HSS study shows significant variance in joint replacement performance measures — 6 takeaways

Hospital for Special Surgery researchers found current assessments of patient-reported outcome measures lack sufficient guidelines.

Here are six takeaways.

1. Three measures are used to assess meaningful change of PROMs, which evaluate the effectiveness of hip or knee replacement procedures. Those measures are Minimal Detectable Change, Minimal Clinically Important Change and Substantial Clinical Benefit.

2. The Knee Injury and Osteoarthritis Outcomes Survey and the Hip Disability and Osteoarthritis Outcomes Survey are commonly used to score those measures.

3. Several methods can be used to calculate the total score.

4. Researchers at HSS studied performance measurement of 2,323 people who underwent a total hip replacement procedure and 2,630 who underwent a total knee replacement procedure.

5. When the distribution-based approach, anchor-based approach and the anchor-based ROC approach were used to calculate the total score, researchers found wide variability in benchmarks. The anchor-based assessment is the only approach accounting for the patient's perspective.

6. "The orthopedic community must be careful before we start using PROMs scores for performance evaluations, and as a next step HSS researchers plan to explore in depth the care experience and broad outcomes of patients in relation to changes in their patient reported outcome scores," said Senior Author Catherine MacLean, MD, PhD, chief value medical officer at HSS.

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