Table of Contents
ISRN Orthopedics
Volume 2013, Article ID 801784, 11 pages
Clinical Study

TEFTOM: A Promising General Trauma Expectation/Outcome Measure—Results of a Validation Study on Pan-American Ankle and Distal Tibia Trauma Patients

1Orthopaedic Trauma Service, College of Medicine Jacksonville, University of Florida, 655 West Eight St, 2nd Floor ACC, Jacksonville, FL 32209, USA
2Clinical Investigation and Documentation, AO Foundation, Stettbachstrasse 6, 8600 Duebendorf, Switzerland
3Department of Surgery, Foothills Medical Centre, University of Calgary, AC 144A, 1403 29th Street NW, Calgary, AB, Canada T2N 2T9
4Department of Orthopaedics and Trauma Surgery, Ribeirão Preto School of Medicine, São Paulo University, São Paolo, Brazil
5Orthopaedic Trauma Service, New York Presbyterian University Hospital of Columbia and Cornell, 525 East 68th Street, New York, NY 10065-4870, USA
6Orthopaedic Trauma Service, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021-4898, USA

Received 10 January 2013; Accepted 30 January 2013

Academic Editors: A. Karantanas, C.-H. Lee, G. Matthes, and E. L. Steinberg

Copyright © 2013 Michael Suk et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. In orthopedics, there is no instrument specifically designed to assess patients’ expectations of their final surgery outcome in general trauma populations. We developed the Trauma Expectation Factor Trauma Outcome Measure (TEFTOM) to investigate the fulfilment of patients’ expectations one year after surgery as a measure of general trauma surgical outcomes. The aim of this paper was to assess the psychometric characteristics of this new general trauma outcome measure. Methods. The questionnaire was tested in 201 ankle and distal tibia fracture patients scheduled for surgery. Patients were followed up for twelve months. The TEFTOM questionnaire was evaluated for its criterion validity, internal consistency, reproducibility, and responsiveness. Results. TOM showed good criterion validity against the American Academy of Orthopaedic Surgeons Foot and Ankle Scale (Pearson’s correlation coefficient = 0.69–0.77). Internal consistency was acceptable for TEF (Cronbach’s alpha = 0.65–0.76) and excellent for TOM (Cronbach’s alpha = 0.76–0.85). Reproducibility was moderate to very good (intraclass coefficient correlation (ICC) ) for TEF and very good (ICC ) for TOM. TOM also proved to be responsive to changes in patients’ condition over time (Wald test; ). Conclusions. TEFTOM is a promising tool for measuring general trauma outcomes in terms of patients’ expectation fulfilment that proved to be valid, internally consistent, reproducible, and responsive to change.