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相同却又不同?探索患者报告结局指标和临床医生报告结局指标在膝关节和髋关节置换术后康复中的作用

Same but Different? Exploring the Role of Patient-Reported Outcome Measures and Clinician-Reported Outcome Measures in Postoperative Knee and Hip Arthroplasty Rehabilitation.

作者信息

Unger Alexandra, Prüfer Ferdinand, Matko Špela, Fischer Michael J, Grote Vincent

机构信息

Ludwig Boltzmann Institute for Rehabilitation Research, 1140 Vienna, Austria.

University of Teacher Education, 9020 Klagenfurt, Austria.

出版信息

J Clin Med. 2025 Mar 28;14(7):2322. doi: 10.3390/jcm14072322.

Abstract

: Patient-reported outcome measures (PROMs) and clinician-reported outcome measures (CROMs) are used in orthopaedic rehabilitation to evaluate patients' health status and recovery. However, controversy still exists regarding their relevance and validity. This evaluation was conducted to assess the effectiveness and role of PROMs and CROMs in the orthopaedic rehabilitation outcome of patients who have undergone either total knee arthroplasty or hip arthroplasty. : Outcome measures of 409 patients (68.3 ± 9.3 years; 34.2% male) with total knee arthroplasty and 308 patients (68.1 ± 10.6 years; 36.3% male) with total hip arthroplasty (control group) were assessed at baseline and after 21 days of inpatient rehabilitation. Effect sizes and correlations were analysed as they related to the use of PROMs and CROMs. To reduce statistical distortions caused by ceiling effects, we used a performance score (T2D) relying on two scores taken at the beginning and end of rehabilitation. : Large effect sizes ( > 0.97) for CROMs and medium effect sizes ( ≥ 0.65) for PROMs were observed in both groups. The standardised mean difference across all outcomes was 0.83 ± 0.59. PROMs worsened in 13.1% of all patients, while almost no patients showed a deterioration in CROMs. Correlations were highest between the Timed Up and Go and the Health Assessment Questionnaire scores (ρ > 0.45). : Different and complementary assessment modalities of PROMs and CROMs serve as valuable clinical tools, providing a valid basis for interpreting patients' health outcomes.

摘要

患者报告结局测量指标(PROMs)和临床医生报告结局测量指标(CROMs)用于骨科康复,以评估患者的健康状况和恢复情况。然而,关于它们的相关性和有效性仍存在争议。本评估旨在评估PROMs和CROMs在接受全膝关节置换术或髋关节置换术患者的骨科康复结局中的有效性和作用。

对409例全膝关节置换术患者(68.3±9.3岁;男性占34.2%)和308例全髋关节置换术患者(对照组,68.1±10.6岁;男性占36.3%)在基线和住院康复21天后的结局指标进行评估。分析了与使用PROMs和CROMs相关的效应量和相关性。为减少天花板效应引起的统计偏差,我们使用了一个基于康复开始和结束时两个分数的表现评分(T2D)。

两组中均观察到CROMs的大效应量(>0.97)和PROMs的中等效应量(≥0.65)。所有结局的标准化平均差为0.83±0.59。13.1%的患者PROMs恶化,而几乎没有患者CROMs出现恶化。定时起立行走测试和健康评估问卷评分之间的相关性最高(ρ>0.45)。

PROMs和CROMs不同且互补的评估方式是有价值的临床工具,为解释患者的健康结局提供了有效的依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/efad/11989588/26c36e0b6c51/jcm-14-02322-g001.jpg

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