Which is the Most Useful Patient Reported Outcome in Femoroacetabular Impingement? Test-retest Reliability of 6 Questionnaires in Young Active Adults

Abstract

ObjectivesThe most reliable patient reported outcomes (PROs) for people with femoroacetabular impingement (FAI) is not known because there have been no direct comparisons of questionnaires. Thus, the aim was to evaluate the test-retest reliability of six existing PROs in a single cohort of young active people with a clinical diagnosis of FAI.MethodsYoung adults with clinical FAI completed six PRO questionnaires on two occasions, 1-2 weeks apart. The PROs were: modified Harris Hip Score (mHHS), Hip dysfunction and Osteoarthritis Score (HOOS), Hip Outcome Score (HOS), Non-Arthritic Hip Score (NHS), International Hip Outcome Tool (iHOT-33), Copenhagen Hip and Groin Outcome Score (HAGOS).ResultsThirty young adults (mean age, 24 years; SD, 4 years; range, 18-30 years; 15 males) with stable symptoms were included. ICC (3.1) values ranged from 0.73-0.93 (95% CI, 0.38-0.98) indicating the most questionnaires reached minimal reliability benchmarks. Measurement error and 95% CIs at the individual level were quite large for most questionnaires (MDC95 12.4-35.6; 95% CI, 837-54.0). In contrast, the MDC values and 95%CI at the group level were quite small for most questionnaires (MDC95 2.2-7.3; 95% CI, 1.6-11).ConclusionsThe NHS appeared to be the most reliable and precise tool to detect change at the individual level. The majority of the questionnaires were reliable and precise enough for use at the group level. As the iHOT-33 and HAGOS also capture a range of domains likely to be relevant in young active individuals, they may be the most useful PROs for assessing differences in groups of young active individuals with hip and groin pain consistent with FAI. First direct comparison of the reliability of patient reported outcomes for young active adults with hip and groin pain consistent with FAI. The NHS demonstrated the greatest reliability and least amount of measurement error at the individual level. The majority of questionnaires appeared to be precise to detect differences at the group level, however the iHOT and HAGOS also capture domains most likely to be relevant in young adults with FAI. Further direct comparisons of these questionnaires are required to assess other measurement properties such as validity, responsiveness and interpretability in young active people with FAI. ObjectivesThe most reliable patient reported outcomes (PROs) for people with femoroacetabular impingement (FAI) is not known because there have been no direct comparisons of questionnaires. Thus, the aim was to evaluate the test-retest reliability of six existing PROs in a single cohort of young active people with a clinical diagnosis of FAI. The most reliable patient reported outcomes (PROs) for people with femoroacetabular impingement (FAI) is not known because there have been no direct comparisons of questionnaires. Thus, the aim was to evaluate the test-retest reliability of six existing PROs in a single cohort of young active people with a clinical diagnosis of FAI. MethodsYoung adults with clinical FAI completed six PRO questionnaires on two occasions, 1-2 weeks apart. The PROs were: modified Harris Hip Score (mHHS), Hip dysfunction and Osteoarthritis Score (HOOS), Hip Outcome Score (HOS), Non-Arthritic Hip Score (NHS), International Hip Outcome Tool (iHOT-33), Copenhagen Hip and Groin Outcome Score (HAGOS). Young adults with clinical FAI completed six PRO questionnaires on two occasions, 1-2 weeks apart. The PROs were: modified Harris Hip Score (mHHS), Hip dysfunction and Osteoarthritis Score (HOOS), Hip Outcome Score (HOS), Non-Arthritic Hip Score (NHS), International Hip Outcome Tool (iHOT-33), Copenhagen Hip and Groin Outcome Score (HAGOS). ResultsThirty young adults (mean age, 24 years; SD, 4 years; range, 18-30 years; 15 males) with stable symptoms were included. ICC (3.1) values ranged from 0.73-0.93 (95% CI, 0.38-0.98) indicating the most questionnaires reached minimal reliability benchmarks. Measurement error and 95% CIs at the individual level were quite large for most questionnaires (MDC95 12.4-35.6; 95% CI, 837-54.0). In contrast, the MDC values and 95%CI at the group level were quite small for most questionnaires (MDC95 2.2-7.3; 95% CI, 1.6-11). Thirty young adults (mean age, 24 years; SD, 4 years; range, 18-30 years; 15 males) with stable symptoms were included. ICC (3.1) values ranged from 0.73-0.93 (95% CI, 0.38-0.98) indicating the most questionnaires reached minimal reliability benchmarks. Measurement error and 95% CIs at the individual level were quite large for most questionnaires (MDC95 12.4-35.6; 95% CI, 837-54.0). In contrast, the MDC values and 95%CI at the group level were quite small for most questionnaires (MDC95 2.2-7.3; 95% CI, 1.6-11). ConclusionsThe NHS appeared to be the most reliable and precise tool to detect change at the individual level. The majority of the questionnaires were reliable and precise enough for use at the group level. As the iHOT-33 and HAGOS also capture a range of domains likely to be relevant in young active individuals, they may be the most useful PROs for assessing differences in groups of young active individuals with hip and groin pain consistent with FAI. First direct comparison of the reliability of patient reported outcomes for young active adults with hip and groin pain consistent with FAI. The NHS demonstrated the greatest reliability and least amount of measurement error at the individual level. The majority of questionnaires appeared to be precise to detect differences at the group level, however the iHOT and HAGOS also capture domains most likely to be relevant in young adults with FAI. Further direct comparisons of these questionnaires are required to assess other measurement properties such as validity, responsiveness and interpretability in young active people with FAI. The NHS appeared to be the most reliable and precise tool to detect change at the individual level. The majority of the questionnaires were reliable and precise enough for use at the group level. As the iHOT-33 and HAGOS also capture a range of domains likely to be relevant in young active individuals, they may be the most useful PROs for assessing differences in groups of young active individuals with hip and groin pain consistent with FAI. First direct comparison of the reliability of patient reported outcomes for young active adults with hip and groin pain consistent with FAI. The NHS demonstrated the greatest reliability and least amount of measurement error at the individual level. The majority of questionnaires appeared to be precise to detect differences at the group level, however the iHOT and HAGOS also capture domains most likely to be relevant in young adults with FAI. Further direct comparisons of these questionnaires are required to assess other measurement properties such as validity, responsiveness and interpretability in young active people with FAI.