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一种 SANE 的结局采集方法?全髋关节置换术后比较单题与多题患者报告结局测量的表现。

A SANE Approach to Outcome Collection? Comparing the Performance of Single- Versus Multiple-Question Patient-Reported Outcome Measures After Total Hip Arthroplasty.

机构信息

Department of Orthopaedics, Dartmouth-Hitchcock Medical Center, Lebanon, NH.

Department of Orthopaedics, Dartmouth-Hitchcock Medical Center, Lebanon, NH; Department of Orthopaedics, Geisel School of Medicine Dartmouth College, Hanover, NH.

出版信息

J Arthroplasty. 2020 Jun;35(6S):S207-S213. doi: 10.1016/j.arth.2020.01.015. Epub 2020 Jan 16.

DOI:10.1016/j.arth.2020.01.015
PMID:32008770
Abstract

BACKGROUND

Several patient-reported outcome measures (PROMs) exist to measure outcomes after total hip arthroplasty (THA) but can be limited by patient-perceived burden and completion rates. We analyzed whether the modified single assessment numerical evaluation (M-SANE), a one-question PROM, would perform similarly to multiple-question PROMs among patients undergoing primary THA.

METHODS

Patients undergoing THA completed the Patient-Reported Outcomes Measurement Information System-10 (PROMIS-10), the Hip Disability and Osteoarthritis Outcomes Score Junior (HOOS-Jr), and M-SANE questionnaires both preoperatively and postoperatively. The M-SANE assessment asked patients to assess their hip on a scale from 0 to 10, with 10 being the best possible score. Validity of M-SANE compared with other PROMs was determined by Spearman's correlation and floor and ceiling effects. Responsiveness was analyzed using standardized response mean (SRM).

RESULTS

One hundred and thirty six patients with at least 1-year follow-up were reviewed. The average M-SANE score improved from 3.3 preoperatively to 7.1 at one year postoperatively. There was moderate to strong correlation at one-year follow-up between the M-SANE and HOOS-Jr (ρ = 0.75, P < .001) and PROMIS-10 physical component summary (ρ = 0.63, P < .001). Floor and ceiling effects of the M-SANE (floor 2.0%, ceiling 21.3%) were comparable to the HOOS-Jr (floor 0.0%, ceiling 20.8%). The responsiveness of the M-SANE after THA (SRM = 1.06, 95% CI: 0.79-1.33) was comparable to HOOS-Jr (SRM = 1.33, 95% CI: 1.08-1.59) and superior to PROMIS-10 physical component summary (SRM = 0.65, 95% CI: 0.55-0.74).

CONCLUSION

The M-SANE has performed similarly across multiple psychometric properties compared with more burdensome PROMs in assessing longitudinal patient-reported outcomes after THA.

摘要

背景

有几种患者报告的结局测量(PROM)用于测量全髋关节置换术(THA)后的结局,但可能会受到患者感知的负担和完成率的限制。我们分析了在接受初次 THA 的患者中,一个问题的 PROM(即改良单评估数值评估,M-SANE)是否与多个问题的 PROM 表现相似。

方法

接受 THA 的患者在术前和术后均完成了患者报告的结局测量信息系统-10(PROMIS-10)、髋关节残疾和骨关节炎结局评分青少年版(HOOS-Jr)和 M-SANE 问卷。M-SANE 评估要求患者在 0 到 10 分的范围内对其髋关节进行评分,其中 10 分为最佳得分。通过 Spearman 相关系数和地板和天花板效应来确定 M-SANE 与其他 PROM 的有效性。使用标准化反应均值(SRM)来分析反应性。

结果

共回顾了 136 例至少随访 1 年的患者。M-SANE 评分从术前的 3.3 分平均改善到术后 1 年的 7.1 分。在术后 1 年的随访中,M-SANE 与 HOOS-Jr(ρ=0.75,P<.001)和 PROMIS-10 身体成分综合评分(ρ=0.63,P<.001)之间存在中度到高度相关。M-SANE(地板效应 2.0%,天花板效应 21.3%)和 HOOS-Jr(地板效应 0.0%,天花板效应 20.8%)的地板和天花板效应相当。THA 后 M-SANE 的反应性(SRM=1.06,95%CI:0.79-1.33)与 HOOS-Jr(SRM=1.33,95%CI:1.08-1.59)相当,优于 PROMIS-10 身体成分综合评分(SRM=0.65,95%CI:0.55-0.74)。

结论

与更繁琐的 PROM 相比,M-SANE 在评估 THA 后患者的纵向报告结局方面,在多个心理测量特性上表现相似。

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