TY - JOUR
T1 - Validity and diagnostic accuracy of foot posture Index-6 using radiographic findings as the gold standard to determine paediatric flexible flatfoot between ages of 6–18 years
T2 - A cross-sectional study
AU - Hegazy, Fatma A.
AU - Aboelnasr, Emad A.
AU - Salem, Yasser
AU - Zaghloul, Ashraf A.
N1 - Funding Information:
The current study had been approved by the Human Research Ethics Committee of Cairo University, Egypt and the Research Ethics Committee of the Ministry of Health and Prevention, United Arab Emirates .
Publisher Copyright:
© 2020 Elsevier Ltd
PY - 2020/4
Y1 - 2020/4
N2 - Background: Diagnosis of flexible flatfoot is usually based upon radiographic or clinical measures. Radiographic measures pose a potential risk of radiation exposure especially in Paediatric population. Clinicians need a valid, accurate, easily used, noninvasive and cost effective measure to evaluate static foot posture clinically. Although, foot posture index-6 (FPI-6) are commonly used in clinical practice, its validity and diagnostic accuracy in evaluation of paediatric flexible flatfoot have not been fully proven yet. Objectives: To investigate validity and diagnostic accuracy of FPI-6 to determine Paediatric flexible flatfoot between ages of 6–18 years using radiographic findings as the gold standard measure. Study design: Cross-sectional study. Methods: A cross-sectional study conducted on 612 participants (1224 feet) with flexible flatfoot aged 6–18 years (mean age ± standard deviation of 12.36 ± 3.39 years). The results of FPI-6 were compared to the gold standard radiographic measures and displayed on the receiver operating characteristic curve. Intra-rater reliability, sensitivity, specificity, predictive values and likelihood ratios were calculated. Posttest probability was calculated from Fagan nomogram. Results: FPI-6 demonstrate high intra-rater reliability (ICC = 0.96) with p value < 0.001. FPI-6 showed a sensitivity of 83.7%, a specificity of 80.4, a positive predictive value of 64.7, a negative predictive value of 92, a positive likelihood ratio of 4.62 and a negative likelihood ratio of 0.20. FPI-6 shows moderate diagnostic accuracy [AUC = 0.82; 95%CI (0.78–0.85)]. Conclusion: FPI-6 is valid with moderate diagnostic accuracy to determine paediatric flexible flatfoot between ages of 6–18 years.
AB - Background: Diagnosis of flexible flatfoot is usually based upon radiographic or clinical measures. Radiographic measures pose a potential risk of radiation exposure especially in Paediatric population. Clinicians need a valid, accurate, easily used, noninvasive and cost effective measure to evaluate static foot posture clinically. Although, foot posture index-6 (FPI-6) are commonly used in clinical practice, its validity and diagnostic accuracy in evaluation of paediatric flexible flatfoot have not been fully proven yet. Objectives: To investigate validity and diagnostic accuracy of FPI-6 to determine Paediatric flexible flatfoot between ages of 6–18 years using radiographic findings as the gold standard measure. Study design: Cross-sectional study. Methods: A cross-sectional study conducted on 612 participants (1224 feet) with flexible flatfoot aged 6–18 years (mean age ± standard deviation of 12.36 ± 3.39 years). The results of FPI-6 were compared to the gold standard radiographic measures and displayed on the receiver operating characteristic curve. Intra-rater reliability, sensitivity, specificity, predictive values and likelihood ratios were calculated. Posttest probability was calculated from Fagan nomogram. Results: FPI-6 demonstrate high intra-rater reliability (ICC = 0.96) with p value < 0.001. FPI-6 showed a sensitivity of 83.7%, a specificity of 80.4, a positive predictive value of 64.7, a negative predictive value of 92, a positive likelihood ratio of 4.62 and a negative likelihood ratio of 0.20. FPI-6 shows moderate diagnostic accuracy [AUC = 0.82; 95%CI (0.78–0.85)]. Conclusion: FPI-6 is valid with moderate diagnostic accuracy to determine paediatric flexible flatfoot between ages of 6–18 years.
KW - Children
KW - Diagnostic accuracy
KW - Flatfoot
KW - Foot posture index-6
KW - Validation
KW - X-ray
UR - http://www.scopus.com/inward/record.url?scp=85078566661&partnerID=8YFLogxK
U2 - 10.1016/j.msksp.2020.102107
DO - 10.1016/j.msksp.2020.102107
M3 - Article
C2 - 31989966
AN - SCOPUS:85078566661
SN - 2468-8630
VL - 46
JO - Musculoskeletal Science and Practice
JF - Musculoskeletal Science and Practice
M1 - 102107
ER -