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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

Authors

Dale J. Cooper

BRIGITTE SCAMMELL b.scammell@nottingham.ac.uk
Dean of The School of Medicine/ professor of Orthopaedic Sciences

Mark E. Batt Mark.Batt@nottingham.ac.uk

Debbie Palmer d.palmer@napier.ac.uk



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 http://eprints.nottingham.ac.uk/id/eprint/49731
Publisher URL https://bmcmedresmethodol.biomedcentral.com/articles/10.1186/s12874-017-0464-8
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





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