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We found the Enneking scoring system to be relevant to our population of patients and would recommend the use of such a scoring system in limb reconstruction.
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The utility of such a score needs to be evaluated prospectively in a large cohort of patients.
For the derivation of such a score function, we follow the idea of the conventional track extraction methodology [21] and use a sequential likelihood ratio test.
We therefore do not recommend the use of such a score in its present form.
Evaluation should be made of a possible association of such a score with the patients' subjective complaints and the radiological grade of osteoarthritis.
Composite scores can be useful summaries of visual function, particularly when the content of such a score is based on the results of factor analysis.
Moreover, the implementation of such a score may reduce the need for echocardiography in a primary-care based screening programme for left ventricular dysfunction.
The value of such a score might be further examined in large-scale studies exploring the association between motivation, measured in this way, and other attributes of the health system, such as hospital performance.
Currently, ratings are made at the domain level and although they could be arbitrarily assigned a value, which could be summed to create a raw 'score', the validity of such a score would also require further testing.
In this article some methodological issues in the design of such a score and its cut-offs are highlighted in order to further propose a strategy to overcome them.
Comparing the score's performance in predicting these elevations to the more traditional MetS diagnosis required using a cutoff value for the MetS risk score itself even though one of the benefits of such a score is its lack of binary nature.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com