title: Development and reliability of a standard rating system for outcome measurement of foot and ankle disorders I: development of standard rating system.
abstract: BACKGROUND
  The aim of this study was to report the five scales comprising the rating system that the Japanese Society for Surgery of the Foot (JSSF) devised (JSSF standard rating system) and the newly offered interpretations and criteria for determinations of each assessment item.
  
  
  METHODS
  We produced the new scales for the JSSF standard system by modifying the clinical rating systems established by the American Orthopaedic Foot and Ankle Society (AOFAS scales) and the Japanese Orthopaedic Association's foot rating scale (JOA scale). We also provided interpretations of each assessment item and the criteria of determinations in the new standard system.
  
  
  RESULTS
  We improved the ambiguous expressions and content in the conventional standard rating systems so they would be easily understood by Japanese people. The result was five scales in total. Four were designed for use specifically for ankle-hindfoot, midfoot, hallux metatarsophalangeal-interphalangeal, and lesser metatarsophalangeal-ineterphalangeal sites; and the fifth was for the foot and ankle with rheumatoid arthritis. Furthermore, we described interpretations and criteria for determinations with regard to evaluation items in each scale.
  
  
  CONCLUSIONS
  Conventionally, the AOFAS scales or the JOA scale have been separately applied depending on the sites or disorders concerned, but it was often difficult to decide on scores during practical evaluations because of differing expressions in different languages and also because of ambiguity in the interpretation of each evaluation item and in scoring standards as well. JSSF improved these scales and added definite interpretations of evaluation items as well as criteria for the rating (to be reported here in part I). Because these steps were expected to improve the reliability of outcomes assessed by each scale, we examined the reliability in scores of the newly developed scales, which are reported in part II (in this issue).
authors.affiliation: Department of Orthopaedic Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kanagawa 216-8511, Japan.
authors.forename: Hisateru
authors.initials: H
authors.lastname: Niki
authors.forename: Haruhito
authors.initials: H
authors.lastname: Aoki
authors.forename: Suguru
authors.initials: S
authors.lastname: Inokuchi
authors.forename: Satoru
authors.initials: S
authors.lastname: Ozeki
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Kinoshita
authors.forename: Hideji
authors.initials: H
authors.lastname: Kura
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Masahiko
authors.initials: M
authors.lastname: Noguchi
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Nomura
authors.forename: Masahito
authors.initials: M
authors.lastname: Hatori
authors.forename: Shinobu
authors.initials: S
authors.lastname: Tatsunami
mesh_terms: D000842:Ankle; D019937:Diagnostic Techniques and Procedures / Q000592:standards*; D005534:Foot Diseases / Q000175:diagnosis*; D006801:Humans; D009985:Orthopedics / Q000592:standards*; D015203:Reproducibility of Results