Collection of the International Hip Outcome Tool-12 Using a Smartphone Application Format Is Faster and Preferred When Compared With the Paper Version: A Pilot Study of rHip

Abstract

Purpose: To evaluate the agreeability between the mobile application-based International Hip Outcome survey with the paper version, as well as compare the time it takes patients each of the versions, and patient preferences between the two. Methods: Patients seen with symptomatic femoroacetabular impingement syndrome were prospectively enrolled in February 2019 and completed both the paper and application-based iHOT-12, in randomized order. Outcomes scores and time to completion were recorded for each version, and patients were also asked which they preferred. Intraclass correlation coefficient was calculated to assess for absolute agreement between the 2 versions. BlandeAltman plots were constructed to evaluate the agreeability between paper and application-based iHOT-12 scores. BlandeAltman plots were evaluated to identify systematic bias and data stratification was performed to identify sequence bias between the application and paper-based collection modalities. Results: Twenty-nine patients (aged15-56 years) completed both the paper and application-based versions of the iHOT-12. Between the application-based and paper versions, the intraclass correlation coefficient was 0.98, and BlandeAltman analysis showed agreement without bias between versions. There was no sequence bias. Accounting for completion order, the application-based iHOT-12 was faster for patients when compared to the paper version (61.4 AE 20.3 vs 71.9 AE 23.6 seconds, P ¼ .02). Twenty-two patients reported a version preference where 19 of 22 (86%) chose application-based (P < .001). Conclusions: The applicationbased iHOT-12 demonstrated absolute agreement with the paper iHOT-12, and is faster for patients to complete. Patients preferred using the application-based iHOT-12 over the paper-based version. Application-based PROs allow for collection of patient data at more frequent time points, which may be helpful in tracking the recovery progress of patients and predicting outcomes. Clinical Relevance: As electronic-based outcome surveys become more common, it is important to know how the results may differ from traditional paper-based surveys.

A Smartphone App Shows Patients Return to Preoperative Gait Metrics 6 Weeks After Hip Arthroscopy, and Gait Metrics Have Low to Moderate Correlations With a Hip-Specific Patient-Reported Outcome Measure

“…rHip has been previously studied in patients with FAIS for collection of the 12-item international Hip Outcome Tool (iHOT-12), showing agreement with paper-based forms. 22 Health data included in the analyses were step count (average daily steps), step length (distance between where one foot hits the ground and where the contralateral foot hits the ground in one step, measure in meters), and average daily walking speed (meters per second).…”

“… 21 However, the improvements in step count had weak correlations with LEFS scores, suggesting that continuous gait performance data may capture an aspect of recovery different from that of PROs. 21 Additionally, there are limited data evaluating the use of apps in hip arthroscopy, 22 , 23 and expected daily activity after hip arthroscopy has not been well characterized.…”