Feasibility of Knee PROMs in Older Chinese Population: A Cross-Sectional Comparative Study of WOMAC, KOOS, and OKS
Ziyang Dong1,2, Yang Li1,2, Shantao Zhang3
1Department of Orthopaedics Peking University Third Hospital Beijing China.
Background And Aims:
Patient-reported outcome measures (PROMs) are widely used to evaluate knee function and symptoms. WOMAC, KOOS, and OKS are commonly used knee-specific PROMs, and their validity and reliability are well established. However, there is limited research focusing on their feasibility among older Chinese population. This study aimed to assess the feasibility of WOMAC, KOOS, and OKS among Chinese individuals aged 45 years and older, and to provide recommendations for their clinical application.
Methods:
Questionnaires, including the three PROMs, informed consent forms, and demographic information, were distributed online to Chinese individuals aged 45 years and older. Study outcomes included completion time, feasibility scores, item skipping rate, PROM abandonment rate, total score of each PROM, and their intercorrelations.
Results:
The completion time for WOMAC was significantly longer than OKS, but shorter than KOOS (p < 0.001). Significantly higher feasibility score was observed in WOMAC (p = 0.001) and OKS (p < 0.001) than KOOS. Subgroup analyses showed that the older group took significantly longer to complete all PROMs than the younger group (p < 0.001). Completion time was shorter in the higher-education group only for WOMAC (p = 0.001). Feasibility scores showed no age-related differences; however, participants with higher education attained significantly greater scores on all three PROMs (p < 0.05). There was no significant difference in item skipping rates across the three PROMs (p > 0.05). However, the abandonment rate for KOOS and OKS was significantly higher than WOMAC (p < 0.001). Correlation analysis demonstrated strong correlations among the three PROMs, with an absolute value of the correlation coefficient larger than 0.8.
Conclusion:
All three PROMs demonstrated good feasibility and strong inter-scale correlations in the older Chinese population. KOOS required the longest completion time, while WOMAC and OKS achieved higher feasibility scores. Higher educational level was associated with greater feasibility across all PROMs, whereas older age primarily prolonged completion time without significantly reducing feasibility.
