What is the optimal time point to assess patient-reported recovery after hip and knee replacement? a systematic review and analysis of routinely reported outcome data from the English patient-reported outcome measures programme

Health and Quality of Life Outcomes

Jill Dawson¹  Hamad Bastaki²  John Patrick Browne³ 

[1] Nuffield Department of Population Health, University of Oxford, Rosemary Rue Building, Old Road Campus, Headington, Oxford OX3 7LF, UK;Department of Surgery, Mubarak Al-Kabeer University Hospital, Kuwait, Kuwait;Department of Epidemiology and Public Health, University College Cork, Western Gateway Building, Western Rd, Cork, Ireland

关键词: Oxford knee score;    Oxford hip score;    Knee replacement;    Hip replacement;    Patient-reported outcomes;    Quality of life;   

Others  :  823408
DOI  :  10.1186/1477-7525-11-128

 received in 2013-03-14, accepted in 2013-07-27,  发布年份 2013

【 摘 要 】

Background

It is unclear if there is a clinically important improvement in the six to 12-month recovery period after hip and knee replacement. This is an obvious gap in the evidence required by patients undergoing these procedures. It is also an issue for the English PROMs (Patient-Reported Outcome Measures) Programme which uses 6-month outcome data to compare the results of hospitals that perform hip and knee replacements.

Methods

A systematic review of studies reporting the Oxford Hip Score (OHS) or Oxford Knee Score (OKS) at 12 months after surgery was performed. This was compared with six-month outcome data collected for 60, 160 patients within the English PROMs programme. A minimally important difference of one standard error of the measurement, equivalent to 2.7 for the OHS and 2.1 for the OKS, was adopted.

Results and discussion

Six studies reported OHS data for 10 different groups containing 8,308 patients in total. In eight groups the change scores reported were at least 2.7 points higher than the six-month change observed in the PROMs programme (20.2 points). Nine studies reported OKS data for 13 different groups containing 4,369 patients in total. In eight groups the change scores reported were at least 2.1 points higher than the six-month change observed in the PROMs programme (15.0 points).

Conclusions

There is some evidence from this systematic review that clinically important improvement in the Oxford hip and knee scores occurs in the six to 12 month recovery period. This trend is more apparent for hip than knee replacement. Therefore we recommend that the English Department of Health study the impact on hospital comparisons of using 12- rather than six-month outcome data.

【 授权许可】

   
2013 Browne et al.; licensee BioMed Central Ltd.

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