La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
University of Queensland, Brisbane, Queensland, Australia.
Am J Sports Med. 2021 Aug;49(10):2677-2688. doi: 10.1177/03635465211027180. Epub 2021 Jul 15.
The International Hip Outcome Tool-33 (iHOT-33) was developed to evaluate patients seeking surgery for hip and/or groin (hip/groin) pain and may not be appropriate for those seeking nonsurgical treatment.
To evaluate the psychometric properties of the iHOT-33 total (iHOT-Total) score and all subscale scores in adults with hip/groin pain who were not seeking surgery.
Cohort study (diagnosis); Level of evidence, 3.
Patients with hip/groin pain who were not seeking surgery were recruited from 2 ongoing studies in Australia. Semistructured one-on-one interviews assessed content validity. Construct validity was assessed by testing hypothesized correlations between iHOT-33 and Copenhagen Hip and Groin Outcome Score (HAGOS) subscale scores. Test-retest reliability was assessed in patients not undertaking treatment and who reported "no change" in their Global Rating of Change (GROC) score at 6-month follow-up. Scores were reliable at group and individual levels if intraclass correlation coefficients (ICCs) were ≥0.80 and ≥0.90, respectively. Scores were responsive if Spearman rank correlations (ρ) between the change in the iHOT-33 score and the GROC score were ≥0.40.
In total, 278 patients with hip/groin pain (93 women; mean age, 31 years) and 55 pain-free control participants (14 women; mean age, 29 years) were recruited. The iHOT-33 demonstrated acceptable content validity. Construct validity was acceptable, with all hypothesized strong positive correlations between iHOT-33 and HAGOS subscale scores confirmed ( range, 0.60-0.76; < .001), except for one correlation between the iHOT-Sport and HAGOS-Sport ( = .058; < .001). All scores were reliable at the group level, except for the iHOT-33 job subscale (iHOT-Job) (ICC range, 0.78-0.88 [95% CI, 0.60-0.93]). None of the subscales met the criteria for adequate reliability for use at the individual level (all ICCs <0.90). Minimal detectable change values (group level) ranged from 2.3 to 3.7 (95% CI, 1.7-5.0). All iHOT-33 subscale scores were responsive (ρ range, 0.40-0.58; ≤ .001), except for the iHOT-Job in patients not undertaking treatment (ρ = 0.27; = .001).
All iHOT-33 subscale scores were valid for use in patients with hip/groin pain who were not seeking surgery. Acceptable test-retest reliability was found for all subscale scores at the group level, except the iHOT-Job. All subscale scores, excluding the iHOT-Job, were responsive, regardless of undertaking physical therapist-led treatment or no treatment.
国际髋关节结局工具-33 版（iHOT-33）是为评估因髋部和/或腹股沟（髋腹股沟）疼痛而寻求手术治疗的患者而开发的，可能不适合寻求非手术治疗的患者。
评估 iHOT-33 总评分（iHOT-Total）和所有亚量表评分在髋腹股沟疼痛且不寻求手术治疗的成年人中的心理测量学特性。
队列研究（诊断）；证据等级，3 级。
从澳大利亚正在进行的 2 项研究中招募了髋腹股沟疼痛且不寻求手术治疗的患者。半结构式一对一访谈评估内容效度。通过测试 iHOT-33 与哥本哈根髋关节和腹股沟结局评分（HAGOS）亚量表评分之间的假设相关性来评估结构效度。在未接受治疗且在 6 个月随访时报告“无变化”的患者中评估测试-重测信度。如果组内相关系数（ICC）分别≥0.80 和≥0.90，则认为评分在组和个体水平上是可靠的。如果 iHOT-33 评分变化与总体变化评分（GROC）之间的 Spearman 秩相关系数（ρ）≥0.40，则认为评分具有反应性。
共纳入 278 例髋腹股沟疼痛患者（93 例女性；平均年龄，31 岁）和 55 例无疼痛对照参与者（14 例女性；平均年龄，29 岁）。iHOT-33 具有可接受的内容效度。结构效度可接受，除 iHOT-Sport 与 HAGOS-Sport 之间的一个相关性（=0.058；<0.001）外，所有假设的 iHOT-33 与 HAGOS 亚量表评分之间的强正相关均得到证实（范围，0.60-0.76；<0.001）。除 iHOT-33 工作亚量表（iHOT-Job）外（ICC 范围，0.78-0.88[95%CI，0.60-0.93]），所有评分在组水平上均可靠，在个体水平上，没有一个亚量表满足足够可靠性的标准（所有 ICC<0.90）。最小可检测变化值（组水平）为 2.3 至 3.7（95%CI，1.7-5.0）。所有 iHOT-33 亚量表评分均具有反应性（ρ范围，0.40-0.58；≤0.001），除了不接受治疗的患者的 iHOT-Job 亚量表（ρ=0.27；=0.001）。
iHOT-33 的所有亚量表评分在不寻求手术治疗的髋腹股沟疼痛患者中均具有有效性。除 iHOT-Job 外，所有亚量表评分在组水平上均具有可接受的测试-重测信度。所有亚量表评分（不包括 iHOT-Job），无论是否接受物理治疗师主导的治疗或不治疗，均具有反应性。
