Carol A Mancuso1, Catherine H Wentzel2, Hassan M K Ghomrawi3, Bryan T Kelly2. 1. Research Division, Hip Preservation Service, Hospital for Special Surgery, New York, New York, U.S.A.; Department of Medicine, Weill Cornell Medical College, New York, New York, U.S.A.. Electronic address: mancusoc@hss.edu. 2. Department of Orthopedic Surgery, Hip Preservation Service, Hospital for Special Surgery, New York, New York, U.S.A. 3. Division of Health Policy, Department of Public Health, Weill Cornell Medical College, New York, New York, U.S.A.
Abstract
PURPOSE: To develop a patient-derived expectations survey for hip preservation surgery. METHODS: Patients were eligible if they were undergoing primary hip surgery and were recruited in person or by telephone. The survey was developed in 3 phases. During phase 1, 64 patients were interviewed preoperatively and asked open-ended questions about their expectations of surgery; a draft survey was assembled by categorizing responses. During phase 2, the survey was administered twice to another group of 50 patients preoperatively to assess test-retest reliability and concordance was measured with weighted kappa values and intraclass correlations. All patients also completed valid standard hip surveys electronically. During phase 3, final items were selected, factor analysis was performed, and a scoring system was developed. RESULTS: In phase 1, 509 expectations were volunteered from which 21 distinct categories were discerned and became the items for the draft survey. In phase 2, the draft survey was completed twice, 4 days apart. In phase 3, all 21 items were retained for the final survey addressing pain, mobility, sports, resumption of active lifestyles, future function, and psychological well-being. An overall score is calculated from the number of items expected and the amount of improvement expected, and ranges from 0 to 100; higher is more expectations. For phase 2 patients, mean scores for both administrations were 82, Cronbach alpha coefficients were 0.88 and 0.91, and the intraclass correlation was 0.92. A higher score (i.e., greater expectations) was associated with worse hip condition measured by standard hip surveys (P ≤ .05). CONCLUSIONS: We developed a patient-derived survey that is valid, reliable, and addresses a spectrum of expectations. The survey generates an overall score that is easy to calculate and interpret and offers a practical and comprehensive way to record patients' preoperative expectations. LEVEL OF EVIDENCE: Level II, prognostic study, prospective sample.
PURPOSE: To develop a patient-derived expectations survey for hip preservation surgery. METHODS:Patients were eligible if they were undergoing primary hip surgery and were recruited in person or by telephone. The survey was developed in 3 phases. During phase 1, 64 patients were interviewed preoperatively and asked open-ended questions about their expectations of surgery; a draft survey was assembled by categorizing responses. During phase 2, the survey was administered twice to another group of 50 patients preoperatively to assess test-retest reliability and concordance was measured with weighted kappa values and intraclass correlations. All patients also completed valid standard hip surveys electronically. During phase 3, final items were selected, factor analysis was performed, and a scoring system was developed. RESULTS: In phase 1, 509 expectations were volunteered from which 21 distinct categories were discerned and became the items for the draft survey. In phase 2, the draft survey was completed twice, 4 days apart. In phase 3, all 21 items were retained for the final survey addressing pain, mobility, sports, resumption of active lifestyles, future function, and psychological well-being. An overall score is calculated from the number of items expected and the amount of improvement expected, and ranges from 0 to 100; higher is more expectations. For phase 2 patients, mean scores for both administrations were 82, Cronbach alpha coefficients were 0.88 and 0.91, and the intraclass correlation was 0.92. A higher score (i.e., greater expectations) was associated with worse hip condition measured by standard hip surveys (P ≤ .05). CONCLUSIONS: We developed a patient-derived survey that is valid, reliable, and addresses a spectrum of expectations. The survey generates an overall score that is easy to calculate and interpret and offers a practical and comprehensive way to record patients' preoperative expectations. LEVEL OF EVIDENCE: Level II, prognostic study, prospective sample.