Development on a hip functional score of adults based on patient-reported outcomes

Abstract

Objective To develop a simple and patient-reported scoring system for evaluating the efficacy of functional reconstruction of adult hip diseases. Methods A candidate indicators list to evaluate hip function was established through literatures review and panel discussion. Using two rounds of Delphi method, experts were invited to judge and score the importance of screening indicators including pain, daily living ability, activity level, labor ability and self-assessment score of the overall hip status,with explanation of the degree of similarity and the basis for determination. In the second round of consultation, the content of integrity and rationality of the scale were added for evaluation. The final indexes of the scale were determined according to the boundary value of the indexes (average value, full frequency, coefficient of variation). The positive coefficient, authoritative coefficient, and coordination coefficient of the two rounds were calculated, and then the weights of each index was identified to form the final rating scale. Results Two rounds of Delphi reclaimed 25 and 24 experts’ responses, which from 28 and 25 questionnaires, and the positive coefficients of the two rounds experts were 89.3% and 96%, respectively. The authoritative coefficient of the first and second level indicators were generally above 0.85; and both of the expert coordination coefficient with the index importance (so called as Kendall coefficient) were above 0.3, and the second round of the coefficient was higher than the first one, and it indicated the final one was better at the consistency. The candidate index of bus in the mobility was rejected in accordance with the threshold of the boundary value on the importance. Finally, it was determined that the hip scoring system (Shanghai Sixth People’s Hospital, SSPH) consisted of two parts: the first part had ten indicators out of four dimensions such as pain, daily living ability, activity level, and labor ability; and the weight scores of these four aspects were 45, 25, 21, 9, respectively. The second part was the patient's self-evaluation score for the overall status of the hip (VAS, out of 100 points); the total score was the sum of the two parts, and the final weights accounted for 85% and 15% between the two parts respectively. Conclusion The SSPH hip score based on patient-reported outcomes formed by the Delphi is simple and feasible, and it can be used as a reference for evaluating the clinical efficacy of hip functional reconstruction. Key words: Delphi technique; Hip joint; Outcome assessment (Health Care)