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The Journal of Bone and Joint Surgery 82:829 (2000)
© 2000 The Journal of Bone and Joint Surgery, Inc.

The Reliability and Validity of the Self-Reported Patient-Specific Index for Total Hip Arthroplasty*

James G. Wright, M.D., M.P.H., F.R.C.S.(C){dagger}, Nancy L. Young, B.Sc.P.T., M.Sc., Ph.D.{dagger} and James P. Waddell, M.D., F.R.C.S.(C){dagger}

Investigation performed at the Departments of Surgery, Public Health Sciences, Clinical Epidemiology and Health Research Program, and Pediatrics and Rehabilitation Sciences, University of Toronto, Toronto, Ontario, Canada
*Although none of the authors has received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article, benefits have been received or will be received but are directed solely to a research fund, foundation, educational institution, or other nonprofit organization with which one or more of the authors is associated.
{dagger}Departments of Surgery (J. G. W. and J. P. W.), Public Health Sciences, Clinical Epidemiology and Health Research Program (J. G. W.), and Pediatrics and Rehabilitation Sciences (N. L. Y.), The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada. E-mail address for J. G. Wright: jgwright{at}sickkids.on.ca

Background: The Patient-Specific Index is unique in that it reflects how individual patients weigh concerns in rating the outcome of total hip arthroplasty. The Patient-Specific Index was originally administered by an interviewer, which is not always feasible and can be costly. The purposes of the present study were (1) to create a self-reported version of the Patient-Specific Index, (2) to determine the reliability of this new self-reported version, and (3) to determine the relationship between the scores on the new self-reported version and those on the original interviewer-administered version.

Methods: A self-reported version of the Patient-Specific Index was developed, and a pilot test was performed on ten patients. Patients who were scheduled for a total hip arthroplasty or who had recently had a total hip arthroplasty were eligible for the reliability and validity testing. A copy of the new self-reported Patient-Specific Index was mailed to the patients, and they completed it independently. The patients' ratings of the importance and severity of twenty-four concerns prior to total hip arthroplasty were added together to create a summary Patient-Specific Index score. To determine test-retest reliability, patients completed the self-reported Patient-Specific Index a second time, two weeks later. To determine criterion validity, participants also completed the interviewer-administered Patient-Specific Index.

Results: Fifty-five patients completed the study. The random-effects intraclass correlation test-retest coefficient was 0.79 (greater than 0.75 represents excellent reliability). The mean Patient-Specific Index scores on the self-reported version and on the interviewer-administered version were 173 and 165 points, respectively (Student t test, p = 0.45). The self-reported Patient-Specific Index was concordant with the interviewer-administered Patient-Specific Index (intraclass correlation coefficient, 0.78).

Conclusions: We concluded that a self-reported version of the Patient-Specific Index, which focuses on the concerns of individuals, is reliable and has criterion validity compared with an interviewer-administered version.


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