Performance of the HOOS-12 and KOOS-12 instruments for evaluating outcomes from joint replacement surgery

Ackerman, Ilana N.; Soh, Sze‐Ee; Harris, Ian; Cashman, Kara; Heath, Emma; Lorimer, Michelle; Graves, Stephen E.

doi:10.1016/j.joca.2021.03.003

Cited by 22 publications

(23 citation statements)

References 23 publications

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“…Both the HOOS-12 and KOOS-12 were developed from the fulllength (42-item) HOOS and KOOS instruments using a twoparameter item response theory (IRT) model and were found to be valid and reliable alternatives to the original versions 5e7 . Our recent psychometric evaluation confirmed the construct validity of the HOOS-12 and KOOS-12, and established that both instruments were highly responsive to change after primary total hip (THR) and total knee replacement (TKR), respectively 8 . However, substantial 'ceiling effects' were noted post-surgery, potentially precluding the monitoring of further improvements in pain, function and quality of life.…”

Section: Introductionmentioning

confidence: 57%

Implications for research and clinical use from a Rasch analysis of the HOOS-12 and KOOS-12 instruments

Soh

Harris

Cashman

et al. 2021

Osteoarthritis and Cartilage

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Section: Introductionmentioning

confidence: 57%

Implications for research and clinical use from a Rasch analysis of the HOOS-12 and KOOS-12 instruments

Soh

Harris

Cashman

et al. 2021

Osteoarthritis and Cartilage

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“…W e previously investigated the validity, reliability, and responsiveness to change 5 of the HOOS-12 and KOOS-12, as well as the structural validity and item performance of those instruments using Rasch analysis 6 . Our current analyses provide pragmatic information that will be highly relevant to those using these instruments for clinical, research, or registry purposes.…”

Section: Discussionmentioning

confidence: 99%

Minimal Clinically Important Changes in HOOS-12 and KOOS-12 Scores Following Joint Replacement

Soh

Harris

Cashman

et al. 2022

Journal of Bone and Joint Surgery

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Background:For patient-reported outcome measures (PROMs) to provide meaningful information to support clinical care, we need to understand the magnitude of change that matters to patients. The aim of this study was to estimate minimal clinically important changes (MCICs) for the 12-item Hip disability and Osteoarthritis Outcome Score (HOOS-12) and Knee injury and Osteoarthritis Outcome Score (KOOS-12) among people undergoing joint replacement for osteoarthritis.Methods:Individual-level data from the Australian Orthopaedic Association National Joint Replacement Registry’s pilot PROMs program were used for this analysis. Preoperative and 6-month postoperative HOOS-12 and KOOS-12 domain and summary impact scores plus a rating of patient-perceived change after surgery (on a 5-point scale ranging from “much worse” to “much better”) were available. Three anchor-based approaches—mean change, receiver operating characteristics (ROC) based on Youden’s J statistic, and predictive modeling using a binary logistic regression model—were used to calculate MCICs based on patient-perceived change.Results:Data were available for 1,490 patients treated with total hip replacement (THR) (mean age, 66 years; 54% female) and 1,931 patients treated with total knee replacement (TKR) (mean age, 66 years; 55% female). Using the mean change method, the MCIC ranged from 24.0 to 27.5 points for the HOOS-12 and 17.5 to 21.8 points for the KOOS-12. The ROC analyses generated comparable MCIC values (28.1 for HOOS-12 and a range of 15.6 to 21.9 for KOOS-12) with high sensitivity and specificity. Lower estimates were derived from predictive modeling following adjustment for the proportion of improved patients (range, 15.7 to 19.2 for HOOS-12 and 14.2 to 16.5 for KOOS-12).Conclusions:We report MCIC values for the HOOS-12 and KOOS-12 instruments that we derived using 3 different methods. As estimates obtained using predictive modeling can be adjusted for the proportion of improved patients, these may be the most clinically applicable. These MCIC values can be used to interpret important changes in pain, function, and quality of life from the patient’s perspective.Levels of Evidence:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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“…It is a self-report questionnaire with forty items and it has five patient-relevant subsets (pain, symptoms including stiffness, function, sports activities, and hip-related quality of life) [17]. The HOOS is a validated and highly reproducible score that is more specific for young adults [8,28].…”

Section: Hip Scores For the Young Adultsmentioning

confidence: 99%

“…Outcome measurements tools can demonstrate ceiling effects when a sizeable proportion of respondents achieve the best possible score and there is no room on the scale to detect further improvement. This may be a function of tool design with regard to the construction of items and item responses but may also relate to the disease or intervention being examined [28]. Ceiling effects have been reported for variable scores such as the mHHS, HAGOS, HOOS-12, the KOOS-12, and the Oxford Hip and Knee Scores.…”

Section: Floor or Ceiling Effectsmentioning

confidence: 99%

See 1 more Smart Citation

Outcome scores after hip surgery in young adults: an editorial approach

Falez

Mavrogenis

Scarlat

2022

International Orthopaedics (SICOT)

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Performance of the HOOS-12 and KOOS-12 instruments for evaluating outcomes from joint replacement surgery

Cited by 22 publications

References 23 publications

Implications for research and clinical use from a Rasch analysis of the HOOS-12 and KOOS-12 instruments

Implications for research and clinical use from a Rasch analysis of the HOOS-12 and KOOS-12 instruments

Minimal Clinically Important Changes in HOOS-12 and KOOS-12 Scores Following Joint Replacement

Outcome scores after hip surgery in young adults: an editorial approach

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