Measuring patient-reported physical function and pain in total hip and knee arthroplasty
Current mandatory questionnaires in hip and knee replacement patients have limitations in their measurement quality
Orthopedic surgeon-in-training Christel Braaksma examined the psychometric properties of currently used patient-reported outcome measures (PROMs) for measuring physical functioning and pain in patients receiving total hip replacement (THP) or total knee replacement (TKP). In addition, she compared a new innovative measurement method called Patient-Reported Outcomes Measurement Information System (PROMIS®) to traditional PROMs. Braaksma also examined the external validation of conversion tables (crosswalks) between traditional PROMs and PROMIS measurement instruments.
The main finding of this dissertation is that the current PROMs that are mandatorily administered at THP and TKP have limitations in their measurement properties. Inaccurate measurements place an unnecessary burden on both patients and caregivers, and reliance on data with limited validity can lead to incorrect clinical decision-making. The innovative alternative, PROMIS, seems more appropriate for assessing individual patients by being less burdensome and offering a broader range of measurement. When switching from traditional PROMs to PROMIS measurements, existing crosswalks can be used at the group level for data continuity from historical measurements.
Both patients and healthcare providers need accurate assessments that support the use of PROM data in research and inform policy development. However, despite the potential benefits, numerous challenges remain in selecting and implementing the most appropriate PROMs in practice. Failure to use the most appropriate PROMs leads to less efficient and less patient-centered care.
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