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

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Abstract
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.