Clement Nick D, Afzal Irrum, Peacock Christian J H, MacDonald Deborah, Macpherson Gavin J, Patton James T, Asopa Vipin, Sochart David H, Kader Deiary F
South West London Elective Orthopaedic Centre, Epsom, UK.
Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK.
Bone Jt Open. 2022 Jul;3(7):573-581. doi: 10.1302/2633-1462.37.BJO-2022-0054.R1.
The aims of this study were to assess mapping models to predict the three-level version of EuroQoL five-dimension utility index (EQ-5D-3L) from the Oxford Knee Score (OKS) and validate these before and after total knee arthroplasty (TKA).
A retrospective cohort of 5,857 patients was used to create the prediction models, and a second cohort of 721 patients from a different centre was used to validate the models, all of whom underwent TKA. Patient characteristics, BMI, OKS, and EQ-5D-3L were collected preoperatively and one year postoperatively. Generalized linear regression was used to formulate the prediction models.
There were significant correlations between the OKS and EQ-5D-3L preoperatively ( = 0.68; p < 0.001) and postoperatively ( = 0.77; p < 0.001) and for the change in the scores ( = 0.61; p < 0.001). Three different models (preoperative, postoperative, and change) were created. There were no significant differences between the actual and predicted mean EQ-5D-3L utilities at any timepoint or for change in the scores (p > 0.090) in the validation cohort. There was a significant correlation between the actual and predicted EQ-5D-3L utilities preoperatively ( = 0.63; p < 0.001) and postoperatively ( = 0.77; p < 0.001) and for the change in the scores ( = 0.56; p < 0.001). Bland-Altman plots demonstrated that a lower utility was overestimated, and higher utility was underestimated. The individual predicted EQ-5D-3L that was within ± 0.05 and ± 0.010 (minimal clinically important difference (MCID)) of the actual EQ-5D-3L varied between 13% to 35% and 26% to 64%, respectively, according to timepoint assessed and change in the scores, but was not significantly different between the modelling and validation cohorts (p ≥ 0.148).
The OKS can be used to estimate EQ-5D-3L. Predicted individual patient utility error beyond the MCID varied from one-third to two-thirds depending on timepoint assessed, but the mean for a cohort did not differ and could be employed for this purpose. Cite this article: 2022;3(7):573-581.
本研究旨在评估从牛津膝关节评分（OKS）预测欧洲五维健康量表三维版效用指数（EQ-5D-3L）的映射模型，并在全膝关节置换术（TKA）前后对这些模型进行验证。
采用一个包含5857例患者的回顾性队列建立预测模型，另一个来自不同中心的721例患者队列用于验证模型，所有患者均接受了TKA。术前及术后1年收集患者特征、体重指数（BMI）、OKS和EQ-5D-3L。采用广义线性回归建立预测模型。
术前OKS与EQ-5D-3L之间（=0.68；p<0.001）、术后（=0.77；p<0.001）以及评分变化之间（=0.61；p<0.001）均存在显著相关性。创建了三种不同的模型（术前、术后和变化模型）。在验证队列中，任何时间点的实际和预测平均EQ-5D-3L效用或评分变化之间均无显著差异（p>0.090）。术前实际和预测的EQ-5D-3L效用之间（=0.63；p<0.001）、术后（=0.77；p<0.001）以及评分变化之间（=0.56；p<0.001）均存在显著相关性。Bland-Altman图显示，较低的效用被高估，较高的效用被低估。根据评估时间点和评分变化，实际EQ-5D-3L±0.05和±0.010（最小临床重要差异（MCID））范围内的个体预测EQ-5D-3L分别在13%至35%和26%至64%之间变化，但建模队列和验证队列之间无显著差异（p≥0.148）。
OKS可用于估计EQ-5D-3L。根据评估时间点的不同，预测的个体患者效用误差超过MCID的比例从三分之一到三分之二不等，但队列的平均值没有差异，可用于此目的。引用本文：2022；3(7):573-581。
