Sabah Shiraz A, Alvand Abtin, Beard David J, Price Andrew J
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford.
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; Nuffield Orthopaedic Centre, Oxford.
J Clin Epidemiol. 2022 Mar;143:159-168. doi: 10.1016/j.jclinepi.2021.12.016. Epub 2021 Dec 15.
To create estimates for clinically meaningful changes and differences in pain and joint function for the Oxford Hip and Knee Scores (OHS/OKS) in primary and revision joint replacement.
694,487 primary and revision joint replacement procedures were analyzed from the NHS PROMs dataset between 2012-2020. Minimal important changes (MIC) and differences (MID) were calculated using distribution and anchor-based methods (including receiver-operating characteristic (ROC) curve and predictive-modelling techniques).
For comparison of two or more groups (such as in a clinic trial), MID estimates were ∼5 points. For cohort studies investigating changes over time in a single group of patients, MIC estimates were 12.4 points (primary hip replacement), 8.6 points (revision hip replacement), 10.5 points (primary knee replacement) and 9.4 points (revision knee replacement). For studies investigating changes over time at the individual patient level, MIC estimates were ∼8 points, ∼6 points, ∼7 points and ∼6 points respectively.
This study has calculated contemporary estimates of clinically important changes and differences for the OHS/OKS for primary and revision hip and knee replacement. These estimates can be used to inform sample size calculations and to interpret changes in joint function over time and differences between groups.
对初次和翻修关节置换中牛津髋关节与膝关节评分（OHS/OKS）在疼痛和关节功能方面具有临床意义的变化及差异进行评估。
对2012年至2020年期间英国国家医疗服务体系患者报告结局测量数据集（NHS PROMs）中的694487例初次和翻修关节置换手术进行分析。使用分布法和基于锚定的方法（包括受试者工作特征曲线（ROC）和预测建模技术）计算最小重要变化（MIC）和差异（MID）。
对于两组或多组比较（如在临床试验中），MID估计约为5分。对于调查单组患者随时间变化的队列研究，MIC估计值分别为：初次髋关节置换12.4分、翻修髋关节置换8.6分、初次膝关节置换10.5分和翻修膝关节置换9.4分。对于在个体患者层面调查随时间变化的研究，MIC估计值分别约为8分、约6分、约7分和约6分。
本研究计算了初次和翻修髋关节及膝关节置换中OHS/OKS具有临床重要意义的变化和差异的当代估计值。这些估计值可用于指导样本量计算，并解释关节功能随时间的变化以及组间差异。
