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The Copenhagen Hip and Groin Outcome Score (HAGOS): development and validation according to the COSMIN checklist
K Thorborg1, P Hölmich, R Christensen
1Faculty of Health Sciences, Department of Orthopaedic Surgery, University of Copenhagen, DK-2300 Copenhagen S, Denmark. kristianthorborg@hotmail.com
Insights
A new Patient-Reported Outcome (PRO) questionnaire, the Copenhagen Hip and Groin Outcome Score (HAGOS), has been developed and validated. HAGOS effectively assesses symptoms and quality of life in active individuals with hip and groin pain.
Area of Science:
- Orthopedics
- Sports Medicine
- Rehabilitation Science
Background:
- Lack of validated Patient-Reported Outcome (PRO) measures for young to middle-aged, active individuals with hip and groin pain.
- Need for a reliable and responsive tool to assess patient perspectives in this demographic.
Purpose of the Study:
- To develop and validate the Copenhagen Hip and Groin Outcome Score (HAGOS) following COSMIN standards.
- To create a PRO suitable for young to middle-aged, physically active patients with chronic hip and/or groin pain.
Main Methods:
- Content validity established through preliminary patient interviews (n=25).
- Validity, reliability, and responsiveness assessed in a clinical study (n=101) of physically active patients.
- Utilized COSMIN recommendations for instrument development and evaluation.
Main Results:
- HAGOS comprises six subscales: Pain, Symptoms, Physical function (daily living and sport/recreation), Participation in Physical Activities, and Quality of Life (QOL).
- Demonstrated substantial test-retest reliability (ICC: 0.82-0.91) and acceptable smallest detectable change.
- Confirmed construct validity (r=0.37-0.73) and responsiveness (r=0.56-0.69) with statistical significance (p < 0.01).
Conclusions:
- HAGOS exhibits adequate measurement qualities for assessing symptoms, activity limitations, participation restrictions, and QOL in the target population.
- Recommended for interventions prioritizing patient perspective and health-related QOL in young to middle-aged, active individuals with hip/groin pain.
- ClinicalTrials.gov Identifier: NCT00716729.
Background:
Valid, reliable and responsive Patient-Reported Outcome (PRO) questionnaires for young to middle-aged, physically active individuals with hip and groin pain are lacking.
Objective:
To develop and validate a new PRO in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) recommendations for use in young to middle-aged, physically active patients with long-standing hip and/or groin pain.
Methods:
Preliminary patient interviews (content validity) included 25 patients. Validity, reliability and responsiveness were evaluated in a clinical study including 101 physically active patients (50 women); mean age 36 years, range 18-63 years.
Results:
The Copenhagen Hip and Groin Outcome Score (HAGOS) consists of six separate subscales assessing Pain, Symptoms, Physical function in daily living, Physical function in Sport and Recreation, Participation in Physical Activities and hip and/or groin-related Quality of Life (QOL). Test-retest reliability was substantial, with intraclass correlation coefficients ranging from 0.82 to 0.91 for the six subscales. The smallest detectable change ranged from 17.7 to 33.8 points at the individual level and from 2.7 to 5.2 points at the group level for the different subscales. Construct validity and responsiveness were confirmed with statistically significant correlation coefficients (0.37-0.73, p < 0.01) for convergent construct validity and for responsiveness from 0.56 to 0.69, p < 0.01.
Conclusion:
HAGOS has adequate measurement qualities for the assessment of symptoms, activity limitations, participation restrictions and QOL in physically active, young to middle-aged patients with long-standing hip and/or groin pain and is recommended for use in interventions where the patient's perspective and health-related QOL are of primary interest. Trial registration ClinicalTrials.gov NCT00716729.
