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Concurrent validity of a patient self-administered examination and a clinical examination for femoroacetabular impingement syndrome
  1. Kwadwo Adu Owusu-Akyaw1,
  2. Carolyn A Hutyra1,
  3. Richard J Evanson2,
  4. Chad E Cook3,
  5. Mike Reiman3,
  6. Richard C Mather4
  1. 1Orthopaedic Surgery, Duke University, Durham, North Carolina, USA
  2. 2Sports Medicine and Spine Center, Plano Orthopedic, Plano, Texas, USA
  3. 3Physical Therapy, Duke University, Durham, North Carolina, USA
  4. 4Orthopedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
  1. Correspondence to Dr Kwadwo Adu Owusu-Akyaw; kwadwo.owusuakyaw{at}


Objective Telehealth has been established as a viable option for improved access and timeliness of care. Physician-guided patient self-evaluation may improve the viability of telehealth evaluation; however, there are little data evaluating the efficacy of self-administered examination (SAE). This study aims to compare the diagnostic accuracy of a patient SAE to a traditional standardised clinical examination (SCE) for evaluation of femoroacetabular impingement syndrome (FAIS).

Methods 75 patients seeking care for hip-related pain were included for participation. All patients underwent both SAE and SCE and were randomised to the order of the examinations. Diagnostic accuracy statistics were calculated for both examination group for a final diagnosis of FAIS. Mean diagnostic accuracy results for each group were then compared using Mann-Whitney U non-parametric tests.

Results The diagnostic accuracy of individual SAE and SCE manoeuvres varied widely. Both SAE and SCE demonstrated no to moderate change in post-test probability for the diagnosis of FAIS. Although low, SAE demonstrated a statistically greater mean diagnostic accuracy compared with the SCE (53.6% vs 45.5%, p=0.02).

Conclusion Diagnostic accuracy was statistically significantly higher for the self-exam than for the traditional clinical exam although the difference may not be clinically relevant. Although the mean accuracy remains relatively low for both exams, these values are consistent with hip exam for FAIS reported in the literature. Having established the validity of an SAE, future investigations will need to evaluate implementation in a telehealth setting.

  • femoroacetabular impingement syndrome
  • telehealth
  • diagnostic accuracy

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  • Contributors All listed authors were integral to the planning, execution, writing and revision of the present study. All coauthors contributed substantially to the study design, acquisition, analysis and/or interpretation of data. Final approval of the submitted manuscript was obtained from all coauthors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Institutional review board approval was obtained prior to initiation of this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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