Overcoming floor and ceiling effects in knee arthroplasty outcome measurement.

IF 4.7 2区 医学 Q2 CELL & TISSUE ENGINEERING Bone & Joint Research Pub Date : 2023-10-04 DOI:10.1302/2046-3758.1210.BJR-2022-0457.R1
Conrad J Harrison, Constantin Y Plessen, Gregor Liegl, Jeremy N Rodrigues, Shiraz A Sabah, David J Beard, Felix Fischer
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Abstract

Aims: To map the Oxford Knee Score (OKS) and High Activity Arthroplasty Score (HAAS) items to a common scale, and to investigate the psychometric properties of this new scale for the measurement of knee health.

Methods: Patient-reported outcome measure (PROM) data measuring knee health were obtained from the NHS PROMs dataset and Total or Partial Knee Arthroplasty Trial (TOPKAT). Assumptions for common scale modelling were tested. A graded response model (fitted to OKS item responses in the NHS PROMs dataset) was used as an anchor to calibrate paired HAAS items from the TOPKAT dataset. Information curves for the combined OKS-HAAS model were plotted. Bland-Altman analysis was used to compare common scale scores derived from OKS and HAAS items. A conversion table was developed to map between HAAS, OKS, and the common scale.

Results: We included 3,329 response sets from 528 patients undergoing knee arthroplasty. These generally met the assumptions of unidimensionality, monotonicity, local independence, and measurement invariance. The HAAS items provided more information than OKS items at high levels of knee health. Combining both instruments resulted in higher test-level information than either instrument alone. The mean error between common scale scores derived from the OKS and HAAS was 0.29 logits.

Conclusion: The common scale allowed more precise measurement of knee health than use of either the OKS or HAAS individually. These techniques for mapping PROM instruments may be useful for the standardization of outcome reporting, and pooling results across studies that use either PROM in individual-patient meta-analysis.

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克服膝关节置换术结果测量中的地板和天花板效应。
目的:将牛津膝关节评分(OKS)和高活性关节成形术评分(HAAS)项目映射到一个通用量表中,并研究该新量表用于测量膝关节健康的心理测量特性。方法:从NHS PROM数据集和全膝或部分膝关节置换术试验(TOPKAT)中获得测量膝关节健康的患者报告结果测量(PROM)数据。对普通规模建模的假设进行了测试。分级反应模型(适用于NHS PROMs数据集中的OKS项目反应)被用作锚,以校准TOPKAT数据集中的配对HAAS项目。绘制了OKS-HAAS组合模型的信息曲线。Bland-Altman分析用于比较OKS和HAAS项目的常见量表得分。开发了一个转换表来映射HAAS、OKS和通用比例。结果:我们纳入了来自528名接受膝关节置换术的患者的3329个反应集。这些通常满足一维性、单调性、局部独立性和测量不变性的假设。HAAS项目比OKS项目在膝关节健康水平高的情况下提供了更多的信息。将两种仪器组合在一起会产生比单独使用任何一种仪器更高的测试水平信息。OKS和HAAS得出的普通量表评分之间的平均误差为0.29 logits。结论:与单独使用OKS或HAAS相比,通用量表可以更精确地测量膝关节健康状况。这些绘制PROM仪器的技术可能有助于结果报告的标准化,并在个体患者荟萃分析中汇集使用任一PROM的研究结果。
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来源期刊
Bone & Joint Research
Bone & Joint Research CELL & TISSUE ENGINEERING-ORTHOPEDICS
CiteScore
7.40
自引率
23.90%
发文量
156
审稿时长
12 weeks
期刊介绍: The gold open access journal for the musculoskeletal sciences. Included in PubMed and available in PubMed Central.
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