SEEK: Salford Environment for Expertise and Knowledge

Journal Article (Refereed)
January 2010

The rheumatoid foot: a systematic literature review of patient reported outcome measures

Walmsley, S & Williams, A & Ravey, M & Graham, A 2010, 'The rheumatoid foot: a systematic literature review of patient reported outcome measures', Journal of Foot and Ankle research, 3(12), pp.1-8.


Background: The foot is often the first area of the body to be systematically affected by rheumatoid arthritis. The
multidimensional consequences of foot problems for patients can be subjectively evaluated using patient-reported
outcome measures (PROMs). However, there is currently no systematic review which has focused specifically upon
the PROMs available for the foot with rheumatoid arthritis. The aim of this systematic review was to appraise the
foot-specific PROMs available for the assessment and/or evaluation of the foot affected with rheumatoid arthritis.
Methods: A systematic search of databases was conducted according to pre-defined inclusion/exclusion criteria.
PROMs identified were reviewed in terms of: conceptual bases, quality of construction, measurement aims and
evidence to support their measurement properties.
Results: A total of 11 PROMs were identified and 5 papers that provided evidence for the measurement properties
of some of the PROMs. Only one of the PROMs was found to be RA disease-specific. The quality of construction,
pretesting and presence of evidence for their measurement properties was found to be highly variable. Conceptual
bases of many of the PROMs was either restricted or based on reductionist biomedical models. All of the PROMs
were found to consist of fixed scales.
Conclusions: There is a need to develop an RA-disease and foot-specific PROM with a greater emphasis on a
biopsychosocial conceptual basis, cognitive pre-testing methods, patient preference-based qualities and evidence
to support the full complement of measurement properties.


SEEK Members

External Authors

Andrea Graham

Steven Walmsley

Publication Details

Journal Name
Journal of Foot and Ankle research