Comparison of psychometric properties of subjective structured assessment instruments of technical performance during knee arthroscopy

Abstract Objectives Various subjective assessment global rating scales to assess proficiency of surgeons while performing knee arthroscopy have been described but it is still unclear as to which of the assessment scale is the most optimal and “gold standard”. The aim of the present study was to compare and contrast psychometric properties like validity and reliability of objective assessment global rating scales for knee arthroscopy. Methods A systematic review was performed of articles published in Pubmed, Embase, AMED, ERIC, Proquest and CINAHL. Ten assessment scales (Arthroscopic surgery skill evaluation tool [ASSET]; Arthroscopy skills score; global ratings of arthroscopic performance; basic arthroscopic knee scoring system [BAKSS]; modified basic arthroscopic knee scoring system [modified BAKSS]; modified objective structured assessment of technical skill [modified OSATS]; modified objective assessment of arthroscopic skills [modified OAAS]); modified orthopaedic competency assessment project [modified OCAP; Imperial global arthroscopy rating scale [IGARS] and Injury grading index [IGI] fulfilled the inclusion criteria. A predefined checklist was used to compare content validity, construct - convergent validity, construct - discriminant validity, criterion validity, predictive validity, internal consistency, inter-rater reliability, intra-rater reliability and test-retest reliability of all the included assessment global rating scales. Results The ASSET demonstrated optimal number of satisfactory psychometric properties of content validity, construct-convergent validity, construct - discriminant validity, criterion validity, internal consistency, inter-rater reliability, intra-rater reliability and test-retest reliability. The IGI demonstrated the least number of satisfactory psychometric properties. Conclusion We recommend the use of Arthroscopic surgery skill evaluation tool [ASSET] as it demonstrates optimal psychometric properties. The ASSET can be used as gold standard to compare existing outcome assessment tools.