Work

Comparison of the European Foot and Ankle Score (EFAS) and the American Orthopedic Foot and Ankle Society Score (AOFAS) in patients with foot and ankle surgery

Year: 2025

Type: article

Abstract: BACKGROUND: Both EFAS and AOFAS are questionnaires used in evaluating postoperative outcome of foot and ankle surgeries. The EFAS is a Patient Reported Outcome Measure (PROM), whereas the AOFAS also contains a physician reported subset and is the most commonly used questionnaire worldwide. Our study compared psychometric properties of both scores in patients with foot or ankle surgery. METHODS: We compared validity and reliability of the EFAS and AOFAS questionnaires in 126 foot and ankle surgical patients. Internal consistency, test-retest reliability, floor and ceiling effects, construct validity, responsiveness and minimal important change were analyzed. RESULTS: The AOFAS and EFAS show similar psychometric properties overall with the EFAS showing better internal consistency than the AOFAS with a smaller standard error of the mean (SEM), while the AOFAS showed a higher sensitivity to change. CONCLUSIONS: Both the EFAS and the AOFAS show comparable psychometric properties. The EFAS performs better regarding SEM and internal consistency. Furthermore EFAS is a PROM without investigator bias and should therefore be preferred. LEVEL OF EVIDENCE: III.

Source: Foot and Ankle Surgery

DOI: 10.1016/j.fas.2025.04.008

Authors: Victoria Julia Frank, Philipp Lichte, Natalia Gutteck, Bertil Bouillon, Dariusch Arbab

Institutions: University Medical Center Hamburg-Eppendorf, Universitätsklinikum Aachen, Martin Luther University Halle-Wittenberg, Witten/Herdecke University

Language: English

Topic: Foot and Ankle Surgery

Subfield: Orthopedics and Sports Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,300