Human Performance Research Centre, Faculty of Health, University of Technology Sydney (UTS), Sydney, New South Wales, Australia
La Trobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia, Bundoora, Victoria, Australia.
Br J Sports Med. 2020 Jul;54(14):848-857. doi: 10.1136/bjsports-2019-101456. Epub 2020 Feb 17.
Hip-related pain is a well-recognised complaint among active young and middle-aged active adults. People experiencing hip-related disorders commonly report pain and reduced functional capacity, including difficulties in executing activities of daily living. Patient-reported outcome measures (PROMs) are essential to accurately examine and compare the effects of different treatments on disability in those with hip pain. In November 2018, 38 researchers and clinicians working in the field of hip-related pain met in Zurich, Switzerland for the first International Hip-related Pain Research Network meeting. Prior to the meeting, evidence summaries were developed relating to four prioritised themes. This paper discusses the available evidence and consensus process from which recommendations were made regarding the appropriate use of PROMs to assess disability in young and middle-aged active adults with hip-related pain. Our process to gain consensus had five steps: (1) systematic review of systematic reviews; (2) preliminary discussion within the working group; (3) update of the more recent high-quality systematic review and examination of the psychometric properties of PROMs according to established guidelines; (4) formulation of the recommendations considering the limitations of the PROMs derived from the examination of their quality; and (5) voting and consensus. Out of 102 articles retrieved, 6 systematic reviews were selected and assessed for quality according to AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews). Two showed moderate quality. We then updated the most recent review. The updated literature search resulted in 10 additional studies that were included in the qualitative synthesis. The recommendations based on evidence summary and PROMs limitations were presented at the consensus meeting. The group makes the following recommendations: (1) the Hip and Groin Outcome Score (HAGOS) and the International Hip Outcome Tool (iHOT) instruments (long and reduced versions) are the most appropriate PROMs to use in young and middle-aged active adults with hip-related pain; (2) more research is needed into the utility of the HAGOS and the iHOT instruments in a non-surgical treatment context; and (3) generic quality of life measures such as the EuroQoL-5 Dimension Questionnaire and the Short Form Health Survey-36 may add value for researchers and clinicians in this field. We conclude that as none of the instruments shows acceptable quality across various psychometric properties, more methods studies are needed to further evaluate the validity of these PROMS-the HAGOS and iHOT-as well as the other (currently not recommended) PROMS.
髋关节相关疼痛是活跃的中青年人群中常见的一种疼痛症状。髋关节疾病患者通常会出现疼痛和功能受限，包括日常生活活动能力下降等问题。患者报告的结局测量（PROMs）对于准确评估和比较不同治疗方法对髋关节疼痛患者残疾的影响至关重要。2018 年 11 月，38 名从事髋关节相关疼痛领域研究的研究人员和临床医生在瑞士苏黎世举行了第一次国际髋关节相关疼痛研究网络会议。在会议之前，针对四个优先主题制定了证据总结。本文讨论了现有证据和共识制定过程，这些过程提出了关于在髋关节相关疼痛的中青年活跃人群中使用 PROMs 评估残疾的适当建议。我们的共识达成过程有五个步骤：（1）系统评价系统评价；（2）工作组内初步讨论；（3）根据既定指南更新较新的高质量系统评价，并检查 PROMs 的心理测量特性；（4）根据检查 PROMs 质量得出的局限性，考虑制定建议；（5）投票和达成共识。在检索到的 102 篇文章中，选择了 6 篇系统评价，并根据 AMSTAR 2（评估系统评价的测量工具）进行了质量评估。其中 2 篇为中度质量。然后，我们更新了最近的综述。更新后的文献检索结果有 10 项额外研究被纳入定性综合分析。基于证据总结和 PROMs 局限性的建议在共识会议上提出。专家组提出以下建议：（1）髋关节和臀部结局评分（HAGOS）和国际髋关节结局工具（长版和简化版）（iHOT）是髋关节相关疼痛的中青年活跃人群中最适合使用的 PROMs；（2）需要更多研究来评估 HAGOS 和 iHOT 工具在非手术治疗环境中的效用；（3）一般生活质量量表，如欧洲五维健康量表和简明健康调查问卷-36，可能会为该领域的研究人员和临床医生增加价值。我们的结论是，由于没有一种工具在各种心理测量特性方面都表现出可接受的质量，因此需要更多的方法学研究来进一步评估这些 PROMs（HAGOS 和 iHOT）以及其他（目前不推荐）PROMs 的有效性。
