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Different hip and knee priority score systems: are they good for the same thing?
Antonio Escobar1, Jose Maria Quintana, Mireia Espallargues
1Research Unit, Hospital of Basurto, Bilbao, Bizkaia, Spain. antonio.escobarmartinez@osakidetza.net
Journal of Evaluation in Clinical Practice
|June 18, 2010
Summary
Two joint replacement prioritization tools, IRYSS hip and knee priority score (IHKPS) and Catalonia hip-knee priority score (CHKPS), showed similar results in sorting patients on waiting lists, despite using different methodologies.
Area of Science:
- Orthopedic surgery
- Health services research
Background:
- Patient prioritization for joint replacement surgery is crucial for efficient waiting list management.
- Existing tools may employ diverse methodologies, necessitating comparative analysis.
Purpose of the Study:
- To compare the efficacy of two distinct prioritization tools: the IRYSS hip and knee priority score (IHKPS) and the Catalonia hip-knee priority score (CHKPS).
- To assess the correlation and agreement between these tools and patient-reported outcomes using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).
Main Methods:
- Applied the IHKPS to patients on the waiting list and retrospectively applied the CHKPS to the same cohort.
- Collected pre-intervention WOMAC scores for all patients.
- Analyzed correlations using Pearson's r and agreement using ICC, Kendall's coefficient, and Cohen's kappa.
Main Results:
- A high correlation (r=0.79) and substantial agreement (ICC=0.74) were found between IHKPS and CHKPS.
- Both tools demonstrated moderate to strong correlations with baseline WOMAC scores, ranging from 0.43 to 0.74.
- The sample included 774 consecutive patients.
Conclusions:
- Both the IHKPS and CHKPS, despite differing methodologies (RAND vs. conjoint analysis), yield similar patient prioritization outcomes.
- These findings support the use of either tool for effectively organizing and sorting joint replacement waiting lists.
