Development and validation of self-reported line drawings of the modified Beighton score for the assessment of generalised joint hypermobility

Cooper, Dale J.; Scammell, Brigitte E.; Batt, Mark E.; Palmer, Debbie

Abstract

Background: The impracticalities and comparative expense of carrying out a clinical assessment is an obstacle in many large epidemiological studies. The purpose of this study was to develop and validate a series of electronic self-reported line drawing instruments based on the modified Beighton scoring system for the assessment of self-reported generalised joint hypermobility.
Methods: Five sets of line drawings were created to depict the 9-point Beighton score criteria. Each instrument consisted of an explanatory question whereby participants were asked to select the line drawing which best represented their joints. Fifty participants completed the self-report online instrument on two occasions, before attending a clinical assessment. A blinded expert clinical observer then assessed participants’ on two occasions, using a standardised goniometry measurement protocol. Validity of the instrument was assessed by participant-observer agreement and reliability by participant repeatability and observer repeatability using unweighted Cohen’s kappa (k). Validity and reliability were assessed for each item in the self-reported instrument separately, and for the sum of the total scores. An aggregate score for generalised joint hypermobility was determined based on a Beighton score of 4 or more out of 9.
Results: Observer-repeatability between the two clinical assessments demonstrated perfect agreement (k 1.00; 95% CI 1.00, 1.00). Self-reported participant-repeatability was lower but it was still excellent (k 0.91; 95% CI 0.74, 1.00). The participant-observer agreement was excellent (k 0.96; 95% CI 0.87, 1.00). Validity was excellent for the self-report instrument, with a good sensitivity of 0.87 (95% CI 0.81, 0.91) and excellent specificity of 0.99 (95% CI 0.98, 1.00).
Conclusions: The self-reported instrument provides a valid and reliable assessment of the presence of generalised joint hypermobility and may have practical use in epidemiological studies.

Citation

Cooper, D. J., Scammell, B. E., Batt, M. E., & Palmer, D. (in press). Development and validation of self-reported line drawings of the modified Beighton score for the assessment of generalised joint hypermobility. BMC Medical Research Methodology, 18(1), https://doi.org/10.1186/s12874-017-0464-8

• Journal Article Type: Article
• Acceptance Date: Dec 20, 2017
• Online Publication Date: Jan 17, 2018
• Deposit Date: Feb 12, 2018
• Publicly Available Date: Feb 12, 2018
• Journal: BMC Medical Research Methodology
• Electronic ISSN: 1471-2288
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 18
• Issue: 1
• DOI: https://doi.org/10.1186/s12874-017-0464-8
• Public URL: https://nottingham-repository.worktribe.com/output/904985
• Publisher URL: https://bmcmedresmethodol.biomedcentral.com/articles/10.1186/s12874-017-0464-8