The Journal of Bone and Joint Surgery (American) 84:1745-1752 (2002)
© 2002 The Journal of Bone and Joint Surgery, Inc.
Comparison of Patient and Doctor Responses to a Total Hip Arthroplasty Clinical Evaluation Questionnaire
Margaret A. McGee, BSc, MPH,
Donald W. Howie, PhD, MBBS, FRACS,
Philip Ryan, MBBS, BSc, FAFPHM,
John R. Moss, MSocSci, BEc, MBBS, FCHSE and
Oksana T. Holubowycz, PhD, MPH, BA
Investigation performed at Royal Adelaide Hospital, Adelaide, South Australia, Australia
Margaret A. McGee, BSc, MPH
Donald W. Howie, PhD, MBBS, FRACS
Oksana T. Holubowycz, PhD, MPH, BA
Orthopedic Outcomes Unit, Department of Orthopedics and Trauma, L4 Bice Building, Royal Adelaide Hospital and University of Adelaide, North Terrace, Adelaide, South Australia 5000, Australia. E-mail address for M.A. McGee: mmcgee{at}mail.rah.sa.gov.au
Philip Ryan, MBBS, BSc, FAFPHM
John R. Moss, MSocSci, BEc, MBBS, FCHSE
Department of Public Health, University of Adelaide, Adelaide, South Australia, Australia
In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from Australian Medicare Initiative (Government), Royal Adelaide Hospital, Adelaide University, Adelaide Bone and Joint Research Foundation. None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Background: Surgeons traditionally undertake a prospective evaluation of patients undergoing total hip arthroplasty in order to determine outcomes. The validity of doctor-derived data is questionable because of the potential for interobserver error, reporting bias, and differences between the perceptions of doctors and patients. Also, the use of doctor-derived data necessitates the use of costly outpatient services. Consequently, there are likely to be benefits associated with the use of patient-derived clinical evaluation data. However, few studies have focused on whether data obtained from the patient and doctor differ.
Methods: The agreement between patient and doctor responses on a sixteen-item total hip arthroplasty clinical evaluation questionnaire completed at more than 2900 clinical assessments was determined. Data from repeated assessments performed preoperatively and postoperatively enabled stratified analyses that were used to examine reasons for disagreement and factors influencing agreement. Agreement was measured with use of the kappa coefficient.
Results: For twelve of the sixteen items, the patient responses had acceptable agreement with the doctor responses. Some important differences between patient-derived and doctor-derived data were found. If the patient had other joint or health problems, had a revision total hip arthroplasty, or reported mild or moderate pain, there was a greater chance of reduced agreement on the pain items. Younger patients demonstrated better agreement with doctors than older patients did.
Conclusions: Patients' perceptions of symptoms and outcomes after total hip arthroplasty are relatively similar to those of their doctor. There is minimum risk of misinterpreting outcomes data by replacing doctor-completed questionnaires with patient-completed questionnaires in uncomplicated total hip arthroplasty cases. For patients with comorbid joint problems or other health problems, and for those reporting substantial pain, direct physician involvement in the evaluation of pain is recommended. The selective use of patient-completed questionnaires has the potential to substantially reduce the costs of outcomes evaluation programs by minimizing doctor input. Pending revision of some of the items, the use of this patient-completed questionnaire is advocated.
 CiteULike  Connotea  Del.icio.us  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
R. V. O'Toole, R. C. Castillo, A. N. Pollak, E. J. MacKenzie, M. J. Bosse, and the LEAP Study Group
Determinants of Patient Satisfaction After Severe Lower-Extremity Injuries
J. Bone Joint Surg. Am.,
June 1, 2008;
90(6):
1206 - 1211.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K E Dreinhofer, P Dieppe, T Sturmer, D Grober-Gratz, M Floren, K-P Gunther, W Puhl, and H Brenner
Indications for total hip replacement: comparison of assessments of orthopaedic surgeons and referring physicians
Ann Rheum Dis,
October 1, 2006;
65(10):
1346 - 1350.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. M. Smith, S. A. Barnes, J. W. Sperling, C. M. Farrell, J. D. Cummings, and R. H. Cofield
Patient and Physician-Assessed Shoulder Function After Arthroplasty
J. Bone Joint Surg. Am.,
March 1, 2006;
88(3):
508 - 513.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Kim, J. H. Lonner, C. L. Nelson, and P. A. Lotke
Response Bias: Effect on Outcomes Evaluation by Mail Surveys After Total Knee Arthroplasty
J. Bone Joint Surg. Am.,
January 1, 2004;
86(1):
15 - 21.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. H. Huo and B. S. Brown
What's New in Hip Arthroplasty
J. Bone Joint Surg. Am.,
September 1, 2003;
85(9):
1852 - 1864.
[Full Text]
[PDF]
|
|
|
|
