The value-of short and simple measures to assess outcomes for patients of total hip replacement surgery
The value-of short and simple measures to assess outcomes for patients of total hip replacement surgery
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DOI：
10.1136/qhc.9.3.146
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发表时间：
2000-09-01
期刊：
影响因子：
--
通讯作者：
Gregg, P
中科院分区：
文献类型：
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作者：
Fitzpatrick, R;Morris, R;Gregg, P
目的：评价患者评估结果测量的性能，牛津髋关节评分，在一项关于初次髋关节置换手术的全国研究中。设计-对患者在接受初次髋关节置换手术前和手术后三个月和一年的健康状况进行调查。设置-NHS英国三个地区的143家医院。患者-从1996年9月开始的13个月内，7151例初次全髋关节置换术患者。主要测量指标：患者，Oxford髋关节评分和髋关节置换术的满意度，外科医生，美国麻醉医师协会（阿萨）的身体状况分类。结果在3个月和12个月随访的邮寄问卷的应答率分别为85.2%和80.7%。包括问卷的所有三次管理，97%或以上的受访者完成了牛津髋关节评分的所有项目（除两个项目外），一次管理中只有一个项目略微降低了评分的可靠性。从基线到3个月评分变化的效应量为2.50，到12个月为3.05。术前被外科医生评定为阿萨分级健康的患者在3个月时更有可能返回完整的问卷（79.4% vs 75.3%）和12个月（72.4%对70.3%）比那些被评为有较差的health. Conclusions总体上有很少的证据表明，困难的病人在完成牛津髋关节评分或不可靠的数据，除了一个调查表项目。该工具对随时间变化的反应非常灵敏，牛津髋关节评分的评分变化与患者对其手术的满意度密切相关。就有效性、响应性和可行性而言，该工具是从患者角度评估全髋关节置换术的适当衡量标准。
Objectives-To evaluate the performance of a patient assessed outcome measure, the Oxford Hip Score, in a national study of primary hip replacement surgery.Design-A survey of patients' health status before undergoing primary hip replacement surgery and three months and one year after surgery.Setting-143 hospitals in three NHS English regions.Patients-7151 patients admitted for primary total hip replacement surgery over a period of 13 months from September 1996.Main measures-For patients, Oxford Hip Score and satisfaction with hip replacement and, for surgeons, American Anesthiologists' Society (ASA) classification of physical status.Results-The response rates to the postal questionnaire at three and 12 months follow up were 85.2% and 80.7%, respectively. Including all three administrations of the questionnaire, all except two items of the Oxford Hip Score were completed by 97% or more respondents and only one item at one administration appeared marginally to reduce the reliability of the score. The effect sizes for changes in the score from baseline to three months was 2.50 and to 12 months was 3.05. Patients rated by surgeons as being healthy preoperatively by the ASA classification were somewhat more likely to return a completed questionnaire at three months (79.4% versus 75.3%) and 12 months (72.4% versus 70.3%) than those rated as having poorer health.Conclusions-Overall there was little evidence of difficulties for patients in completing the Oxford Hip Score or of unreliable data, except in relation to one questionnaire item. The instrument was very responsive to change over time and score changes for the Oxford Hip Score related well to patients' satisfaction with their surgery. The instrument is an appropriate measure in terms of validity, responsiveness, and feasibility for evaluating total hip replacement from the perspective of the patient.