TENDINopathy severity assessment – patellar (TENDINS-P): development and content validity assessment of a new patient-reported outcome measure for patellar tendinopathy

Key Points

1. TENDINS-P is the only patellar tendinopathy patient-reported outcome measure developed and validated using the COSMIN guidelines.

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BACKGROUND & OBJECTIVE

The VISA-P is a widely used patient-reported outcome measure (PROM) primarily designed for the athletic population, to differentiate individuals with patellar tendinopathy from those without and to track functional improvements from treatment interventions (1,2). Patient involvement in item generation, item relevance, comprehensiveness (to ensure the key aspects of a construct are included) and comprehensibility (items, response options, and instructions are understood as intended) are essential in the development of a PROM (3).

The study aimed to develop a PROM for patellar tendinopathy using patient and clinician feedback and validate the content to measure the severity of patellar tendinopathy-related disability.

Patient involvement in item generation, item relevance, comprehensiveness and comprehensibility are essential in the development of a patient-reported outcome measure.

TENDINS-P enables differentiated sub-domain scoring for individual assessment of the disability pattern.

METHODS

The development and content validation of TENDINS-P occurred between February 2024 and October 2025 using mixed-method validation and COSMIN guidelines. Five authors determined tendon-related disability as the construct to ensure the tool measured the severity of disability versus being a

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