Age-Adjusted Normative Values for Hip Patient-Reported Outcome Measures

Background: Patient-reported outcome measures (PROMs) are essential clinical instruments used for assessing patient function, assisting in clinical decision making, and quantifying outcomes of surgical and nonsurgical management. However, PROMs are often designed using patients with preexisting pathology and typically assume that a patient without the pathology would have a perfect or near perfect score. This may result in unrealistic expectations or falsely underestimate how well a patient is doing after treatment. The influence of age on PROMs about the hip of healthy individuals has not been studied. Hypothesis: We hypothesize that in asymptomatic individuals hip-specific PROM scores will decrease in an age-dependent manor. Study Design: Cross-sectional study; Level of evidence, 3. Methods: In this multicenter survey study, volunteers who denied preexisting hip pathology and previous hip surgery completed 3 PROMs online or as traditional paper questionnaires. The International Hip Outcome Tool (iHOT), the modified Harris Hip Score (mHHS), and the Hip Outcome Score–Activities of Daily Living (HOS-ADL) and HOS—Sport were completed. Analysis of variance with a Tukey post hoc test was used to analyze differences in PROMs among subgroups. An independent-samples Student t test and a χ2 test were used to analyze differences in continuous and categorical data, respectively. Results: In total 496, 571, 534, and 532 responses were collected for the iHOT, mHHS, HOS-ADL, and HOS–Sport, respectively. Respondents’ PROMs were scored and arranged into 3 groups by age: <40 years, 40 to 60 years, and >60 years. The iHOT, mHHS, HOS-ADL, and HOS–Sport of these asymptomatic respondents all decreased in an age-dependent manner: iHOT (<40, 94.1; 40-60, 92.4; >60, 87.0), mHHS (<40, 94.8; 40-60, 91.3; >60, 89.1), HOS-ADL (<40, 98.4; 40-60, 95.0; >60, 90.9), and HOS–Sport (<40, 95.7; 40-60, 82.9; >60, 72.9) (analysis of variance between-group differences, P < .05). Conclusion: This study demonstrated that the iHOT, mHHS, and HOS-ADL and HOS–Sport scores in asymptomatic people decrease in an age-dependent manner. It is important to compare a patient’s outcome scores with the age-normalized scores to establish an accurate reference frame with which to interpret outcomes.

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Patient-Reported Outcome Measures and Clinical Outcomes in Children with Foregut Anomalies

Children ◽

10.3390/children8070587 ◽

2021 ◽

Vol 8 (7) ◽

pp. 587

Author(s):

Isabel I. Sreeram ◽

Chantal A. ten Kate ◽

Joost van Rosmalen ◽

Johannes M. Schnater ◽

Saskia J. Gischler ◽

...

Keyword(s):

Linear Regression ◽

Clinical Outcomes ◽

Outcome Measures ◽

Clinical Decision Making ◽

Linear Regression Analysis ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Added Value ◽

Patient Reported

Increasing numbers of children and adults with chronic disease status highlight the need for a value-based healthcare system. Patient-reported outcome measures (PROMs) are essential to value-based healthcare, yet it remains unclear how they relate to clinical outcomes such as health and daily functioning. We aimed to assess the added value of self-reported PROMs for health status (HS) and quality of life (QoL) in the long-term follow-up of children with foregut anomalies. We evaluated data of PROMs for HS and/or QoL among eight-year-olds born with congenital diaphragmatic hernia (CDH), esophageal atresia (EA), or congenital lung malformations (CLM), collected within the infrastructure of a multidisciplinary, longitudinal follow-up program. Clinical outcomes were categorized into different outcome domains, and their relationships with self-reported HS and QoL were assessed through multivariable linear regression analyses. A total of 220 children completed HS and/or QoL self-reports. In children with CDH and EA, lower cognition was significantly associated with lower self-reported HS. Due to the low number of cases, multivariable linear regression analysis was not possible in children with CLM. HS, QoL, and clinical outcomes represent different aspects of a child’s wellbeing and should be measured simultaneously to facilitate a more holistic approach to clinical decision making.

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Benefits and Disadvantages of Electronic Patient-reported Outcome Measures: Systematic Review

JMIR Perioperative Medicine ◽

10.2196/15588 ◽

2020 ◽

Vol 3 (1) ◽

pp. e15588 ◽

Cited By ~ 1

Author(s):

Jill Meirte ◽

Nick Hellemans ◽

Mieke Anthonissen ◽

Lenie Denteneer ◽

Koen Maertens ◽

...

Keyword(s):

Systematic Review ◽

Data Quality ◽

Outcome Measures ◽

Symptom Management ◽

Completion Time ◽

Clinical Decision Making ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Health Technologies ◽

Patient Reported

Background Patient-reported outcome measures (PROMs) are important in clinical practice and research. The growth of electronic health technologies provides unprecedented opportunities to systematically collect information via PROMs. Objective The aim of this study was to provide an objective and comprehensive overview of the benefits, barriers, and disadvantages of the digital collection of qualitative electronic patient-reported outcome measures (ePROMs). Methods We performed a systematic review of articles retrieved from PubMED and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed during all stages. The search strategy yielded a total of 2333 records, from which 32 met the predefined inclusion and exclusion criteria. The relevant ePROM-related information was extracted from each study. Results Results were clustered as benefits and disadvantages. Reported benefits of ePROMs were greater patient preference and acceptability, lower costs, similar or faster completion time, higher data quality and response rates, and facilitated symptom management and patient-clinician communication. Tablets were the most used ePROM modality (14/32, 44%), and, as a platform, Web-based systems were used the most (26/32, 81%). Potential disadvantages of ePROMs include privacy protection, a possible large initial financial investment, and exclusion of certain populations or the “digital divide.” Conclusions In conclusion, ePROMs offer many advantages over paper-based collection of patient-reported outcomes. Overall, ePROMs are preferred over paper-based methods, improve data quality, result in similar or faster completion time, decrease costs, and facilitate clinical decision making and symptom management. Disadvantages regarding ePROMs have been outlined, and suggestions are provided to overcome the barriers. We provide a path forward for researchers and clinicians interested in implementing ePROMs. Trial Registration PROSPERO CRD42018094795; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=94795

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Application of Machine Learning Methods on Patient Reported Outcome Measurements for Predicting Outcomes: A Literature Review

Informatics ◽

10.3390/informatics8030056 ◽

2021 ◽

Vol 8 (3) ◽

pp. 56

Author(s):

Deepika Verma ◽

Kerstin Bach ◽

Paul Jarle Mork

Keyword(s):

Machine Learning ◽

Literature Review ◽

Clinical Outcomes ◽

Outcome Measures ◽

Clinical Decision Making ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Learning Methods ◽

Machine Learning Methods ◽

Patient Reported

The field of patient-centred healthcare has, during recent years, adopted machine learning and data science techniques to support clinical decision making and improve patient outcomes. We conduct a literature review with the aim of summarising the existing methodologies that apply machine learning methods on patient-reported outcome measures datasets for predicting clinical outcomes to support further research and development within the field. We identify 15 articles published within the last decade that employ machine learning methods at various stages of exploiting datasets consisting of patient-reported outcome measures for predicting clinical outcomes, presenting promising research and demonstrating the utility of patient-reported outcome measures data for developmental research, personalised treatment and precision medicine with the help of machine learning-based decision-support systems. Furthermore, we identify and discuss the gaps and challenges, such as inconsistency in reporting the results across different articles, use of different evaluation metrics, legal aspects of using the data, and data unavailability, among others, which can potentially be addressed in future studies.

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Benefits and Disadvantages of Electronic Patient-reported Outcome Measures: Systematic Review (Preprint)

10.2196/preprints.15588 ◽

2019 ◽

Author(s):

Jill Meirte ◽

Nick Hellemans ◽

Mieke Anthonissen ◽

Lenie Denteneer ◽

Koen Maertens ◽

...

Keyword(s):

Systematic Review ◽

Data Quality ◽

Outcome Measures ◽

Symptom Management ◽

Completion Time ◽

Clinical Decision Making ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Health Technologies ◽

Patient Reported

BACKGROUND Patient-reported outcome measures (PROMs) are important in clinical practice and research. The growth of electronic health technologies provides unprecedented opportunities to systematically collect information via PROMs. OBJECTIVE The aim of this study was to provide an objective and comprehensive overview of the benefits, barriers, and disadvantages of the digital collection of qualitative electronic patient-reported outcome measures (ePROMs). METHODS We performed a systematic review of articles retrieved from PubMED and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed during all stages. The search strategy yielded a total of 2333 records, from which 32 met the predefined inclusion and exclusion criteria. The relevant ePROM-related information was extracted from each study. RESULTS Results were clustered as benefits and disadvantages. Reported benefits of ePROMs were greater patient preference and acceptability, lower costs, similar or faster completion time, higher data quality and response rates, and facilitated symptom management and patient-clinician communication. Tablets were the most used ePROM modality (14/32, 44%), and, as a platform, Web-based systems were used the most (26/32, 81%). Potential disadvantages of ePROMs include privacy protection, a possible large initial financial investment, and exclusion of certain populations or the “digital divide.” CONCLUSIONS In conclusion, ePROMs offer many advantages over paper-based collection of patient-reported outcomes. Overall, ePROMs are preferred over paper-based methods, improve data quality, result in similar or faster completion time, decrease costs, and facilitate clinical decision making and symptom management. Disadvantages regarding ePROMs have been outlined, and suggestions are provided to overcome the barriers. We provide a path forward for researchers and clinicians interested in implementing ePROMs. CLINICALTRIAL PROSPERO CRD42018094795; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=94795

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Arthroscopic Labral Treatment in Adolescents: Clinical Outcomes With Minimum 5-Year Follow-up

The American Journal of Sports Medicine ◽

10.1177/0363546519825627 ◽

2019 ◽

Vol 47 (4) ◽

pp. 870-875 ◽

Cited By ~ 3

Author(s):

Jody M. Litrenta ◽

Brian H. Mu ◽

Austin W. Chen ◽

Itay Perets ◽

Victor Ortiz-Declet ◽

...

Keyword(s):

Clinical Outcomes ◽

Outcome Measures ◽

Hip Arthroscopy ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Labral Repair ◽

Harris Hip Score ◽

Labral Tears ◽

Patient Reported

Background: The success of hip arthroscopy has led to increased application in younger populations. However, hip arthroscopy remains a challenging procedure, and its safety and efficacy in the adolescent population have been controversial. Most existing literature on outcomes in such patients contains only short-term follow-up, and a paucity of evidence is available regarding long-term outcomes in adolescents. Purpose: To report on clinical outcomes at a minimum 5-year follow-up in patients younger than 18 years who underwent arthroscopic treatment of labral tears. Study Design: Case series; Level of evidence, 4. Methods: Data were prospectively collected and retrospectively reviewed on all patients younger than 18 years who underwent hip arthroscopy in a tertiary hip preservation setting at a single institution. Patients were excluded if they had previous ipsilateral hip conditions or surgery. All patients underwent either labral repair or debridement for treatment of a labral tear. Patient-reported outcome measures were recorded at 3 months and at 1, 2, or a minimum of 5 years. These included the modified Harris Hip Score (mHHS), Nonarthritic Hip Score, Hip Outcome Score–Sports Specific Subscale (HOS-SSS), visual analog scale, and patient satisfaction. Additionally, the abbreviated International Hip Outcome Tool and Short Form Health Survey were collected at latest follow-up. Results: The study included 44 hips in 32 patients that underwent arthroscopic labral repair (86.4%) or labral debridement (13.6%) between April 2008 and April 2011, with latest follow-up at a mean of 69.2 months (range, 60.0-89.9 months) postoperatively. The average age at surgery was 16.3 years (range, 14.2-17.9 years), and 39 hips from female patients. Statistically significant improvements were seen in all patient-reported outcome measures from preoperative to minimum 5-year follow-up. Improvements were noted at 1-year follow-up and maintained at minimum 5-year follow-up. At the latest follow-up, the Patient Acceptable Symptomatic State was achieved in 95.5% of patients for the mHHS and 72.7% for the HOS-SSS. Two patients subsequently underwent secondary arthroscopy on the ipsilateral hip; however, the survivorship of all hips was 100%. Conclusion: Hip arthroscopy for the treatment of labral tears in adolescents remains a technically challenging procedure that should be approached with appropriate caution. The results of the present study on a population treated in a specialized hip preservation center demonstrate that hip arthroscopy is a safe procedure with stable improvement in patient-reported outcome measures at 5 years.

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