Department of Podiatric Surgery, County Health Partnerships, Park House Health and Social Care Centre, Burton Road, Carlton, Nottingham, NG4 3DQ, UK.
J Foot Ankle Res. 2012 Jul 9;5(1):17. doi: 10.1186/1757-1146-5-17.
In the United Kingdom patient-reported outcome measures (PROMS) have been adopted as a key measure of foot surgery outcomes. The intention of this study was to evaluate the responsiveness of a regional outcome measure; the Manchester Oxford Foot Questionnaire (MOXFQ) and a generic measure; the EuroQol EQ-5D, in the context of day care Podiatric Surgery.
A prospective audit of 375 consecutive day care surgical admissions was undertaken. All patients attending for surgery, who agreed to participate, were included. Pre operation patients completed the MOXFQ and the EQ-5D. Both questionnaires were completed again at 6 months post operation. Additional data was collected on patient demographics, surgical procedures and complications.
Few complications were encountered and most patients (84%) returned for a final review 6 months post operation. Mean MOXFQ scores improved for each domain: pain; 51.7 pre-operation, reduced to 16.5 post-operation, walking; 50.2 reduced to 14.1 and social interaction; 45.7 reduced to 10.6. The minimal clinically important differences (MCID) estimates for the pain domain were exceeded by 82.6% of patients, while 74.8% exceeded the MCID for walking and 68.5% exceeded the MCID for social interaction. A small number of patients (2.9%) deteriorated across all three MOXFQ domains.The EQ-5D Index, summary of health related quality of life, improved from 0.66 pre-operation to 0.86 post operation. The EQ-5D index MCID was exceeded by 79.2% of patients. Index scores deteriorated for 1.8% of patients following surgery. Effect sizes measured following surgery were largest for the MOXFQ domains: Walking; 1.39, Pain; 1.52 and Social Interaction: 1.39. The EQ-5D index effect size was 0.83. The EQ-5D visual analogue scale (VAS) was not influenced by surgery.
Both the MOXFQ and EQ-5D index (but not the VAS) appear sensitive to changes in health status at 6 months following elective foot surgery. Both instruments were particularly responsive to changes in pain, mobility and activity or social interaction following treatment. The MOXFQ was developed specifically for foot surgery and as such appears to be the more sensitive instrument. However the generic EQ-5D may allow comparison of general health states in the wider health community. Both instruments when used together appear well suited to the measurement of change in perceived health status following foot surgery.
在英国，患者报告的结局测量（PROMs）已被用作足部手术结局的关键测量指标。本研究的目的是评估一种区域性结局测量工具（曼彻斯特-牛津足部问卷（MOXFQ））和一种通用测量工具（欧洲五维健康量表（EQ-5D））在日间足部手术中的反应能力。
对 375 例连续的日间手术入院患者进行前瞻性审核。所有接受手术且同意参与的患者均被纳入研究。术前患者完成 MOXFQ 和 EQ-5D 问卷。术后 6 个月再次完成这两个问卷。收集患者人口统计学、手术程序和并发症的额外数据。
仅发生少量并发症，大多数患者（84%）在术后 6 个月时进行最终复查。每个领域的 MOXFQ 评分均有所改善：疼痛评分从术前的 51.7 分降至术后的 16.5 分，行走评分从术前的 50.2 分降至术后的 14.1 分，社会互动评分从术前的 45.7 分降至术后的 10.6 分。疼痛领域的最小临床重要差异（MCID）估计值被 82.6%的患者超过，而行走和社会互动领域分别有 74.8%和 68.5%的患者超过 MCID。少数患者（2.9%）在所有三个 MOXFQ 领域的评分都有所恶化。EQ-5D 健康相关生活质量综合指数从术前的 0.66 分提高到术后的 0.86 分。EQ-5D 指数 MCID 被 79.2%的患者超过。术后有 1.8%的患者指数评分恶化。术后测量的效应大小最大的是 MOXFQ 各领域：行走（1.39）、疼痛（1.52）和社会互动（1.39）。EQ-5D 指数的效应大小为 0.83。EQ-5D 视觉模拟量表（VAS）不受手术影响。
MOXFQ 和 EQ-5D 指数（但不是 VAS）在足部手术 6 个月后似乎都能敏感地反映健康状况的变化。这两种工具都特别能反映治疗后疼痛、活动能力或社会互动方面的变化。MOXFQ 是专门为足部手术开发的，因此它似乎是更敏感的工具。然而，通用的 EQ-5D 可能允许在更广泛的健康社区中比较一般的健康状况。当两者一起使用时，它们似乎非常适合测量足部手术后感知健康状况的变化。
