Hammarstedt Jon E, Redmond John M, Gupta Asheesh, Dunne Kevin F, Vemula S Pavan, Domb Benjamin G
University of Illinois at Chicago, Chicago, IL, USA.
Mayo Clinic, Jacksonville, FL, USA.
Knee Surg Sports Traumatol Arthrosc. 2017 Jan;25(1):50-54. doi: 10.1007/s00167-015-3802-6. Epub 2015 Oct 24.
Patient-reported outcome (PRO) scores are used to evaluate treatment modalities in orthopaedic surgery. The method of PRO collection may introduce bias to reported surgical outcomes due to the presence of an interviewer. This study evaluates post-operative PROs for variation of outcomes between survey methods-in-person, online, or telephone.
From 2008 to 2011, 456 patients underwent arthroscopic surgical treatment for acetabular labral tears. All pre-operative surveys were completed in the clinic during pre-operative visit. Two-year follow-up questionnaires were completed by 385 (84 %) patients. The PRO data were prospectively collected pre- and post-operatively using five tools: modified Harris Hip Score (mHHS), Hip Outcome Score Activities of Daily Living (HOS-ADLS), Hip Outcome Score Sports-Specific Subscale (HOS-SSS), Non-Arthritic Hip Score (NAHS), and visual analog scale. Patients were grouped according to method of 2-year follow-up: in-person during follow-up visit (102 patients, 26 %), online by email prompt (138 patients, 36 %), or telephone with an interviewer (145 patients, 38 %).
Pre-operative baseline PRO scores demonstrated no statistically significant difference between groups for mHHS, HOS-ADLS, HOS-SSS, and NAHS. Two-year post-operative PRO scores obtained by telephone were statistically greater than scores obtained in-person or online for mHHS (p < 0.001), HOS-ADLS (p < 0.001), and HOS-SSS (p < 0.01).
This study demonstrates higher patient-reported outcome scores and greater improvement by telephone surveys compared to in-person or online. The variation of results between collection methods is indicative of a confounding variable. Clinically, it is important to understand these confounding variables in order to assess patient responses and guide treatment.
IV.
患者报告结局（PRO）评分用于评估骨科手术的治疗方式。由于存在访谈者，PRO收集方法可能会给报告的手术结局带来偏差。本研究评估了术后PRO在面对面、在线或电话等调查方法之间的结局差异。
2008年至2011年，456例患者因髋臼唇撕裂接受了关节镜手术治疗。所有术前调查均在术前门诊完成。385例（84%）患者完成了两年的随访问卷。术前和术后前瞻性地使用五种工具收集PRO数据：改良Harris髋关节评分（mHHS）、髋关节结局评分日常生活活动（HOS-ADLS）、髋关节结局评分运动特定子量表（HOS-SSS）、非关节炎髋关节评分（NAHS）和视觉模拟量表。根据两年随访方法对患者进行分组：随访就诊时面对面（102例患者，26%）、通过电子邮件提示在线（138例患者，36%）或与访谈者电话沟通（145例患者，38%）。
术前基线PRO评分在mHHS、HOS-ADLS、HOS-SSS和NAHS方面，组间无统计学显著差异。术后两年通过电话获得的PRO评分在mHHS（p<0.001）、HOS-ADLS（p<0.001）和HOS-SSS（p<0.01）方面，在统计学上高于面对面或在线获得的评分。
本研究表明，与面对面或在线调查相比，电话调查的患者报告结局评分更高，改善更大。收集方法之间的结果差异表明存在混杂变量。临床上，了解这些混杂变量对于评估患者反应和指导治疗很重要。
IV级。
