Original ArticlesThe Harris hip score: Comparison of patient self-report with surgeon assessment*,**
Section snippets
Materials and methods
This study is based on a cohort of 36 patients with 50 primary THAs who were a minimum of 1 year postsurgery. These were consecutive patients returning for routine annual follow-up who had undergone THA by a single senior surgeon. No cases were excluded. Patients were seen between November 1994 and June 1995.
All patients were surveyed by mailed questionnaire before the clinical follow-up appointment. The mean time between completion of questionnaires and clinical follow-up was 30 days. During
Statistical analysis
The primary analysis focused on the comparison of responses to the individual items in the self-report HHS as completed by patients and the physician-assessed HHS. These items included pain, limp, support, distance walked, sitting, putting on shoes and socks, and climbing stairs. For each item, we calculated the unweighted distribution of responses, degree of concordance, and κ statistic [26]. The κ statistic is a measure of reproducibility between repeated assessments of the same categorical
Results
There were 11 men and 25 women, with a mean age of 69 years (Table 2).Age (y) 69 ± 12 Gender Men 11 (31%) Women 25 (69%) Education Completed high school 12 (33%) Completed college 9 (25%) Postgraduate schooling 15 (42%) Side Left 22 (44%) Right 28 (56%) Total hip arthroplasty Unilateral 22 (61%) Bilateral 14 (39%) Primary diagnosis (no. hips) Congenital hip dysplasia 24 (48%) Osteoarthritis 8 (16%) Avascular necrosis 3 (6%) Rheumatoid arthritis 3 (6%) Other 12 (24%)
Discussion
This study compared the performance of a self-report HHS with that of the traditional physician-administered HHS. Our results show that the self-report format was easy to use by patients, with 6 of the 7 items having a response rate of >85%. The correlation between the overall score from the 2 formats was 0.99 and exceeded that of the correlation between the 2 self-administrations of the WOMAC and SF36. The agreement between the 2 formats was excellent with concordance rates ranging from 85% to
Acknowledgements
We thank Bob Lew and Liz Wright, for their help with the statistical analysis.
References (32)
- et al.
Correlation of patient questionnaire responses and physician history in grading clinical outcome following hip and knee arthroplasty
J Arthroplasty
(1996) - et al.
Outcome after total hip arthroplasty, comparison of a traditional disease specific and a quality of life measurement outcome
J Arthroplasty
(1997) - et al.
Enhancement of the value of hip questionnaires by telephone follow-up evaluation
J Arthroplasty
(1997) - et al.
A comparison of different indices of responsiveness
J Clin Epidemiol
(1997) The shoulder
(1934)- et al.
Hip and knee rating scales for total joint arthroplasty: a critical but constructive review. Part I
J Orthop Rheum
(1989) - et al.
Clinical and radiographic evaluation of total hip replacement
J Bone Joint Surg
(1990) - et al.
The total hip arthroplasty outcome evaluation form of the American Academy of Orthopaedic Surgeons
J Bone Joint Surg
(1991) NIH consensus conference: Total hip replacement. NIH Consensus Development Panel on Total Hip Replacement
JAMA
(1995)- et al.
The MOS 36-item short-form health survey (SF): I. conceptual framework and item selection
Med Care
(1992)
SF-36 health survey: manual and interpretation guide
A preliminary evaluation of the dimensionality and clinical importance of pain and disability in osteoarthritis of the hip and knee
Clin Rheumatol
Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee
J Rheumatol
WOMAC Osteoarthritis Index: a users guide
Osteoarthritis clinical trials: candidate variables and clinimetric properties
J Rheumatol
Comparison of a generic and a disease-specific measure of pain and physical function after knee replacement surgery
Med Care
Cited by (0)
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Funds were received in partial or total support of the research material described in this article from the William H. Harris Foundation, Health Services Research Fellowship from the Orthopaedic Research and Education Foundation and American Academy of Orthopaedic Surgeons, and Research Fellowship from the Canadian Arthritis Society.
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Reprint requests: Nizar N. Mahomed, MD, Toronto Western Hospital, 399 Bathurst Street, ECW 1-002, Toronto, Ontario, M5T 2S8.