Department of Orthopedic Surgery, Montefiore Hospital Medical Center and The Albert Einstein College of Medicine, Bronx, New York, USA.
Division of Orthopedic Surgery, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Am J Sports Med. 2022 Jan;50(1):79-84. doi: 10.1177/03635465211056666. Epub 2021 Nov 22.
Patient-reported outcome measures (PROMs) are essential clinical instruments used for assessing patient function, assisting in clinical decision making, and quantifying outcomes of surgical and nonsurgical management. However, PROMs are often designed using patients with preexisting pathology and typically assume that a patient without the pathology would have a perfect or near perfect score. This may result in unrealistic expectations or falsely underestimate how well a patient is doing after treatment. The influence of age on PROMs about the hip of healthy individuals has not been studied.
We hypothesize that in asymptomatic individuals hip-specific PROM scores will decrease in an age-dependent manor.
Cross-sectional study; Level of evidence, 3.
In this multicenter survey study, volunteers who denied preexisting hip pathology and previous hip surgery completed 3 PROMs online or as traditional paper questionnaires. The International Hip Outcome Tool (iHOT), the modified Harris Hip Score (mHHS), and the Hip Outcome Score-Activities of Daily Living (HOS-ADL) and HOS-Sport were completed. Analysis of variance with a Tukey post hoc test was used to analyze differences in PROMs among subgroups. An independent-samples Student test and a χ test were used to analyze differences in continuous and categorical data, respectively.
In total 496, 571, 534, and 532 responses were collected for the iHOT, mHHS, HOS-ADL, and HOS-Sport, respectively. Respondents' PROMs were scored and arranged into 3 groups by age: <40 years, 40 to 60 years, and >60 years. The iHOT, mHHS, HOS-ADL, and HOS-Sport of these asymptomatic respondents all decreased in an age-dependent manner: iHOT (<40, 94.1; 40-60, 92.4; >60, 87.0), mHHS (<40, 94.8; 40-60, 91.3; >60, 89.1), HOS-ADL (<40, 98.4; 40-60, 95.0; >60, 90.9), and HOS-Sport (<40, 95.7; 40-60, 82.9; >60, 72.9) (analysis of variance between-group differences, < .05).
This study demonstrated that the iHOT, mHHS, and HOS-ADL and HOS-Sport scores in asymptomatic people decrease in an age-dependent manner. It is important to compare a patient's outcome scores with the age-normalized scores to establish an accurate reference frame with which to interpret outcomes.
患者报告的结果测量（PROM）是用于评估患者功能、辅助临床决策和量化手术和非手术治疗结果的重要临床工具。然而，PROM 通常是使用患有预先存在的病理学的患者设计的，并且通常假设没有病理学的患者会得到完美或近乎完美的分数。这可能导致不切实际的期望或错误地低估了患者在治疗后的表现。年龄对健康个体髋关节 PROM 的影响尚未得到研究。
我们假设在无症状个体中，髋关节特异性 PROM 评分将随年龄呈依赖性下降。
横断面研究；证据水平，3 级。
在这项多中心调查研究中，否认有预先存在的髋关节病理学和既往髋关节手术的志愿者在线或通过传统纸质问卷完成了 3 项 PROM。使用国际髋关节结果工具（iHOT）、改良 Harris 髋关节评分（mHHS）以及髋关节结果评分-日常生活活动（HOS-ADL）和髋关节结果评分-运动（HOS-Sport）进行评估。使用方差分析和 Tukey 事后检验分析亚组之间 PROM 的差异。使用独立样本 Student t 检验和 χ 检验分别分析连续和分类数据的差异。
共收集到 iHOT、mHHS、HOS-ADL 和 HOS-Sport 的 496、571、534 和 532 份回复。对回复者的 PROM 进行评分，并根据年龄将其分为 3 组：<40 岁、40-60 岁和>60 岁。这些无症状回复者的 iHOT、mHHS、HOS-ADL 和 HOS-Sport 均呈年龄依赖性下降：iHOT（<40 岁，94.1；40-60 岁，92.4；>60 岁，87.0）、mHHS（<40 岁，94.8；40-60 岁，91.3；>60 岁，89.1）、HOS-ADL（<40 岁，98.4；40-60 岁，95.0；>60 岁，90.9）和 HOS-Sport（<40 岁，95.7；40-60 岁，82.9；>60 岁，72.9）（组间差异的方差分析，<.05）。
本研究表明，无症状人群的 iHOT、mHHS 和 HOS-ADL 和 HOS-Sport 评分随年龄呈依赖性下降。与年龄标准化评分相比，比较患者的结果评分对于建立准确的参考框架来解释结果非常重要。
