Can the Oxford Scores Be Used to Monitor Symptomatic Progression of Patients Awaiting Knee or Hip Arthroplasty?

Naylor, Justine; Kamalasena, Gihan; Hayen, Andrew; Harris, Ian A.; Adie, Sam

doi:10.1016/j.arth.2013.03.003

Cited by 7 publications

(4 citation statements)

References 22 publications

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“…Similar 95% limits of agreement have also been seen in test-retest studies of reliability indicating that the differences seen between methods in this study may be explained by the normal week-to-week variation of responses to the survey questions, which may also incorporate true health changes between surveys (13). While patient recovery following arthroplasty largely plateaus after 6 months, the one month window either side of the 6 month date which we allowed for conducting interviews may have confounded the test-retest reliability.…”

Section: Discussionsupporting

confidence: 81%

Interpreter proxy versus healthcare interpreter for administration of patient surveys following arthroplasty: a pilot study.

Xue

Churches

Armstrong

et al. 2019

Preprint

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Background: Clinical quality registries and other systems that conduct routine post-discharge surveillance of patient outcomes following surgery may have difficulty surveying patients who have limited proficiency in the language of the healthcare provider. Interpreter proxies (family and carers) are often used due to limited access to certified healthcare interpreters (due to cost or availability). The aim of this study was to assess the reliability of engaging interpreter proxies compared with certified healthcare interpreters for the administration of patient-reported health-related surveys for people with limited English proficiency (LEP). Methods: People with LEP and due for a routine 6-month telephone follow-up post knee or hip arthroplasty were invited to participate. Participants were randomly allocated to having their first interview with an interpreter proxy or a certified healthcare interpreter followed by the second (crossover) interview within 2 weeks (range: 4 to 12 days) after the first interview using the alternative method. Agreement between the two methods was assessed using quadratic weighted Cohen's kappa, intraclass correlation and concordance correlation co-efficient where appropriate for EQ-5D health domains, total Oxford hip and knee scores, patient satisfaction, operation success, readmission, reoperation, and post-surgical complication responses. The mean of the differences between the same data items collected by each of the two methods was also calculated. Results: 85 participants (96%) completed the study. There was substantial to excellent inter-rater agreement (kappa=0.69-0.87 and ICCs above 0.74) for all but one measure. The mean differences between family proxy and healthcare interpreter scores for each participant were small, ranging from 0.01 (score range of 1-5) to 0.72 (score range of 0-100). Conclusion: These results suggest that using interpreter proxies is a reliable alternative to certified healthcare interpreters in conducting patient-reported health surveys, potentially making this process easier and cost effective for researchers and registries.

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Section: Discussionsupporting

confidence: 81%

Interpreter proxy versus healthcare interpreter for administration of patient surveys following arthroplasty: a pilot study.

Xue

Churches

Armstrong

et al. 2019

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…Similar 95% limits of agreement have also been seen in test-retest studies of reliability indicating that the differences seen between methods in this study may be explained by the normal week-to-week variation of responses to the survey questions, which may also incorporate true health changes between surveys [13]. While patient recovery following arthroplasty largely plateaus after 6 months, the 1 month window either side of the 6 month date which we allowed for conducting interviews may have confounded the test-retest reliability.…”

Section: Discussionsupporting

confidence: 74%

Interpreter proxy versus healthcare interpreter for administration of patient surveys following arthroplasty: a pilot study

Xue

Churches

Armstrong

et al. 2019

BMC Med Res Methodol

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BackgroundClinical quality registries and other systems that conduct routine post-discharge surveillance of patient outcomes following surgery may have difficulty surveying patients who have limited proficiency in the language of the healthcare provider. Interpreter proxies (family and carers) are often used due to limited access to certified healthcare interpreters (due to cost or availability). The aim of this study was to assess the reliability of engaging interpreter proxies compared with certified healthcare interpreters for the administration of patient-reported health-related surveys for people with limited English proficiency (LEP).MethodsPeople with LEP and due for a routine 6-month telephone follow-up post knee or hip arthroplasty were invited to participate. Participants were randomly allocated to having their first interview with an interpreter proxy or a certified healthcare interpreter followed by the second (crossover) interview within 2 weeks (range: 4 to 12 days) after the first interview using the alternative method. Agreement between the two methods was assessed using quadratic weighted Cohen’s kappa, intraclass correlation and concordance correlation co-efficient where appropriate for EQ-5D health domains, total Oxford hip and knee scores, patient satisfaction, operation success, readmission, reoperation, and post-surgical complication responses. The mean of the differences between the same data items collected by each of the two methods was also calculated.ResultsEighty five participants (96%) completed the study. There was substantial to excellent inter-rater agreement (kappa = 0.69–0.87 and ICCs above 0.74) for all but one measure. The mean differences between family proxy and healthcare interpreter scores for each participant were small, ranging from 0.01 (score range of 1–5) to 0.72 (score range of 0–100).ConclusionThese results suggest that using interpreter proxies is a reliable alternative to certified healthcare interpreters in conducting patient-reported health surveys, potentially making this process easier and cost effective for researchers and registries.

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“…Our MDC 95 for the KOOS subscales were generally smaller than the 95% LOA (equivalent to the MDC 95 ) for those reported by Roos and Toksvig-Larsen [21] which ranged from 40 (Symptoms) to 60 (Sport and Recreation subscale), whilst our MDC 95 for the HOOS subscales were slightly larger than those reported by Ornetti et al [39] which ranged from 10 to 20. In terms of how the agreement indices of the KOOS and HOOS Pain, Symptom and ADL Function subscales compare with the OKS and OHS, we found that the CV% were similar (16% for both OKS and OHS) [32]. These observations are interesting as it appears the greater specificities afforded by the KOOS and HOOS subscales do not guarantee a smaller measurement error compared to a survey that does not differentiate contributions made by pain and functional impairment.…”

Section: Discussionmentioning

confidence: 95%

“…We examined a well-defined cohort likely to be representative of patients with severe OA waitlisted for arthroplasty. This contention is supported by the observations that: 1) the age (68 and 65 yrs), BMI (34 and 31), and gender (female, 63 and 54%) profiles of the knee and hip cohorts respectively, reflect those of the entire patient populations waitlisted for hip or knee arthroplasty at the two sites involved (age, 69 and 65 yrs; BMI, 34 and 30; female gender, 68 and 58%, knee and hip cohorts respectively) as per the data each site routinely collects for submission to the State’s arthroplasty registry (Arthoplasty Clinical Outcome Registry for NSW, ACORN), and; 2) the baseline physical and patient-reported characteristics of our cohorts reflect those reported elsewhere [30-32,39-41]. Our sample size exceeded the minimum recommended sample size for reproducibility studies, we therefore contend the error margins are credible estimates and not unduly influenced by an inadequate sample size.…”

Section: Discussionmentioning

confidence: 99%

Minimal detectable change for mobility and patient-reported tools in people with osteoarthritis awaiting arthroplasty

Naylor

Hayen

Davidson

et al. 2014

BMC Musculoskelet Disord

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BackgroundThoughtful use of assessment tools to monitor disease requires an understanding of clinimetric properties. These properties are often under-reported and, thus, potentially overlooked in the clinic. This study aimed to determine the minimal detectable change (MDC) and coefficient of variation per cent (CV%) for tools commonly used to assess the symptomatic and functional severity of knee and hip osteoarthritis.MethodsWe performed a test-retest study on 136 people awaiting knee or hip arthroplasty at one of two hospitals. The MDC95 (the range over which the difference [change] for 95% of patients is expected to lie) and the coefficient of variation per cent (CV%) for the visual analogue scale (VAS) for joint pain, the six-minute walk test (6MWT), the timed up-and-go (TUG) test, the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Hip Disability and Osteoarthritis Outcome Score (HOOS) subscales were calculated.ResultsKnee cohort (n = 75) - The MDC95 and CV% values were as follows: VAS 2.8 cm, 15%; 6MWT 79 m, 8%; TUG +/-36.7%, 13%; KOOS pain 20.2, 19%; KOOS symptoms 24.1, 22%; KOOS activities of daily living 20.8, 17%; KOOS quality of life 26.6, 44. Hip cohort (n = 61) - The MDC95 and CV% values were as follows: VAS 3.3 cm, 17%; 6MWT 81.5 m, 9%; TUG +/-44.6%, 16%; HOOS pain 21.6, 22%; HOOS symptoms 22.7, 19%; HOOS activities of daily living 17.7, 17%; HOOS quality of life 24.4, 43%.ConclusionsDistinguishing real change from error is difficult in people with severe osteoarthritis. The 6MWT demonstrates the smallest measurement error amongst a range of tools commonly used to assess disease severity, thus, has the capacity to detect the smallest real change above measurement error in everyday clinical practice.

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Can the Oxford Scores Be Used to Monitor Symptomatic Progression of Patients Awaiting Knee or Hip Arthroplasty?

Cited by 7 publications

References 22 publications

Interpreter proxy versus healthcare interpreter for administration of patient surveys following arthroplasty: a pilot study.

Interpreter proxy versus healthcare interpreter for administration of patient surveys following arthroplasty: a pilot study.

Interpreter proxy versus healthcare interpreter for administration of patient surveys following arthroplasty: a pilot study

Minimal detectable change for mobility and patient-reported tools in people with osteoarthritis awaiting arthroplasty

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