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

Figures & data

Figure 1 Instrument flow diagram.

Abbreviations: PROMs, patient-reported outcome measures; OU, Oxford University; AMED, Allied and Complementary Medicine Database; PROMs, patient-reported outcome measures.

Table 1 Hip and knee scores

Instrument group	Hip				Knee
Instrument (groups tested)	HOOS (h)	HRQ (h)	PSI (h)	OHS (h)	Knee disorders subjective history (VAS) (k)	KOOS (k)	KOOS-PS (k)	OKS (k)	OKS-APQ (k)
Number of studies	5	1	4	20	1	3	2	23	1
Reproducibility	++	+	+	++	0	+	0	+++	+++
Internal consistency	+	0	0	++	0	0	+++	+++	+++
Validity: content	0	0	++	++	+	+	+	+++	+++
Construct	++	+	++	+++	+	+	++	+++	+++
Responsiveness	+	+	++	+++	0	0	++	+++	+++
Interpretability	0	0	0	+++	0	0	0	++	0
Floor/ceiling/precision	+	0	0	−/+	0	+	0	++	++
Acceptability	0	0	0	+++	−	0	0	+++	+++

Notes: Psychometric and operational criteria: “0” not reported; “−” no evidence in favor; “+” some limited evidence in favor; “++” some good evidence in favor”; “+++” good evidence in favor; “+/–” mixed evidence.

Abbreviations: HOOS, Hip Disability and Osteoarthritis Outcome Score; HRQ, Hip Rating Questionnaire; PSI, patient-specific index; OHS, Oxford Hip Score; KOOS, Knee Injury and Outcomes Osteoarthritis Score; KOOS-PS, KOOS-Physical Function Short Form; OKS, Oxford Knee Score; OKS-APQ, OKS-Activity and Participation Questionnaire; h, hip; k, knee; VAS, visual analog scale.

Table 4 Other scores

Instrument	WHOQOL-BREF (h/k)	Aberdeen IAP (h/k)	Aberdeen IAP (modified) (h/k)	NEADL (h)	AQOL (h/k)	MSK functional limitations index (k)	HAQ (k)	MHAQ (h/k)	MHAQ (h)	K10 (h/k)
Number of studies	1	1	1	1	2	1	2	2	N/a	1
Reproducibility	0	0	0	++	0	0	0	0	0	0
Internal consistency	++	+	++	++	0	0	−	0	0	0
Validity: content	+	+	0	−	0	0	0	0	+	−
Construct	0	+	+	+	+	+	++	+	+	+
Responsiveness	+	0	0	−	++	0	−	−	+	−
Interpretability	0	0	0	0	0	0	0	0	0	0
Floor/ceiling/	++	+	0	+	0	0	+	++	0	++
precision
Acceptability	0	0	0	0	0	+	0	0	0	0

Notes: Psychometric and operational criteria: “0” not reported; “−” no evidence in favor; “+” some limited evidence in favor; “++” some good evidence in favor”; “+++” good evidence in favor.

Abbreviations: WHOQOL-BREF, World Health Organization Quality of Life Instrument; Aberdeen IAP, Aberdeen Impairment, Activity Limitation, and Participation Restriction; NEADL, Nottingham Extended Activities of Daily Living; AQOL, Assessment of Quality of Life; MSK, musculoskeletal; HAQ, Health Assessment Questionnaire; MHAQ, Modified Health Assessment Questionnaire; K10, The Kessler Psychological Distress Scale; h, hip; k, knee; N/a, not applicable.

Table 2 Lower limb and pain scores

Instrument group	Lower limb							Pain
Instrument (group tested)	LEFS (h/k)	WOMAC (h/k)	WOMAC (h)	WOMAC (k)	WOMAC SF (h/k)	Lower limb core score (h/k)	MODEMS-HK (AAOS) hip and knee core score (h/k)	ICOAP (h/k)	P4 (h/k)	McGill pain-short form (h/k)
Number of studies	5	25	N/a	N/a	N/a	1	1	2	1	2
Reproducibility	+	++	++	+	0	0	0	+	0	++
Internal consistency	+	+	0	0	+	0	0	+	++	0
Validity: content	+	+	+	+	+	+	+	++	+	0
Construct	++	+++	+	++	++	0	+	+	+	+
Responsiveness	++	+++	++	++	+	0	++	−	0	−
Interpretability	+	++	++	++	0	0	0	0	0	0
Floor/ceiling/precision	0	−/+	−	0	0	0	++	0	0	0
Acceptability	0	++	+	+	0	0	+	0	0	0

Notes: Psychometric and operational criteria: “0” not reported; “−” no evidence in favor; “+” some limited evidence in favor; “++” some good evidence in favor”; “+++” good evidence in favor; “+/−” mixed evidence.

Abbreviations: LEFS, Lower Extremity Functional Scale; WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index; WOMAC-SF, WOMAC Short Form; MODEMS-HQ, Musculoskeletal Outcome Data Evaluation and Management System Hip and Knee Core Scale; AAOS, American Academy of Orthopedic Surgeons; ICOAP, Intermittent and Constant Osteoarthritis Pain Measure; h, hip; k, knee; N/a, not applicable.

Table 3 Utility and generic scores

Instrument group	Utility					Generic
Instrument (group tested)	SF6D (h)	HUI2 and HUI3 (h)	EQ-5D (h/k)	EQ-5D (h)	EQ-5D (k)	SF-36 (h/k)	SF-36 (h)	SF-36 (k)	SF-12 (h/k)	SF-12 (h)	SF-12 (k)	SIP (h)
Number of studies	1	4	9	N/a	N/a	14	N/a	N/a	3	N/a	N/a	2
Reproducibility	0	0	0	0	0	0	0	0	++	0	0	0
Internal consistency	0	0	N/a	N/a	N/a	0	0	−	0	0	0	0
Validity: content	0	0	0	0	0	0	0	0	0	0	0	+
Construct	0	++	+	0	+	+	0	+	0	0	+	+
Responsiveness	++	+	0	0	+	0	++	+	0	+	+	−
Interpretability	0	0	0	++	++	0	+	+	0	+	+	0
Floor/ceiling/precision	−	0	0	0	++	0	−	0	+++	0	0	−
Acceptability	0	0	0	0	++	0	0	0	0	0	0	0

Notes: Psychometric and operational criteria: “0” not reported; “−” no evidence in favor; “+” some limited evidence in favor; “++” some good evidence in favor”; “+++” good evidence in favor.

Abbreviations: SF6D, Short Form 6D; HUI2 and HUI3, Health Utilities Index Mark 2 and Mark 3; EQ-5D, European Quality of Life Questionnaire 5D; SF-12, Short Form 12; SF-36, short form 36; SIP, sickness impact profile; h, hip; k, knee; N/a, not applicable.