Unidad de Investigación, Hospital de Basurto - CIBER Epidemiología y Salud Pública (CIBERESP), Bilbao, Bizkaia, Spain.
Osteoarthritis Cartilage. 2012 Feb;20(2):87-92. doi: 10.1016/j.joca.2011.11.007. Epub 2011 Nov 20.
To identify new cut-off values beyond which patients can be considered as satisfied or as responders through patient acceptable symptom state (PASS) and OMERACT-OARSI (Outcome Measures in Rheumatology-Osteoarthritis Research Society International) set of responder criteria in total joint replacement.
Secondary analysis of a 1-year prospective multicenter study of 861 patients, 510 with total knee replacement (TKR) and 351 with total hip prosthesis (THR). Pain and function data were collected by the reverse scoring option of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). PASS values were identified with the 25th centile estimation using an anchoring question about satisfaction with actual symptoms. OMERACT-OARSI set of responder criteria was based on a combination of absolute and relative change of pain, function and global patient's assessment. Receiver operating characteristic (ROC) analysis was used as a complementary approach.
The values for PASS were about 80 and 69 for pain and function in THR, while these values were 80 and 68 when using OMERACT-OARSI criteria. Regarding TKR, PASS values were about 75 and 67 in pain and function with both criteria. ROC values were slightly lower in all cases. PASS and OMERACT-OARSI values varied moderately across tertiles of baseline severity.
With the provided data we can establish when a patient can be considered as satisfied/responder in joint replacement. The scores achieved at 1 year were very similar according to both criteria.
通过患者可接受的症状状态(PASS)和 OMERACT-OARSI(骨关节炎研究协会国际的结果测量)反应标准集,确定新的截断值,超过该值可认为患者在全关节置换中是满意或有反应的。
对 861 例患者(510 例全膝关节置换术[TKR]和 351 例全髋关节置换术[THR])进行为期 1 年的前瞻性多中心研究的二次分析。疼痛和功能数据通过 Western Ontario 和 McMaster 大学骨关节炎指数(WOMAC)的反向评分选项收集。通过关于对实际症状的满意度的锚定问题,使用第 25 百分位估计法确定 PASS 值。OMERACT-OARSI 反应标准集基于疼痛、功能和全球患者评估的绝对和相对变化的组合。使用接收者操作特征(ROC)分析作为补充方法。
THR 中疼痛和功能的 PASS 值分别约为 80 和 69,而使用 OMERACT-OARSI 标准时,这些值分别为 80 和 68。对于 TKR,PASS 值在疼痛和功能方面分别约为 75 和 67,两种标准均如此。在所有情况下,ROC 值均略低。PASS 和 OMERACT-OARSI 值在基线严重程度的三分位数之间变化适中。
根据所提供的数据,我们可以确定在关节置换中何时可以认为患者是满意/有反应的。根据这两个标准,患者在 1 年内的得分非常相似。