is a strong evidence of good construct validity and test-retest reliability regarding the FJS, with moderate evidence of good internal consistency. Ceiling and floor effects were very low, showing a very promising discriminatory power between patients with a good outcome and patients with an excellent outcome. Therefore, especially in patients expected to achieve high levels of function after total joint replacement, we highly recommend the use of FJS for the long-term assessment of their treatment.

Keywords: floor and ceiling effect; forgotten joint score; patient-reported outcome measures; test-retest reliability; total hip arthroplasty; total knee arthroplasty.

PubMed Disclaimer

Publication types