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Journal of Bone and Joint Surgery - British Volume, Vol 86-B, Issue 6,
801-808.
doi: 10.1302/0301-620X.86B6.14950 Copyright © 2004 by British Editorial Society of Bone and Joint Surgery Patient-reported outcome in total hip replacementA COMPARISON OF FIVE INSTRUMENTS OF HEALTH STATUSM. Ostendorf, MSc, PhD, Student1; H. F. van Stel, PhD, Clinical Epidemiologist2; E. Buskens, MD, PhD, Clinical Epidemiologist2; A. J. P. Schrijvers, PhD, Professor of Health Services2; L. N. Marting, MD3; A. J. Verbout, MD, PhD, Professor, Orthopaedic Surgeon1; and W. J. A. Dhert, MD, PhD, Director of Orthopaedic Research1
1 Department of Orthopaedics, University Medical Center, P O Box 85500, 3508 GA, Utrecht, The Netherlands. Correspondence should be sent to Dr M. Ostendorf. Our aim was to define the minimum set of patient-reported outcome measures which are required to assess health status after total hip replacement (THR). In 114 patients, we compared the pre-operative characteristics and sensitivity to change of the Oxford hip score (OHS), the Western Ontario and McMaster Universities osteoarthritis index (WOMAC), the SF-36, the SF-12 (derived from the SF-36), and the Euroqol questionnaire (EQ-5D). At one year after operation, very large effect sizes were found for the disease-specific measures, the physical domains of the SF-12, SF-36 and the EQ-5Dindex (1.3 to 3.0). Patients in Charnley class A showed more change in the OHS, WOMAC pain and function, the physical domains of the SF-36 and the EQ-5Dvas (p < 0.05) compared with those in the Charnley B and C group. In this group, the effect size for the OHS more than doubled the effect sizes of WOMAC pain and physical function. We found high correlations and correlations of change between the OHS, the WOMAC, the physical domains of the SF-12 and the SF-36 and EQ-5Dindex. The SF-36 and EQ-5D scores at one year after operation approached those of the general population. Furthermore, we found a binomial distribution of the pre-operative EQ-5Dindex score and a pre-operative discrepancy and post-operative agreement between the EQ-5Dvas and EQ-5Dindex. We recommend the use of the OHS and SF-12 in the assessment of THR. The SF-36 may be used in circumstances when smaller changes in health status are investigated, for example in the follow-up of THR. The EQ-5D is useful in situations in which utility values are needed in order to calculate cost-effectiveness or quality-adjusted life years (QALYs), such as in the assessment of new techniques in THR. This article has been cited by other articles:
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