In MSK healthcare, HODA-A is used as a measurement instrument to identify specific characteristics of a person’s anatomy that proceed to inform and manage patient care (see table below).  Therefore, the validity and reliability of HODA-A as a measurement instrument is central to understanding and informing MSK healthcare, right?

But, for 70 years, HODA-A has undergone reliability studies and has yet to demonstrate acceptable validity and reliability, with the most recent studies concluding HODA-A is clinically unacceptable and should not be used in MSK healthcare. Note to reader… although there are many MSK healthcare professionals using HODA-A to inform MSK health, practitioners of manual therapy (PoMT) seem to be the only discipline who are targeted to prove their HODA-A reliability (population bias).

EXTRACT FROM: Jo Abbott Ph.D. Thesis

Why does HODA-A continue to be used?

  1. Clinically, in a real-world setting, implementation of HODA-A provides a safe, cost effective, and environmentally convenient assessment of a person’s MSK system, and anecdotal evidence suggests HODA-A has ‘face validity‘ – a term used to describe if something “looks like” it is going to measure what it is supposed to measure.
  2. HODA-A continues to be used clinically because many researchers perpetually use HODA-A to construct scientific studies (see Researcher in table above), with some studies being termed ‘Gold Standard‘ i.e., 3D Mocap, yet the critical data capture points of the markers were located using HODA-A.
  3. when critically analysing the literature, HODA-A lacks any validity studies – validity is the most important measurement property for a measurement instrument, a measurement instrument has no reliability if validity has not first been established.

Interested to learn more? Then it's time to delve in...