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Letter to the Editor

consider them equivalent trials because of the many methodological differences, some of which are outlined above. We do agree with Dr Rompe, however, on the lack of valid outcomes for the measurement of pain and function associated with lateral epicondylitis. The so-called Roles and Maudsley scale has never been validated or shown to be reliable or sensitive to change. However, we disagree with Dr Rompe that the Patient-Rated Forearm Evaluation Questionnaire (PRFEQ) is the “one assessment tool designed specifically for patients with lateral epicondylitis that is simple and reliable and has been scientifically scrutinized and validated.” As far as the peer-reviewed, indexed literature is concerned, there have only been 2 published studies on the properties of the PRFEQ: the study by Overend et al and the study by Leung et al. Neither of these studies has looked at the reliability of the PRFEQ over a sufficient period of time so as to deem it useful for detecting “no change” over the course of a randomized controlled trial (Overend et al investigated 1-week test-retest reliability, whereas Leung et al measured half-hour testretest reliability); nor have any studies investigated the sensitivity of the PRFEQ to clinically relevant change. Finally, Leung et al measured criterion validity of the Hong Kong Chinese version of the PRFEQ against the Roles and Maudsley score (an unvalidated measurement tool) as the criterion. This comparison does not validate the PRFEQ, in our opinion. Therefore, although we agree with Dr Rompe’s call for an agreement for a standard outcome measure for trials evaluating treatments for lateral epicondylitis, we do not agree that the PRFEQ currently meets the criteria to establish it as the standard tool of measurement in such trials. Further work on validating the PRFEQ is still required before such agreement can take place.