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Rheumatology 2001; 40: 528-536
© 2001 British Society for Rheumatology


Original Papers

A brief screening tool for knee pain in primary care. 1. Validity and reliability

C. Jinks, M. Lewis, B. N. Ong1 and P. Croft

Primary Care Sciences Research Centre and
1 School of Health, Keele University, Keele, Staffordshire ST5 5BG, UK

Objectives. To design and test the performance of a new knee pain screening tool (KNEST), both separately and together with a combination of existing questionnaires, which will be used to assess the general health status of knee pain sufferers in primary care.

Methods. A postal survey of knee pain and disability was sent to a random sample of 240 individuals aged over 55 yr registered with two general practices in North Staffordshire. The survey questionnaire consisted of the KNEST; a pain manikin; the Short Form 36 (SF-36); the Hospital Anxiety and Depression Scale (HADS); demographic questions; and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for those who reported knee pain. A second, identical questionnaire was sent 2 weeks later to a random subsample of responders (n=80) to test repeatability.

Results. An 85% baseline response rate was achieved for the first questionnaire. The 12-month prevalence of knee pain identified from baseline responders to the survey was 45%. A response rate of 74% was achieved for the repeatability questionnaire. Each section of the questionnaire was well completed and repeatability was good for nearly all measures (most reliability scores exceeded 0.6). A new core question about knee pain showed good internal reliability, with an agreement score of 91% between baseline and retest assessment, and good construct validity in relation to knee pain identified on the pain manikin (agreement 95%). Good agreement was found between recalled consultation for knee pain in the questionnaire and evidence of consultation for knee pain in general practice records.

Conclusions. The KNEST appears to be a reliable and valid composite tool for the study of population needs and outcomes of care for people aged over 55 yr with knee pain.

KEY WORDS: Knee Pain Screening Tool (KNEST), SF-36, WOMAC, HADS, Knee pain, Knee osteoarthritis, Primary care, Needs assessment, GP record review, Epidemiology.

Correspondence to: C. Jinks, Primary Care Sciences Research Centre, 60 The Covert, Keele University, Keele ST5 5BG, UK.


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