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

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posted on 01.06.2020, 14:12 by Dale J Cooper, Brigitte E Scammell, Mark E Batt, Debbie Palmer

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.

Funding

This work was supported by Arthritis Research UK [grant number 20194], funding gratefully received from Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis.

History

Citation

Cooper, D.J., Scammell, B.E., Batt, M.E. et al. Development and validation of self-reported line drawings of the modified Beighton score for the assessment of generalised joint hypermobility. BMC Med Res Methodol 18, 11 (2018). https://doi.org/10.1186/s12874-017-0464-8

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VoR (Version of Record)

Published in

BMC Medical Research Methodology

Volume

18

Issue

1

Publisher

Springer Science and Business Media LLC

eissn

1471-2288

Acceptance date

20/12/2017

Copyright date

2018

Language

en

Publisher version

https://bmcmedresmethodol.biomedcentral.com/articles/10.1186/s12874-017-0464-8

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