The grading of hallux valgus. The Manchester Scale.
This article describes a new, noninvasive method of assessing the severity of hallux valgus deformity by means of a set of standardized photographs. Six podiatrists were independently asked to grade the level of deformity of 13 subjects (26 feet) on a scale of 1 (no deformity) to 4 (severe deformity). The reliability of the four-point scale for the severity of hallux valgus was investigated by means of kappa-type statistics for more than two raters. The results showed that the grading method had excellent interobserver repeatability with a combined kappa-type statistic of 0.86, making it a suitable instrument for clinical and research purposes.
Diabetes Foot Clinic, Disablement Services Centre, Withington Hospital, Cavendish Rd, Manchester M20 8LB, England.
A P
AP
Garrow
A
A
Papageorgiou
A J
AJ
Silman
E
E
Thomas
M I
MI
Jayson
G J
GJ
Macfarlane
D005528:Foot / Q000473:pathology; D006215:Hallux Valgus / Q000145:classification* / Q000473:pathology; D006801:Humans; D015588:Observer Variation; D010781:Photography / Q000706:statistics & numerical data; D011032:Podiatry / Q000706:statistics & numerical data; D011897:Random Allocation; D015203:Reproducibility of Results; D012720:Severity of Illness Index