Abstract
BackgroundThe Oxford Hip Score is used to evaluate the outcome after total hip arthroplasty. The Oxford Hip Score was developed more than 20 years ago with only some degree of patient involvement. We question if the Oxford Hip Score is still relevant for the present-day total hip artrhoplasty patients. We aimed to determine whether the Oxford Hip Score contains items that are relevant for present-day patients with osteoarthritis undergoing total hip arthroplasty, thus investigating the content validity.MethodsPatients aged 60–75 years, undergoing total hip arthroplasty for primary osteoarthritis were recruited to participate in focus group interviews preoperatively and at 3 and 12 months after primary total hip arthroplasty. We conducted 6 focus group interviews in which 30 patients participated. The interviews were audio-recorded and transcribed verbatim. Using Interpretative Phenomenological Analysis, we inductively organised the interview transcripts into particular items/themes which we then compared to items in the Oxford Hip Score.ResultsWe identified 6 general items with 41 sub-items. The 6 general items were pain, walking, physical activities, functional abilities, quality of life and psychological health. We found that items in the Oxford Hip Score were all in some way relevant to the patients but that the Oxford Hip Score lacks several important items relevant for present-day total hip artrhoplasty patients, including several physical activities, functional abilities and certain aspects of quality of life and psychological health.ConclusionWe found that the Oxford Hip Score lacks important items for present-day patients in our population. Due to findings regarding several additional items that are not present in the Oxford Hip Score, particularly concerning physical activities and quality of life, we question the content validity of the Oxford Hip Score for a present-day population. Our findings indicate a need for a revision of the Oxford Hip Score.
Highlights
Patient-reported outcome measures (PROMs) are important in the evaluation of patient outcome and quality of life following total hip arthroplasty (THA) [1, 2]
The 6 general items were pain, walking, physical activities, functional abilities, quality of life and psychological health (Table 3). By comparing these items to the Oxford Hips Score (OHS) we found that the items on the OHS were all relevant to the patients, some
Our study found that patients placed much emphasis on pain medication and discussed several additional items not included in the OHS, supporting the questionability of the content validity of the OHS regarding pain
Summary
Patient-reported outcome measures (PROMs) are important in the evaluation of patient outcome and quality of life following total hip arthroplasty (THA) [1, 2]. Patients should be included in the development of PROMs to ensure content validity and, thereby, reliability, reducing the ceiling effect [5, 6]. We opted to focus on the Oxford Hips Score (OHS) as it is used in research worldwide [8, 9], is included in national databases [8, 10] and has been used and validated in several countries [4, 11, 12]. We aimed to determine whether the Oxford Hip Score contains items that are relevant for present-day patients with osteoarthritis undergoing total hip arthroplasty, investigating the content validity
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