J Evans1, Rupen Dattani2, Vijayaraj Ramasamy3, Vipul Patel4. 1. 1 University of Exeter Medical School, Exeter, UK. 2. 2 Chelsea and Westminster NHS Foundation Trust, London, UK. 3. 3 Sri Ramakrishna Hospital, Coimbatore, Tamil Nadu, India. 4. 4 South West London Elective Orthopaedic Centre, Epsom, UK.
Abstract
AIM: Generic patient-reported outcome measures (PROMs) allow comparison of health-related quality of life across populations and pathologies. For these comparisons to be valid, the PROM must be responsive; the score must change when the patient's quality of life changes. This study aims to assess the responsiveness of the EQ-5D-three level (3L) in elective shoulder surgery. METHODS: Pre- and post-operative EQ-5D-3L and Oxford Shoulder Scores (OSS) were prospectively collected across a range of 204 elective shoulder surgeries. Internal responsiveness was assessed through significance testing of mean change scores and standardized response means (SRMs). External responsiveness of the EQ-5D-3L was assessed against the minimal clinically important difference in OSS, using receiver operating characteristic curve and change score correlation. RESULTS: Both EQ-5D-3L and OSS scores improved significantly over time ( p < 0.05). The SRM for the EQ-5D was 1.27 (95% CI 1.14-1.41) and for OSS 2.36 (2.22-2.52). Area under the curve for EQ-5D was 0.49. Only a weak correlation was found between EQ-5D and OSS change scores ( r = 0.21). DISCUSSION: The EQ-5D-3L is adequately internally responsive to change following elective shoulder surgery but is unable to differentiate patients demonstrating minimal clinically important change. The EQ-5D therefore only partially reflects patient experience.
AIM: Generic patient-reported outcome measures (PROMs) allow comparison of health-related quality of life across populations and pathologies. For these comparisons to be valid, the PROM must be responsive; the score must change when the patient's quality of life changes. This study aims to assess the responsiveness of the EQ-5D-three level (3L) in elective shoulder surgery. METHODS: Pre- and post-operative EQ-5D-3L and Oxford Shoulder Scores (OSS) were prospectively collected across a range of 204 elective shoulder surgeries. Internal responsiveness was assessed through significance testing of mean change scores and standardized response means (SRMs). External responsiveness of the EQ-5D-3L was assessed against the minimal clinically important difference in OSS, using receiver operating characteristic curve and change score correlation. RESULTS: Both EQ-5D-3L and OSS scores improved significantly over time ( p < 0.05). The SRM for the EQ-5D was 1.27 (95% CI 1.14-1.41) and for OSS 2.36 (2.22-2.52). Area under the curve for EQ-5D was 0.49. Only a weak correlation was found between EQ-5D and OSS change scores ( r = 0.21). DISCUSSION: The EQ-5D-3L is adequately internally responsive to change following elective shoulder surgery but is unable to differentiate patients demonstrating minimal clinically important change. The EQ-5D therefore only partially reflects patient experience.
Authors: S Fitschen-Oestern; P Behrendt; E Martens; J Finn; J Schiegnitz; C Borzikowsky; A Seekamp; M Weuster; S Lippross Journal: J Orthop Date: 2019-08-14
Authors: Maroeska M Rovers; Stan Rw Wijn; Janneke Pc Grutters; Sanne Jjpm Metsemakers; Robin J Vermeulen; Ron van der Pennen; Bart Jjm Berden; Hein G Gooszen; Mirre Scholte; Tim M Govers Journal: BMJ Open Date: 2022-04-08 Impact factor: 2.692