Responsiveness and clinically important differences for the WOMAC and SF-36 after hip joint replacement

Quintana, José M.; Escobar, Antonio; Bilbao, Amaia; Aróstegui, Inmaculada; Lafuente, Iratxe; Vidaurreta, I.

doi:10.1016/j.joca.2005.06.012

Cited by 307 publications

(196 citation statements)

References 25 publications

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“…Other studies have previously explored the issue of whether patients responded to THR (4,16,27,28). An early US study by MacWilliam et al identified predictors of outcome in 1,500 patients receiving THR (27).…”

Section: Discussionmentioning

confidence: 99%

“…One of the difficulties in trying to decide whether an individual has or has not responded to THR is that disease severity at the time of surgery varies enormously (15), and that there are floor and ceiling effects in the patientreported outcome measures used to assess severity (16). Ceiling effects occur when a large number of patients have the maximum score (i.e., most severe disease; these patients have the greatest potential to improve following surgery), whereas floor effects occur when a high percentage of patients have the minimum score (e.g., no pain or functional limitations).…”

Section: Introductionmentioning

confidence: 99%

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Patient‐reported outcomes one year after primary hip replacement in a European Collaborative Cohort

Judge¹,

Cooper²,

Williams³

et al. 2010

Arthritis Care & Research

130

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Results. On average, there was a large improvement in WOMAC scores 12 months after surgery, but whereas some patients improved, others got worse. The OMERACT-OARSI method classified 85.7% of patients as responders, MID 70.1%, and return to normal 64.1%. In general, each approach classified the same groups of patients as responding to THR. Based on total WOMAC score, patients who were younger, morbidly obese, employed, and better educated were more likely to respond to THR, but the effects were attenuated after adjustment for confounding, with only the effect of education remaining important. Conclusion. The overall average response to THR was good, but ϳ14 -36% of patients did not improve, or were worse, 12 months postsurgery. Although the OMERACT-OARSI criteria were originally designed for use in clinical drug trials, they performed well in classifying patient response 12 months post-THR. Further research is required to understand the determinants of patient outcomes following THR.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patient‐reported outcomes one year after primary hip replacement in a European Collaborative Cohort

Judge¹,

Cooper²,

Williams³

et al. 2010

Arthritis Care & Research

130

View full text Add to dashboard Cite

show abstract

“…It also is possible that waiting only 6 months to assess the impact of a THA may have introduced bias. Although some studies report that improvement is seen at 6 months [8,9,12,25], some suggest a longer followup period is needed [20]. Third, the WOMAC provides valuable information and is considered the correct instrument for evaluating changes in studies such as ours [15,26].…”

Section: Discussionmentioning

confidence: 90%

“…When working with the WOMAC and other instruments, showing clinically meaningful changes, not just statistically significant changes, is crucial. Therefore, we used the MCID of the WOMAC [25]. However, even the MCID must be used carefully and not as an absolute measure, as there are several practical problems in estimating that parameter [16].…”

Section: Discussionmentioning

confidence: 99%

“…The MCID improvement, implying relief or improvement, in the WOMAC pain and function domains has been defined as a decrease of 30 points or more, whereas the MCID improvement in the WOMAC stiffness domain has been defined as an increase of 25 points or more [25]. We performed statistical analyses using SAS for Windows statistical software, version 9.1 (SAS Institute Inc, Cary, NC, USA).…”

Section: Methodsmentioning

confidence: 99%

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Factors and Consequences of Waiting Times for Total Hip Arthroplasty

Vergara

Bilbao

González

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Various priority criteria for waiting lists for THA have been proposed. These criteria, however, are not typically included in clinical practice, resulting in unclear management procedures. Further, the clinical effects of waiting times on subsequent pain control or function are unclear. Questions/purposes Therefore, we asked (1) what factors affect the waiting time for THA when no prioritization criteria are implemented, and (2) does waiting time influence pain and function after THA? Patient and Methods We prospectively identified all 1495 patients on a waiting list for THA during a year. Of these patients, 991 fulfilled the inclusion criteria, and waiting times were available for 695, of whom 527 (76%) responded to a followup questionnaire. Variables included wait time, sociodemographic data, comorbidities, and WOMAC and SF-36 questionnaires, collected preoperatively and 6 months after surgery. Results The mean wait time was 5 months (SD, 3.0). Patients with lower levels of pain and better function on the WOMAC scale, or better physical function on the SF-36, had longer waiting times. The gains in function were smaller for patients who waited more than 6 months. The likelihood of perceiving a gain greater than the minimal clinically important difference was greater for patients waiting less than 3 months. Conclusion Only pain and previous function were significant determinants of prioritizing patients on the waiting list. Suboptimal patient selection had clinical consequences in function gain that affect the quality of the clinical care.

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Association of the 36-Item Short Form Health Survey Physical Component Summary Score With Patient Satisfaction and Improvement 2 Years After Total Knee Arthroplasty

et al. 2019

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Responsiveness and clinically important differences for the WOMAC and SF-36 after hip joint replacement

Abstract: These values indicate expected gains after THR. However, the MCID and MDC values must be viewed cautiously due to the uncertainty of these estimators and should not be considered as absolute thresholds.

Cited by 307 publications

References 25 publications

Patient‐reported outcomes one year after primary hip replacement in a European Collaborative Cohort

Patient‐reported outcomes one year after primary hip replacement in a European Collaborative Cohort

Factors and Consequences of Waiting Times for Total Hip Arthroplasty

Association of the 36-Item Short Form Health Survey Physical Component Summary Score With Patient Satisfaction and Improvement 2 Years After Total Knee Arthroplasty

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