The Oxford hip score: the patient's perspective

Area of Science:

• Orthopaedic surgery outcome measurement
• Patient-reported outcome measures (PROMs)

Background:

• Patient-centred outcome measures have become standard in orthopaedic intervention assessment.
• The Oxford hip score (OHS) is a joint-specific tool for assessing disability in total hip replacement (THR) patients.
• Limited research exists on patient perspectives of the OHS.

Purpose of the Study:

• To evaluate the adequacy of the Oxford hip score (OHS) as a disability measure from the patient's viewpoint.
• To qualitatively analyze patient annotations on the OHS.

Main Methods:

• 276 orthopaedic patients (156 pre-THR, 120 post-THR) completed the OHS between April 2004 and May 2005.
• Patient annotations on the OHS were recorded.
• Annotations were grouped into thematic categories for analysis.

Main Results:

• 46 (17%) patients provided 52 annotations.
• Key difficulties identified include: lack of question clarity (aids), pain reporting, restrictive/irrelevant questions, co-morbidity influence, and double-barrelled questions.

Conclusions:

• The OHS is a useful tool for THR disability assessment but has identified limitations.
• These issues are relevant to patient-centred outcome tools broadly.
• Further development of individualized outcome measures for osteoarthritis is in progress.