Systematic review of measurement properties of patient-reported outcome measures used in patients undergoing hip and knee arthroplasty

Abstract

Objectives

To identify patient-reported outcome measures (PROMs) that have been developed and/or used with patients undergoing hip or knee replacement surgery and to provide a shortlist of the most promising generic and condition-specific instruments.

Methods

A systematic review of the literature was performed to identify measures used in patients undergoing hip and knee replacement and extract and evaluate information on their methodological quality.

Results

Thirty-two shortlisted measures were reviewed for the quality of their measurement properties. On the basis of the review criteria, the measures with most complete evidence to date are the Oxford Hip Score (OHS) (for patients undergoing hip replacement surgery) and the Oxford Knee Score (OKS), with OKS-Activity and Participation Questionnaire (for patients undergoing knee replacement surgery).

Conclusion

A large number of these instruments lack essential evidence of their measurement properties (eg, validity, reliability, and responsiveness) in specific populations of patients. Further research is required on almost all of the identified measures. The best-performing condition-specific PROMs were the OKS, OHS, and Western Ontario and McMaster Universities Osteoarthritis Index. The best-performing generic measure was the Short Form 12. Researchers can use the information presented in this review to inform further psychometric studies of the reviewed measures.

Keywords:

• knee
• hip
• patient-reported outcome measures
• systematic review
• measurement properties
• validity
• reliability

Acknowledgments

A copy of the OHS, OKS, and OKS-APQ questionnaires and permission to use these measures can be acquired from Isis Innovation Ltd, the technology transfer company of the University of Oxford via website: http://www.isis-innovation.com/outcomes/index.html or email: [email protected]. The research reported in this manuscript was supported by the NIHR Health Technology Assessment program grant award: “Introducing Standardized and Evidence Based Thresholds for Hip and Knee Replacement Surgery – The Arthroplasty Candidacy Help Engine (The ACHE tool)”, under the grant number 11/63/01.

Disclosure

The authors report no conflicts of interest in this work.