This Article Full Text Full Text (PDF) CME: Take the activity for this article: CME 1: January, February, March 2008 (publication date April 4, 2008; expir... [Supplementary Material] Letters to the Editor: Submit a response Letters to the Editor: View responses Alert me when this article is cited Alert me when Letters to the Editor are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Rights and Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bryant, D. Articles by Guyatt, G. Search for Related Content PubMed Articles by Bryant, D. Articles by Guyatt, G. Related Collections Adult Knee Social Bookmarking                   What's this?

Patients Can Provide a Valid Assessment of Quality of Life, Functional Status, and General Health on the Day They Undergo Knee Surgery

¹ Faculty of Health Sciences, Elborn College, Room 1438, The University of Western Ontario, London, ON N6G 1H1, Canada. E-mail address: dianne.bryant{at}uwo.ca
² School of Rehabilitation Sciences, Institute of Applied Sciences, Room 430, McMaster University, 1200 Main Street West, Hamilton, ON L8N 3Z5, Canada. E-mail address: stratfor{at}mcmaster.ca
³ Sports Medicine and Shoulder Service, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021. E-mail address: marxr{at}hss.edu
⁴ Clinical Epidemiology and Biostatistics, Hamilton Health Sciences Center, Rooms 2C16 (S.W.) and 2C12 (G.G.), McMaster University, 1200 Main Street West, Hamilton, ON L8N 3Z5, Canada. E-mail address for S. Walter: walter{at}mcmaster.ca. E-mail address for G. Guyatt: guyatt{at}mcmaster.ca

Investigation performed at McMaster University, Hamilton, and The University of Western Ontario, London, Ontario, Canada

Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from Lawson Health Research Institute and Smith and Nephew. Neither they nor a member of their immediate families 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, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

A commentary is available with the electronic versions of this article, on our web site (www.jbjs.org) and on our quarterly CD-ROM (call our subscription department, at 781-449-9780, to order the CD-ROM).

Methods: One hundred and seventy-seven patients undergoing anterior cruciate ligament reconstruction and/or knee arthroscopy completed quality-of-life, functional status, and general health instruments at four weeks preoperatively, on the day of surgery, and one year postoperatively. We evaluated results with use of three conceptual frameworks: (1) that ratings provided four weeks preoperatively provide a gold standard for preoperative ratings, (2) that there is no gold standard for preoperative ratings and that, if valid, ratings on the day of surgery should be highly correlated with ratings at four weeks preoperatively and moderately and similarly correlated with ratings at one year postoperatively, and (3) that ratings provided four weeks preoperatively and on the day of surgery are measuring identical constructs and should therefore show high reliability.

Results: Most patients (97%) had a chronic injury as the interval between the injury and surgery was more than ninety days. Data collected on the day of surgery demonstrated high predictive validity with data collected within one month before surgery. There was no significant heterogeneity between variances for data collected four weeks preoperatively and on the day of surgery. The correlation between data collected on the day of surgery and four weeks preoperatively was moderate to high (range, 0.64 to 0.93), and the correlation between preoperative ratings and the one-year postoperative ratings was moderate (range, 0.40 to 0.59) across all instruments. Agreement between the ratings provided four weeks preoperatively and on the day of surgery was excellent (intraclass correlation coefficient, 0.64 to 0.91), and the standard error of measurement was small across instruments.

Conclusions: In the treatment of chronic knee injuries, patients can accurately rate their quality of life, general health, and functional status on the day on which they undergo surgery.

CiteULike    Connotea    Del.icio.us    Facebook    Technorati    Twitter    What's this?

Letters to the Editor:

Stanford University Libraries' HighWire Press (TM) assists in the publication of JBJS Online.
Copyright © 2008 by The Journal of Bone and Joint Surgery, Inc. Online ISSN: 1535-1386.
The Journal of Bone and Joint Surgery®, JBJS®, JB&JS®, and eJBJS® are registered in the U.S. Patent and Trademark Office.