Willingness to go through surgery again validated the WOMAC clinically important difference from THR/TKR surgery

被引：107

作者：

Chesworth, Bert M. ^{[1
,2
]}

Mahomed, Nizar N. ^{[3
]}

Bourne, Robert B. ^{[4
]}

Davis, Aileen M. ^{[5
,6
,7
]}

机构：

[1] Univ Western Ontario, Fac Hlth Sci, Sch Phys Therapy, Elborn Coll, London, ON N6G 1H1, Canada

[2] Univ Western Ontario, Dept Epidemiol & Biostat, London, ON N6A 5C1, Canada

[3] Univ Hlth Network, Div Orthopaed Surg, Toronto, ON, Canada

[4] Univ Western Ontario, London Hlth Sci Ctr, Div Orthopaed Surg, London, ON N6G 1H1, Canada

[5] Toronto Western Res Inst, Hlth Care & Outcomes Res Div, Toronto, ON, Canada

[6] Toronto Western Res Inst, Arthritis Community Res Evaluat Unit, Toronto, ON, Canada

[7] Univ Toronto, Dept Hlth Policy Management & Evaluat, Toronto, ON, Canada

来源：

JOURNAL OF CLINICAL EPIDEMIOLOGY | 2008年 / 61卷 / 09期

关键词：

arthroplasty; total hip replacement; total knee replacement; clinically important difference; WOMAC; validation;

D O I：

10.1016/j.jclinepi.2007.10.014

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Objective: The objective was to determine the clinically important difference (CID) from primary total hip replacement (THR) and total knee replacement (TKR) surgeries using the Western Ontario McMaster University (WOMAC) osteoarthritis index. Study Design and Setting: WOMAC scores were collected at decision for and 1 year after surgery (n = 2,709). Transition ratings (15-point scale) were obtained at I year for pain and function, as well as a global assessment of willingness to go through surgery again. A "good deal better" defined the positive CID. WOMAC change scores for transition ratings and willingness to go through surgery again were evaluated using receiver operating characteristic curves. Patient characteristics within transition rating categories were examined. Results: For THR, the positive CIDs were 41 of 100 for pain and 34 of 100 for function. The negative CIDs were 35 and 33, respectively. For TKR, the positive CIDs were 36 for pain and 33 for function. The negative CID, were 30 and 25, respectively. Change scores for willingness to go through surgery again validated CID values. Postoperative complications decreased the likelihood of a positive CID. Conclusion: Improvement that is "a good deal better" is an appropriate threshold for the THR/TKR positive CID. Attaining a positive CID is negatively related to postoperative complications. (C) 2008 Elsevier Inc. All rights reserved.

引用

页码：907 / 918

页数：12

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