Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA.
Am J Sports Med. 2021 May;49(6):1578-1588. doi: 10.1177/0363546521999403. Epub 2021 Mar 19.
There is much debate in the current literature with regard to the most appropriate hip-specific patient-reported outcome (PRO) measurement for assessment of femoroacetabular impingement syndrome (FAIS) and outcomes after surgical treatment. Despite systematic reviews assessing the validity of classic hip-specific PROs as well as newer PROs developed to target the young, active population, there lacks a direct comparison of the question content between each PRO.
To compare the question composition and degree of overlap between commonly used PROs for FAIS.
Cross-sectional study.
A literature review yielded the 6 most commonly cited PROs for assessment of FAIS: modified Harris Hip Score (mHHS), Hip disability and Osteoarthritis Outcome Score (HOOS), Copenhagen Hip and Groin Outcome Score (HAGOS), Nonarthritic Hip Score (NAHS), international Hip Outcome Tool (iHOT-33), and Hip Outcome Score (HOS). Questions from each PRO were classified as identical, similar, or unique after pooled comparison, and the number of overlapping (identical or similar) questions between each PRO was determined. Questions were then classified into 5 domains: pain, symptoms, functional activities, sports, and quality of life, and variations in questions assessing each domain based on PRO were analyzed.
Analysis of 164 total questions from 6 PROs showed that 87 questions (53%) were identical between 2 or more PROs, 39 (24%) were similar, and 38 (23%) were unique. The iHOT-33 contained the highest number of unique questions, with 13 of 33 (39.4%), while the HOOS contained the lowest number of unique questions, with 3 of 40 (7.5%). The HOOS, HAGOS, and iHOT-33 contained questions assessing all 5 domains of patient outcomes; the NAHS did not evaluate quality of life; the mHHS only assessed pain, symptoms, and functional activities; and the HOS only assessed functional activities and sports.
As there is a high percentage of overlapping (identical or similar) questions between the most commonly used hip-specific PROs for FAIS, multiple tests may be appropriate for use. The iHOT-33, HOOS, and HAGOS are well suited for the general population as they offer comprehensive assessments across all domains, while the HOS provides added focus to sports/activity assessments for athletes and highly active patients.
目前文献中有很多关于评估髋关节撞击综合征（FAIS）和手术治疗后结果的最合适的髋关节特异性患者报告结局（PRO）测量的争论。尽管有系统评价评估了经典髋关节特异性 PRO 的有效性，以及为针对年轻、活跃人群开发的新型 PRO，但每种 PRO 之间的问题内容缺乏直接比较。
比较 FAIS 常用 PRO 的问题组成和重叠程度。
横断面研究。
文献综述得出了评估 FAIS 的 6 种最常引用的 PRO：改良 Harris 髋关节评分（mHHS）、髋关节残疾和骨关节炎结局评分（HOOS）、哥本哈根髋关节和腹股沟结局评分（HAGOS）、非关节炎髋关节评分（NAHS）、国际髋关节结局工具（iHOT-33）和髋关节结局评分（HOS）。在汇总比较后，将每个 PRO 的问题分为相同、相似或独特，并确定每个 PRO 之间重叠（相同或相似）问题的数量。然后，问题被分为 5 个领域：疼痛、症状、功能活动、运动和生活质量，并分析了基于 PRO 评估每个领域的问题变化。
对 6 种 PRO 中的 164 个总问题进行分析，结果显示 2 个或更多 PRO 之间有 87 个问题（53%）相同，39 个（24%）相似，38 个（23%）独特。iHOT-33 包含的独特问题最多，33 个中有 13 个（39.4%），而 HOOS 包含的独特问题最少，40 个中有 3 个（7.5%）。HOOS、HAGOS 和 iHOT-33 包含评估患者结局的所有 5 个领域的问题；NAHS 不评估生活质量；mHHS 仅评估疼痛、症状和功能活动；HOS 仅评估功能活动和运动。
由于 FAIS 最常用的髋关节特异性 PRO 之间存在很高比例的重叠（相同或相似）问题，因此可能适合使用多种测试。iHOT-33、HOOS 和 HAGOS 非常适合普通人群，因为它们在所有领域提供全面评估，而 HOS 则为运动员和高度活跃的患者提供了对运动/活动评估的额外关注。
