Department of Orthopaedic Surgery, Herlev University Hospital, Denmark.
Acta Orthop. 2013 Feb;84(1):12-7. doi: 10.3109/17453674.2013.765622. Epub 2013 Jan 23.
Patient-reported outcome measures (PROMs) are used by some arthroplasty registries to evaluate results after surgery, but non-response may bias the results. The aim was to identify a potential bias in the outcome scores of subgroups in a cohort of patients from the Danish Shoulder Arthroplasty Registry (DSR) and to characterize non-responders.
Patient-reported outcome of 787 patients operated in 2008 was assessed 12 months postoperatively using the Western Ontario Osteoarthritis of the Shoulder (WOOS) index. In January 2012, non-responders and incomplete responders were sent a postal reminder. Non-responders to the postal reminder were contacted by telephone. Total WOOS score and WOOS subscales were compared for initial responders (n = 509), responders to the postal reminder (n = 156), and responders after telephone contact (n = 27). The predefined variables age, sex, diagnosis, geographical region, and reoperation rate were compared for responding and non-responding cohorts.
A postal reminder increased the response rate from 65% (6% incomplete) to 80% (3% incomplete) and telephone contact resulted in a further increase to 82% (2% incomplete). We did not find any statistically significant differences in total WOOS score or in any of the WOOS subscales between responders to the original questionnaire, responders to the postal reminder, and responders after telephone contact. However, a trend of worse outcome for non-responders was found. The response rate was lower in younger patients.
Non-responders did not appear to bias the overall results after shoulder replacement despite a trend of worse outcome for a subgroup of non-responders. As response rates rose markedly by the use of postal reminders, we recommend the use of reminders in arthroplasty registries using PROMs.
一些关节置换术注册中心使用患者报告的结局测量（PROMs）来评估手术后的结果，但无应答可能会使结果产生偏差。本研究的目的是确定丹麦肩关节置换术注册中心（DSR）患者队列中，亚组结局评分的潜在偏差，并对无应答者的特征进行描述。
2008 年接受手术的 787 例患者在术后 12 个月时使用 Western Ontario Osteoarthritis of the Shoulder（WOOS）指数评估患者报告的结局。2012 年 1 月，对未应答者和不完全应答者发送了邮寄提醒。对邮寄提醒未应答者通过电话进行联系。比较初始应答者（n=509）、邮寄提醒应答者（n=156）和电话联系应答者（n=27）的总 WOOS 评分和 WOOS 亚量表。比较应答者和未应答者队列的年龄、性别、诊断、地理位置和再次手术率等预设变量。
邮寄提醒将应答率从 65%（6%为不完全应答）提高到 80%（3%为不完全应答），电话联系后应答率进一步提高到 82%（2%为不完全应答）。我们未发现原始问卷应答者、邮寄提醒应答者和电话联系应答者之间的总 WOOS 评分或 WOOS 亚量表评分存在任何统计学上的显著差异。然而，我们发现无应答者的结局存在恶化的趋势。在年轻患者中，应答率较低。
尽管存在部分无应答者结局恶化的趋势，但在肩关节置换术后，无应答者似乎并未使整体结果产生偏差。由于使用邮寄提醒后应答率显著提高，我们建议在使用 PROMs 的关节置换术注册中心中使用提醒。
