Collection and Reporting of Patient-reported Outcome Measures in Arthroplasty Registries: Multinational Survey and Recommendations

Bohm, Éric; Kirby, Sarah; Trepman, Elly; Rolfson, Ola; Wilkinson, J. Mark; Sayers, Adrian; Overgaard, Søren; Lyman, Stephen; Franklin, Patricia D.; Dunn, Jennifer; Denissen, Geke; W‐Dahl, Annette; Ingelsrud, Lina Holm; Navarro, Ronald A.

doi:10.1097/corr.0000000000001852

Cited by 46 publications

(56 citation statements)

References 45 publications

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“…4 the nonresponse rate that will invalidate the results of a study is unclear, 5 but a response rate of > 60% has been defined as acceptable by the international Society of arthroplasty Registries (iSaR) pROms working group. [3][4][5][6] the effect of non-response on data interpretation remains unclear. understanding the reasons for non-response is essential to both accurately interpret the data we do have and maximize response rates for the future.…”

Section: Introductionmentioning

confidence: 99%

Loss to patient-reported outcome measure follow-up after hip arthroplasty and knee arthroplasty

et al. 2022

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Aims The aim of this study was to determine satisfaction rates after hip and knee arthroplasty in patients who did not respond to postoperative patient-reported outcome measures (PROMs), characteristics of non-responders, and contact preferences to maximize response rates. Methods A prospective cohort study of patients planned to undergo hip arthroplasty (n = 713) and knee arthroplasty (n = 737) at a UK university teaching hospital who had completed preoperative PROMs questionnaires, including the EuroQol five-dimension health-related quality of life score, and Oxford Hip Score (OHS) and Oxford Knee Score (OKS). Follow-up questionnaires were sent by post at one year, including satisfaction scoring. Attempts were made to contact patients who did not initially respond. Univariate, logistic regression, and receiver operator curve analysis was performed. Results At one year, 667 hip patients (93.5%) and 685 knee patients (92.9%) had undergone surgery and were alive. No response was received from 151/667 hip patients (22.6%), 83 (55.0%) of whom were ultimately contacted); or from 108/685 knee patients (15.8%), 91 (84.3%) of whom were ultimately contacted. There was no difference in satisfaction after arthroplasty between initial non-responders and responders for hips (74/81 satisfied vs 476/516 satisfied; p = 0.847) or knees (81/93 satisfied vs 470/561 satisfied; p = 0.480). Initial non-response and persistent non-response was associated with younger age, higher BMIs, and worse preoperative PROMs for both hip and knee patients (p < 0.050). Being in employment was associated with persistent non-response for hip patients (p = 0.047). Multivariate analysis demonstrated that younger age (p < 0.038), higher BMI (p = 0.018), and poorer preoperative OHS (p = 0.031) were independently associated with persistent non-response to hip PROMs. No independent associations were identified for knees. Using a threshold of > 66.4 years predicted a preference for contact by post (area under the curve 0.723 (95% confidence interval (CI) 0.647 to 0.799; p < 0.001, though this CI crosses the 0.7 limit considered reliable). Conclusion The majority of initial non-responders were ultimately contactable with effort. Satisfaction rates were not inferior in patients who did not initially respond to PROMs. Cite this article: Bone Jt Open 2022;3(4):275–283.

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Section: Introductionmentioning

confidence: 99%

Loss to patient-reported outcome measure follow-up after hip arthroplasty and knee arthroplasty

et al. 2022

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“…Many papers assessed the physical functioning of patients undergoing hip replacement surgery using different patient-reported outcome measures. They provided a shortlist of the most promising generic and joint-specific instruments [4,5,11,12]. In Garnier et al [4], seventy-three studies were investigated, and 26 instruments were included, one of the most frequently assessed instruments being HHS.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the increased interest in evaluating outcomes following hip arthroplasty, challenges remain in ensuring that such assessments of outcome are accurate, reliable, and relevant [4]. Generic patient-reported outcome measures describe a patient's global health status, and numerous comprehensive specific Patient-Reported Outcome Measures (PROMs) instruments are available for patients with hip problems [5]. Health-related quality-of-life data are valuable as they can provide relevant health-status information to health professionals and should be used as rationale for implementing the most adequate standard of health care [6].…”

Section: Introductionmentioning

confidence: 99%

Measurement properties of New Mobility Score to evaluate functional recovery in the elderly following total hip arthroplasty

et al. 2022

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Introduction/Objective. The aim of this study is to identify and evaluate the use of New Mobility Score in estimating functional recovery 3 months after total hip arthroplasty (THA). Methods. Seventy patients, aged > 60, who underwent THA. Treatment group was subjected to the comprehensive rehabilitation program and control group to the standard one. Primary outcome was assessed with Harris Hip Score (HHS) and New Mobility Score (NMS), and secondary one by Medical Outcomes Health Survey (Short Form Health Survey - SF-36). Questionnaires were collected before and three months after hip surgery. Results. Treatment group showed significant improvement 3 months postoperatively. The correlation in both groups between HHS and NMS was very strong (r > 0.700). Treatment group following surgery showed strong correlation between Recovery through Personal Care Services (PCS) and HHS and NMS (r > 0.700), moderate to strong between pain categories and HHS (r = 0.380; r = 0.583) and NMS (r = 0.424). Control group showed strong correlation between PCS and HHS (r = 0.704), and NMS (r = 0.568) and moderate to pain categories and HHS (r = 0.546; r = 0.466). The area under the curve (AUC) described the inherent validity of all measurement used AUCNMS = 0.724, p = 0.001, AUCHHS = 0.788, p = 0.000 and AUCPCS = 0.747, p = 0.001. Conclusion. The NMS could be successfully used in routine clinical assessment of elderly patients following THA. The trial is registered in ISRCTN Register with https://doi.org/10.1186/ISRCTN73197506

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“…12 ethical approval was not required since the data were deidentified and available in the public domain. this study is reported following the Reporting of studies Conducted using observational Routinely-collected data (ReCoRd) checklist, 15 and a checklist for transparent reporting of PRoMs from arthroplasty registries developed by Bohm et al 16 study dataset. the nhs PRoMs dataset includes patients undergoing nhs-funded primary hip and knee arthroplasty procedures in england from 1 april 2009 to 31 March 2020.…”

Section: Methodsmentioning

confidence: 99%

Early patient-reported outcomes from primary hip and knee arthroplasty have improved over the past seven years

Sabah

Knight

Alvand

et al. 2022

The Bone & Joint Journal

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Aims Routinely collected patient-reported outcome measures (PROMs) have been useful to quantify and quality-assess provision of total hip arthroplasty (THA) and total knee arthroplasty (TKA) in the UK for the past decade. This study aimed to explore whether the outcome following primary THA and TKA had improved over the past seven years. Methods Secondary data analysis of 277,430 primary THAs and 308,007 primary TKAs from the NHS PROMs programme was undertaken. Outcome measures were: postoperative Oxford Hip/Knee Score (OHS/OKS); proportion of patients achieving a clinically important improvement in joint function (responders); quality of life; patient satisfaction; perceived success; and complication rates. Outcome measures were compared based on year of surgery using multiple linear and logistic regression models. Results For primary THA, multiple linear regression modelling found that more recent year of surgery was associated with higher postoperative OHS (unstandardized coefficient (B) 0.15 points (95% confidence interval (CI) 0.14 to 0.17); p < 0.001) and higher EuroQol five-dimension index (EQ-5D) utility (B 0.002 (95% CI 0.001 to 0.002); p < 0.001). The odds of being a responder (odds ratio (OR) 1.02 (95% CI 1.02 to 1.03); p < 0.001) and patient satisfaction (OR 1.02 (95% CI 1.01 to 1.03); p < 0.001) increased with year of surgery, while the odds of any complication reduced (OR 0.97 (95% CI 0.97 to 0.98); p < 0.001). No trend was found for perceived success (p = 0.555). For primary TKA, multiple linear regression modelling found that more recent year of surgery was associated with higher postoperative OKS (B 0.21 points (95% CI 0.19 to 0.22); p < 0.001) and higher EQ-5D utility (B 0.002 (95% CI 0.002 to 0.003); p < 0.001). The odds of being a responder (OR 1.04 (95% CI 1.03 to 1.04); p < 0.001), perceived success (OR 1.02 (95% CI 1.01 to 1.02); p < 0.001), and patient satisfaction (OR 1.02 (95% CI 1.01 to 1.02); p < 0.001) all increased with year of surgery, while the odds of any complication reduced (OR 0.97 (95% CI 0.97 to 0.97); p < 0.001). Conclusion Nearly all patient-reported outcomes following primary THA/TKA improved by a small amount over the past seven years. Due to the high proportion of patients achieving good outcomes, PROMs following THA and TKA may need to focus on better discrimination of patients achieving high scores to be able to continue to measure improvement in outcomes. Cite this article: Bone Joint J 2022;104-B(6):687–695.

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Collection and Reporting of Patient-reported Outcome Measures in Arthroplasty Registries: Multinational Survey and Recommendations

Abstract: This is a repository copy of Collection and reporting of patient-reported outcome measures in arthroplasty registries : multinational survey and recommendations.

Cited by 46 publications

References 45 publications

Loss to patient-reported outcome measure follow-up after hip arthroplasty and knee arthroplasty

Loss to patient-reported outcome measure follow-up after hip arthroplasty and knee arthroplasty

Measurement properties of New Mobility Score to evaluate functional recovery in the elderly following total hip arthroplasty

Early patient-reported outcomes from primary hip and knee arthroplasty have improved over the past seven years

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