Can the Knee Outcome and Osteoarthritis Score (KOOS) Function Subscale Be Linked to the PROMIS Physical Function to Crosswalk Equivalent Scores?

An increased focus on patient-reported outcome measures (PROMs) has led to a proliferation of these measures in orthopaedic surgery. Mandating a single PROM in clinical and research orthopaedics is not feasible given the breadth of data already collected with older measures and the emergence of psychometrically superior measures. Creating crosswalk tables for scores between measures allows providers to maintain control of measure choice. Furthermore, crosswalk tables permit providers to compare scores collected with older outcome measures with newly collected ones. Given the widespread use of the newer Patient-reported Outcome Measure Information System Physical Function (PROMIS PF) and the established Knee Outcome and Osteoarthritis Score (KOOS), it would be clinically useful to link these two measures. Can the KOOS Function in Activities of Daily Living (ADL) subscale be robustly linked to the PROMIS PF to create a crosswalk table of equivalent scores that accurately reflects a patient's reported physical function level on both scales? We sought to establish a common standardized metric for collected responses to the PROMIS PF and the KOOS ADL to develop equations for converting a PROMIS PF score to a score for the KOOS-ADL subscale and vice versa. To do this, we performed a retrospective, observational study at two academic medical centers and two community hospitals in an urban and suburban healthcare system. Patients 18 years and older who underwent TKA were identified. Between January 2017 and July 2020, we treated 8165 patients with a TKA, 93% of whom had a diagnosis of primary osteoarthritis. Of those, we considered patients who had completed a full KOOS and PROMIS PF 10a on the same date as potentially eligible. Twenty-one percent (1708 of 8165) of patients were excluded because no PROMs were collected at any point, and another 67% (5454 of 8165) were excluded because they completed only one of the required PROMs, leaving 12% (1003 of 8165) for analysis here. PROMs were collected each time they visited the health system before and after their TKAs. Physical function was measured by the PROMIS PF version 1.0 SF 10a and KOOS ADL scale. Analyses to accurately create a crosswalk of equivalent scores between the measures were performed using the equipercentile linking method with both unsmoothed and log linear smoothed score distributions. Crosswalks were created, and adequate validation results supported their validity; we also created tables to allow clinicians and clinician scientists to convert individual patients' scores easily. The mean difference between the observed PROMIS PF scores and the scores converted by the crosswalk from the KOOS-ADL scores was -0.08 ± 4.82. A sensitivity analysis was conducted, confirming the effectiveness of these crosswalks to link the scores of two measures from patients both before and after surgery. The PROMIS PF 10a can be robustly linked to the KOOS ADL measure. The developed crosswalk table can be used to convert PROMIS PF scores from KOOS ADL and vice versa. The creation of a crosswalk table between the KOOS Function in ADL subscale and PROMIS PF allows clinicians and researchers to easily convert scores between the measures, thus permitting greater choice in PROM selection while preserving comparability between patient cohorts and PROM data collected from older outcome measures. Creating a crosswalk, or concordance table, between the two scales will facilitate this comparison, especially when pooling data for meta-analyses.

Heng M ，Tang X ，Schalet BD ，Collins AK ，Chen AF ，Melnic CM ，O'Brien TM ，Sisodia RC ，Franklin PD ，Cella D ... -  《-》

Patient-Reported Outcomes Measurement Information System Physical Function and Global Physical Health Subscale Strongly Correlate and Perform Similarly to the Knee Injury and Osteoarthritis Outcome Score-Physical Function Short Form.

Esposito JG ，Bernstein DN ，Melnic CM ，Kwon YM ，Tobert DG ... -  《-》

Mapping and Crosswalk of the Oxford Hip Score and Different Versions of the Hip Disability and Osteoarthritis Outcome Score.

Patient-reported outcome measures such as the Oxford-12 Hip Score and Hip Disability and Osteoarthritis Outcome Score (HOOS) are used in daily orthopaedic practice to evaluate patients. Because different studies use different scores, it would be important to build conversion tables between scores (crosswalk) to compare the results of one study with those of another study. Various mapping methods can be used to develop crosswalk tables that convert Oxford-12 scores to the HOOS (and its derivatives, including the HOOS physical function short form, HOOS joint replacement, and HOOS-12) and vice versa. Although prior studies have investigated this issue, they are limited to short forms of the HOOS score. Consequently, they cannot be applied to hip preservation surgery and do not include quality-of-life items, whereas the Oxford-12 Hip Score is used for all hip evaluations. We prospectively studied the Oxford-12 and HOOS and its derivatives to (1) determine which version of the HOOS has the best mapping with the Oxford-12, (2) define the most-appropriate mapping method using selected indicators, and (3) generate crosswalk tables between these two patient-reported outcome measures. The study enrolled 500 adult patients before primary THA (59% men [294 of 500 patients]) with hip osteoarthritis or avascular necrosis of the femoral head who completed the HOOS and Oxford-12. Patients were recruited from January 2018 to September 2019 in a tertiary-care university hospital, and we included all primary THAs in patients older than 18 years with a BMI lower than 35 kg/m2 and greater than 18 kg/m2. After a minimum of 6 months of follow-up, 39% (195 of 500) of the patients were assessed using the same tools. To determine which version of the HOOS mapped best to the Oxford-12 and what the most-appropriate mapping method was, we used preoperative data from all 500 patients. Because there is no consensus on the method to establish crosswalk, various mapping methods (linear regression, tobit regression, and quantile regression) and equating methods (linear equating and equipercentile method) were applied along with cross-validation to determine which method was the most suitable and which form of the HOOS provided the best result according to different criteria (mean absolute error, r2, and Kolmogorov-Smirnov distance).To generate crosswalk tables, we created a conversion table (between the Oxford-12 and the HOOS form that was chosen after answering our first research question and the method chosen after answering our second question) using preoperative and postoperative data (n = 695). This table was meant to be simple to use and allows easy conversions from one scoring system to another. The Oxford-12 and HOOS were strongly correlated (Pearson correlation coefficient range 0.586-0.842) for the HOOS subcategories and HOOS physical function, HOOS joint replacement, and HOOS-12. The correlation between the HOOS-12 and Oxford-12 was the strongest (r = 0.825). According to the three different criteria and five methods, the HOOS-12 was the best suited for mapping. The goal was to minimize the mean absolute error (perfect model = 0), have a Kolmogorov-Smirnov distance as close as possible to 0, and have the r2 as close as possible to 1. Regarding the most-suitable method for the crosswalk mapping (research question 2), the five methods generated similar results for the r2 (range 0.63-0.67) and mean absolute error (range 6-6.2). For the Kolmogorov-Smirnov distance, the equipercentile method was the best (Kolmogorov-Smirnov distance 0.04), with distance reduced by 43% relative to the regression methods (Kolmogorov-Smirnov distance 0.07). A graphical comparison of the predicted and observed scores showed that the equipercentile method provided perfect superposition of predicted and observed values after mapping. Finally, crosswalk tables were produced between the HOOS-12 and Oxford-12. The HOOS-12 is the most complete and suitable form of the HOOS for mapping with the Oxford-12, while the equipercentile method is the most suitable for predicting values after mapping. This study provides clinicians with a reliable tool to crosswalk between these scores not only for joint arthroplasty but also for all types of hip surgeries while also assessing quality of life. Our findings should be confirmed in additional studies. The resulting crosswalk tables can be used in meta-analyses, systematic reviews, or clinical practice to compare clinical studies that did not include both outcome scores. In addition, with these tools, the clinician can collect only one score while still being able to compare his or her results with those obtained in other databases and registries, and to add his or her results to other databases and joint registries.

Putman S ，Preda C ，Girard J ，Duhamel A ，Migaud H ... -  《-》

Crosswalks Between Knee and Hip Arthroplasty Short Forms: HOOS/KOOS JR and Oxford.

Polascik BA ，Hidaka C ，Thompson MC ，Tong-Ngork S ，Wagner JL ，Plummer O ，Lyman S ... -  《-》

A systematic review of crosswalks for converting patient-reported outcome measure scores in hip, knee, and shoulder replacement surgery.

Ackerman IN ，Soh SE ，Hallstrom BR ，Fang YY ，Franklin P ，Lützner J ，Ingelsrud LH ，International Society of Arthroplasty Registries Patient-Reported Outcome Measures Working Group ... -  《-》