The Journal of Bone and Joint Surgery (American). 2009;91:2827-2837.
doi:10.2106/JBJS.H.01415
© 2009 The Journal of Bone and Joint Surgery, Inc.
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Older Patients Can Accurately Recall Their Preoperative Health Status Six Weeks Following Total Hip Arthroplasty

Jackie Marsh, MSc1, Dianne Bryant, MSc, PhD1 and Steven J. MacDonald, MD, FRCSC2

1 Faculty of Health Sciences, Elborn College, Room 1438, The University of Western Ontario, 1201 Western Road, London, ON N6G 1H1, Canada. E-mail address for J. Marsh: jmarsh2{at}uwo.ca. E-mail address for D. Bryant: dianne.bryant{at}uwo.ca
2 London Health Sciences Centre, University Hospital, 339 Windermere Road, London, ON N6A 5A5, Canada. E-mail address: steven.macdonald{at}lhsc.on.ca

Investigation performed at the University of Western Ontario, London Health Sciences Centre, University Hospital, London, Ontario, Canada

A commentary by Hans J. Kreder, MD, MPH, FRCS(C), and Joel Finkelstein, MD, FRCS(C), is available at www.jbjs.org/commentary and as supplemental material to the online version of this article.

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. 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.

Background: In clinical trials, use of patient recall data would be beneficial when the collection of baseline data is impossible, such as in trauma situations. We investigated the ability of older patients to accurately recall their preoperative quality of life, function, and general health status at six weeks following total hip arthroplasty.

Methods: We randomized consecutive patients who were fifty-five years of age or older into two groups. At each assessment, patients completed self-report questionnaires (at four weeks preoperatively, on the day of surgery, and at six weeks and three months postoperatively for Group 1 and at six weeks and three months postoperatively for Group 2). At six weeks postoperatively, all patients completed the questionnaires on the basis of their recollection of their preoperative health status. We evaluated the validity and reliability of recall ratings, the degree of error in recall ratings, and the effects of the use of recall data on power and sample size requirements.

Results: A total of 174 patients (mean age, seventy-one years) who were undergoing either primary or revision total hip arthroplasty were randomized and included in the analysis (118 patients were in Group 1 and fifty-six were in Group 2). Agreement between actual and recalled data was excellent for disease-specific questionnaires (intraclass correlation coefficient, 0.86, 0.87, and 0.88) and moderate for generic health measures (intraclass correlation coefficient, 0.48, 0.58, and 0.60). Increased error associated with recalled ratings compared with actual ratings necessitates minimal increases in sample size or results in small decreases in power.

Conclusions: Patients undergoing total hip arthroplasty can accurately recall their preoperative health status at six weeks postoperatively.

Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.


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