Patient-Reported Outcome Surveys for Femoroacetabular Impingement Syndrome Demonstrate Strong Correlations, High Minimum Clinically Important Difference Agreement and Large Ceiling Effects

Hartwell, Matthew J.; Soriano, Kylen K.J.; Nguyen, Thu Quynh; Monroe, Emily; Wong, Stephanie E.; Zhang, Alan L.

doi:10.1016/j.arthro.2022.03.023

Cited by 13 publications

(5 citation statements)

References 21 publications

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“…In previous studies, legacy PROMs have demonstrated variability in their observed ceiling and floor effects, while PROMIS CATs have consistently minimized such effects. 5,13,14,21 The PROMIS has been validated in numerous orthopaedic conditions and has demonstrated an ability to outperform legacy PROMs. In 175 patients with shoulder instability, Saad et al 23 compared the PROMIS Global-10 with various legacy shoulder PROMs.…”

Section: Discussionmentioning

confidence: 99%

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The Promising 2-Year Performance of the Patient-Reported Outcomes Measurement Information System in Primary Hip Arthroscopy for Femoroacetabular Impingement Syndrome

Vogel,

Wright-Chisem,

Alvero

et al. 2024

Am J Sports Med

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Background: Minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) thresholds have been previously defined for the Patient-Reported Outcomes Measurement Information System (PROMIS) at 1-year follow-up in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome; however, the MCID and PASS thresholds are yet to be defined for the PROMIS at 2-year follow-up. Purpose: (1) To establish MCID and PASS thresholds for the PROMIS Pain Interference (PROMIS-PI) and PROMIS Physical Function (PROMIS-PF) at 2-year follow-up and (2) to correlate PROMIS scores with hip-specific patient-reported outcome measure (PROM) scores. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Patients undergoing primary hip arthroscopy for femoroacetabular impingement syndrome between August and November 2020 with preoperative and minimum 2-year postoperative data were identified. Collected scores included those for the PROMIS-PI, PROMIS-PF, Hip Outcome Score–Activities of Daily Living (HOS-ADL), Hip Outcome Score–Sports Subscale (HOS-SS), International Hip Outcome Tool–12 (iHOT-12), and visual analog scale (VAS) for pain. MCID thresholds were calculated using the distribution-based method and PASS thresholds using the anchor-based method. Pearson correlation coefficients were used to compare scores between PROMs. Results: A total of 65 patients met the criteria for inclusion (72.3% female; mean age, 36.9 ± 13.5 years; mean body mass index, 26.2 ± 6.0). The mean follow-up was 25.3 ± 3.3 months. Significant preoperative to postoperative improvements were observed for all PROMs ( P < .001). MCID thresholds and achievement rates were as follows: HOS-ADL, 10.1 and 75%, respectively; HOS-SS, 13.8 and 79%, respectively; iHOT-12, 14.0 and 67%, respectively; VAS pain, –13.8 and 78%, respectively; PROMIS-PI, –4.7 and 65%, respectively; and PROMIS-PF, 5.8 and 60%, respectively. PASS thresholds and achievement rates were as follows: HOS-ADL, 78.7 and 67%, respectively; HOS-SS, 76.4 and 62%, respectively; iHOT-12, 67.4 and 60%, respectively; VAS pain, 25.5 and 61%, respectively; PROMIS-PI, 57.0 and 65%, respectively; and PROMIS-PF, 45.6 and 58%, respectively. PROMIS-PI scores correlated most strongly with HOS-ADL ( r = −0.836), HOS-SS ( r = −0.767), and iHOT-12 ( r = −0.719) scores and exhibited at least moderate correlations ( r≥−0.595) with the other PROM scores. PROMIS-PF demonstrated moderate correlations with all the other PROM scores ( r≥−0.586). Strong correlations were seen between the hip-specific PROM scores ( r≥−0.745). Conclusion: This study defined 2-year MCID and PASS thresholds for the PROMIS-PI and PROMIS-PF and demonstrated moderate to strong correlations between PROMIS scores and hip-specific PROM scores.

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Section: Discussionmentioning

confidence: 99%

“…In previous studies, legacy PROMs have demonstrated variability in their observed ceiling and floor effects, while PROMIS CATs have consistently minimized such effects. 5,13,14,21…”

Section: Discussionmentioning

confidence: 99%

The Promising 2-Year Performance of the Patient-Reported Outcomes Measurement Information System in Primary Hip Arthroscopy for Femoroacetabular Impingement Syndrome

Vogel,

Wright-Chisem,

Alvero

et al. 2024

Am J Sports Med

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“…These results suggested that the inactive group receives the greater benefit from arthroscopy compared with more active patients. The greater PROs improvement following hip arthroscopy for the inactive group may be explained by greater initial room for improvement and a ceiling effect inherent in the PROs 5,20–22 …”

Section: Discussionmentioning

confidence: 99%

“…The greater PROs improvement following hip arthroscopy for the inactive group may be explained by greater initial room for improvement and a ceiling effect inherent in the PROs. 5 , 20 , 21 , 22 …”

Section: Discussionmentioning

confidence: 99%

Does Preoperative Activity Level Affect Postoperative Clinical Outcomes Following Hip Arthroscopy in Femoroacetabular Impingement Syndrome (FAIS) Patients?

Yang

Shao

Zheng

et al. 2023

Orthopaedic Surgery

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Objective: When considering surgical treatment options, many patients who undergo hip arthroscopy value continuing active lifestyles. To address these concerns, the purpose of this study was to determine the effect of preoperative activity level on postoperative patient-reported outcomes (PROs) in femoroacetabular impingement syndrome (FAIS) patients following hip arthroscopy.Methods: Data was retrospectively reviewed for FAIS patients who received hip arthroscopy between 2016 and 2018.Patients were divided into active group and inactive group based on preoperative HOS-SSS scores. Preoperative active patients were 1:1 propensity-score matched to inactive patients based on age, sex, BMI, and follow-up period. PROs (HOS-ADL, HOS-ADL, iHOT-12, mHHS), VAS scores, radiographic measures, performed procedures, complications, and revision surgery were compared and analyzed for both groups by Student's t test.Results: A total of 71 patients in the active group and 71 patients in the inactive group were found using propensityscore matching. Active patients had superior preoperative HOS-ADL, HOS-SSS, iHOT-12, mHHS (p < 0.001 for all), and VAS (p = 0.002) scores compared with inactive patients. At the final follow-up, active patients still had better PROs in HOS-ADL (p = 0.003), HOS-SSS (p < 0.001), iHOT-12 (p = 0.043), and mHHS scores (p = 0.003). There was no difference detected in postoperative VAS score (p = 0.117) between the two groups. However, inactive patients showed significantly higher net improvement in HOS-ADL (p = 0.009), HOS-SSS (p = 0.005), and iHOT-12 (p = 0.023).Conclusions: Active patients have absolute higher preoperative PROs and achieve better postoperative PROs than inactive patients. However, inactive patients can obtain greater net improvements in PROs following hip arthroscopic surgery, with comparable pain alleviation as active patients.

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“…A study on the association between the mHHS and HOOS in patients with femoroacetabular impingement 14 at 2 years postoperatively revealed the highest correlations were between the mHHS and the HOOS subscales of pain ( r = 0.86; P < .001) and activities of daily living ( r = 0.85; P < .001). Preoperative testing showed a moderate to high correlation between the mHHS and HOOS (symptoms: r = 0.63; pain: r = 0.74; activities of daily living: r = 0.76; sports: r = 0.65; and quality of life: r = 0.57), while our study revealed moderate correlations between the TH-mHHS and TH-HOOS (symptoms: r = 0.50; pain: r = 0.54; activities of daily living: r = 0.65; sports: r = 0.58; and quality of life: r = 0.59).…”

Section: Discussionmentioning

confidence: 99%

Validity and Reliability of the Thai Version of the Modified Harris Hip Score for Patients With Hip Abnormalities

Chumchuen

Apivatgaroon

Phanichwong

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: The modified Harris Hip Score (mHHS) is one of the more commonly used patient-reported outcome measures to evaluate and monitor treatment in patients with hip abnormalities and has been translated into several languages. Purpose: To develop a Thai version of the mHHS (TH-mHHS) and evaluate the validity and reliability of the measure. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: The TH-mHHS was developed using the forward-backward translation method. Patients who presented with hip pain during the first clinic visit completed the Thai version of questionnaires including the mHHS, 36-item Short Form Health Survey (TH-SF36), and Hip disability and Osteoarthritis Outcome Score (TH-HOOS). The validity between the measures was tested using the Spearman correlation coefficient. The test-retest reliability of the TH-mHHS was assessed using the intraclass correlation coefficient, and internal consistency was assessed using the Cronbach alpha. Results: A total of 64 patients were enrolled who had a mean age of 52.8 ± 16.6 years (range, 17-80 years). There were 64% female and 36% male participants. The TH-mHHS showed a moderate correlation with all subscales of the TH-HOOS and the total TH-HOOS ( r = 0.50-0.65; P < .01) and a high correlation with the physical functioning subscale and physical component summary of the TH-SF36 ( r = 0.73 and 0.75, respectively; P < .01). The test-retest reliability was excellent, with an intraclass correlation coefficient of 0.95 (95% CI, 0.92-0.97; P < .001). The internal consistency was acceptable, with a Cronbach alpha of .71. No floor or ceiling effects were observed. Conclusion: The TH-mHHS showed a moderate to high correlation with the TH-SF36 and TH-HOOS, excellent test-retest reliability, and acceptable internal consistency. This measure can be effectively used for evaluating Thai patients with hip disorders, especially an older and arthritic population.

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Patient-Reported Outcome Surveys for Femoroacetabular Impingement Syndrome Demonstrate Strong Correlations, High Minimum Clinically Important Difference Agreement and Large Ceiling Effects

Cited by 13 publications

References 21 publications

The Promising 2-Year Performance of the Patient-Reported Outcomes Measurement Information System in Primary Hip Arthroscopy for Femoroacetabular Impingement Syndrome

The Promising 2-Year Performance of the Patient-Reported Outcomes Measurement Information System in Primary Hip Arthroscopy for Femoroacetabular Impingement Syndrome

Does Preoperative Activity Level Affect Postoperative Clinical Outcomes Following Hip Arthroscopy in Femoroacetabular Impingement Syndrome (FAIS) Patients?

Validity and Reliability of the Thai Version of the Modified Harris Hip Score for Patients With Hip Abnormalities

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