title: Comparison of the Self-reported Foot and Ankle Score (SEFAS) and the American Orthopedic Foot and Ankle Society Score (AOFAS).
abstract: BACKGROUND
  The Self-reported Foot and Ankle Score (SEFAS) is a patient-reported outcome measure, while the American Orthopedic Foot and Ankle Society Score (AOFAS) is a clinician-based score, both used for evaluation of foot and ankle disorders. The purpose of this study was to compare the psychometric properties of these 2 scoring systems.
  
  
  METHODS
  A total of 95 patients with great toe disorders and 111 patients with ankle or hindfoot disorders completed the 2 scores before and after surgery. We evaluated time to complete the scores in seconds, correlations between scores with Spearman's correlation coefficient (r s), floor and ceiling effects by proportion of individuals who reached the minimum or maximum values, test-retest reliability and interobserver reliability by intraclass correlation coefficient (ICC), internal consistency by Cronbach's coefficient alpha (CA), and responsiveness by effect size (ES). Data are provided as correlation coefficients, means, and standard deviations.
  
  
  RESULTS
  SEFAS was completed 3 times faster than AOFAS. The scores correlated with an r s of .49 for great toe disorders and .67 for ankle/hindfoot disorders (both P < .001). None of the scores had any floor or ceiling effect. SEFAS test-retest ICC values measured 1 week apart were .89 for great toe and .92 for ankle/hindfoot disorders, while the corresponding ICC values for AOFAS were .57 and .75. AOFAS interobserver reliability ICC values were .70 for great toe and .81 for ankle/hindfoot disorders. SEFAS CA values were .85 for great toe and .86 for ankle/hindfoot disorders, while the corresponding CA values for AOFAS were .15 and .42. SEFAS ES values were 1.15 for great toe and 1.39 for ankle/hindfoot disorders, while the corresponding ES values for AOFAS were 1.05 and 1.73.
  
  
  CONCLUSIONS
  As SEFAS showed similar or better outcome in our tests and was completed 3 times faster than AOFAS, we recommend SEFAS for evaluation of patients with foot and ankle disorders.
  
  
  METHODS
  Level II, prospective comparative study.
authors.affiliation: Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital Malmö, Sweden Hand & Foot Surgery Center, Stockholm, Sweden maria.coster@med.lu.se.
authors.forename: Maria C
authors.initials: MC
authors.lastname: Cöster
authors.affiliation: Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital Malmö, Sweden.
authors.forename: Björn E
authors.initials: BE
authors.lastname: Rosengren
authors.affiliation: Departments of Rheumatology and Clinical Sciences, Lund University, Lund, Sweden.
authors.forename: Ann
authors.initials: A
authors.lastname: Bremander
authors.affiliation: Department of Clinical Physiology, Kalmar Hospital, Kalmar and Department of Medicine and Health Sciences, University Hospital Linköping, Linköping, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Brudin
authors.affiliation: Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital Malmö, Sweden.
authors.forename: Magnus K
authors.initials: MK
authors.lastname: Karlsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005534:Foot Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011446:Prospective Studies; D011594:Psychometrics; D015203:Reproducibility of Results; D057566:Self Report; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: AOFAS; SEFAS; ankle; comparison; foot; hindfoot; reliability; responsiveness; score; validity