Willingness to go through surgery again validated the WOMAC clinically important difference from THR/TKR surgery

Abstract Objective The objective was to determine the clinically important difference (CID) from primary total hip replacement (THR) and total knee replacement (TKR) surgeries using the Western Ontario McMaster University (WOMAC) osteoarthritis index. Study Design and Setting WOMAC scores were colle...

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Veröffentlicht in:Journal of clinical epidemiology 2008-09, Vol.61 (9), p.907-918
Hauptverfasser: Chesworth, Bert M, Mahomed, Nizar N, Bourne, Robert B, Davis, Aileen M
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container_end_page 918
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container_title Journal of clinical epidemiology
container_volume 61
creator Chesworth, Bert M
Mahomed, Nizar N
Bourne, Robert B
Davis, Aileen M
description Abstract Objective The objective was to determine the clinically important difference (CID) from primary total hip replacement (THR) and total knee replacement (TKR) surgeries using the Western Ontario McMaster University (WOMAC) osteoarthritis index. Study Design and Setting WOMAC scores were collected at decision for and 1 year after surgery ( n = 2,709). Transition ratings (15-point scale) were obtained at 1 year for pain and function, as well as a global assessment of willingness to go through surgery again. A “good deal better” defined the positive CID. WOMAC change scores for transition ratings and willingness to go through surgery again were evaluated using receiver operating characteristic curves. Patient characteristics within transition rating categories were examined. Results For THR, the positive CIDs were 41 of 100 for pain and 34 of 100 for function. The negative CIDs were 35 and 33, respectively. For TKR, the positive CIDs were 36 for pain and 33 for function. The negative CIDs were 30 and 25, respectively. Change scores for willingness to go through surgery again validated CID values. Postoperative complications decreased the likelihood of a positive CID. Conclusion Improvement that is “a good deal better” is an appropriate threshold for the THR/TKR positive CID. Attaining a positive CID is negatively related to postoperative complications.
doi_str_mv 10.1016/j.jclinepi.2007.10.014
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Study Design and Setting WOMAC scores were collected at decision for and 1 year after surgery ( n = 2,709). Transition ratings (15-point scale) were obtained at 1 year for pain and function, as well as a global assessment of willingness to go through surgery again. A “good deal better” defined the positive CID. WOMAC change scores for transition ratings and willingness to go through surgery again were evaluated using receiver operating characteristic curves. Patient characteristics within transition rating categories were examined. Results For THR, the positive CIDs were 41 of 100 for pain and 34 of 100 for function. The negative CIDs were 35 and 33, respectively. For TKR, the positive CIDs were 36 for pain and 33 for function. The negative CIDs were 30 and 25, respectively. Change scores for willingness to go through surgery again validated CID values. Postoperative complications decreased the likelihood of a positive CID. Conclusion Improvement that is “a good deal better” is an appropriate threshold for the THR/TKR positive CID. Attaining a positive CID is negatively related to postoperative complications.</description><identifier>ISSN: 0895-4356</identifier><identifier>EISSN: 1878-5921</identifier><identifier>DOI: 10.1016/j.jclinepi.2007.10.014</identifier><identifier>PMID: 18687289</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Arthritis ; Arthroplasty ; Arthroplasty, Replacement, Hip - psychology ; Arthroplasty, Replacement, Hip - rehabilitation ; Arthroplasty, Replacement, Knee - psychology ; Arthroplasty, Replacement, Knee - rehabilitation ; Biological and medical sciences ; Clinically important difference ; Data collection ; Epidemiology ; Female ; Health sciences ; Health Status ; Health Status Indicators ; Humans ; Internal Medicine ; Joint surgery ; Male ; Medical sciences ; Ontario - epidemiology ; Orthopedic surgery ; Osteoarthritis ; Osteoarthritis - epidemiology ; Osteoarthritis - psychology ; Osteoarthritis - rehabilitation ; Pain ; Pain Measurement - methods ; Pain, Postoperative - psychology ; Patient Satisfaction ; Probability ; Quality of Life - psychology ; Ratings &amp; rankings ; Reoperation - psychology ; Severity of Illness Index ; Studies ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surveys and Questionnaires ; Total hip replacement ; Total knee replacement ; Validation ; WOMAC</subject><ispartof>Journal of clinical epidemiology, 2008-09, Vol.61 (9), p.907-918</ispartof><rights>Elsevier Inc.</rights><rights>2008 Elsevier Inc.</rights><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c545t-b84826b38a29c4f1d0b540486102d95ce3989fc1c49321c9ba5e5d793cb6f5033</citedby><cites>FETCH-LOGICAL-c545t-b84826b38a29c4f1d0b540486102d95ce3989fc1c49321c9ba5e5d793cb6f5033</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1033833501?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3549,27923,27924,45994,64384,64386,64388,72340</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=20594754$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18687289$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chesworth, Bert M</creatorcontrib><creatorcontrib>Mahomed, Nizar N</creatorcontrib><creatorcontrib>Bourne, Robert B</creatorcontrib><creatorcontrib>Davis, Aileen M</creatorcontrib><creatorcontrib>OJRR Study Group</creatorcontrib><title>Willingness to go through surgery again validated the WOMAC clinically important difference from THR/TKR surgery</title><title>Journal of clinical epidemiology</title><addtitle>J Clin Epidemiol</addtitle><description>Abstract Objective The objective was to determine the clinically important difference (CID) from primary total hip replacement (THR) and total knee replacement (TKR) surgeries using the Western Ontario McMaster University (WOMAC) osteoarthritis index. Study Design and Setting WOMAC scores were collected at decision for and 1 year after surgery ( n = 2,709). Transition ratings (15-point scale) were obtained at 1 year for pain and function, as well as a global assessment of willingness to go through surgery again. A “good deal better” defined the positive CID. WOMAC change scores for transition ratings and willingness to go through surgery again were evaluated using receiver operating characteristic curves. Patient characteristics within transition rating categories were examined. Results For THR, the positive CIDs were 41 of 100 for pain and 34 of 100 for function. The negative CIDs were 35 and 33, respectively. For TKR, the positive CIDs were 36 for pain and 33 for function. The negative CIDs were 30 and 25, respectively. Change scores for willingness to go through surgery again validated CID values. Postoperative complications decreased the likelihood of a positive CID. Conclusion Improvement that is “a good deal better” is an appropriate threshold for the THR/TKR positive CID. Attaining a positive CID is negatively related to postoperative complications.</description><subject>Aged</subject><subject>Arthritis</subject><subject>Arthroplasty</subject><subject>Arthroplasty, Replacement, Hip - psychology</subject><subject>Arthroplasty, Replacement, Hip - rehabilitation</subject><subject>Arthroplasty, Replacement, Knee - psychology</subject><subject>Arthroplasty, Replacement, Knee - rehabilitation</subject><subject>Biological and medical sciences</subject><subject>Clinically important difference</subject><subject>Data collection</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Health sciences</subject><subject>Health Status</subject><subject>Health Status Indicators</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Joint surgery</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Ontario - epidemiology</subject><subject>Orthopedic surgery</subject><subject>Osteoarthritis</subject><subject>Osteoarthritis - epidemiology</subject><subject>Osteoarthritis - psychology</subject><subject>Osteoarthritis - rehabilitation</subject><subject>Pain</subject><subject>Pain Measurement - methods</subject><subject>Pain, Postoperative - psychology</subject><subject>Patient Satisfaction</subject><subject>Probability</subject><subject>Quality of Life - psychology</subject><subject>Ratings &amp; rankings</subject><subject>Reoperation - psychology</subject><subject>Severity of Illness Index</subject><subject>Studies</subject><subject>Surgery</subject><subject>Surgery (general aspects). 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Study Design and Setting WOMAC scores were collected at decision for and 1 year after surgery ( n = 2,709). Transition ratings (15-point scale) were obtained at 1 year for pain and function, as well as a global assessment of willingness to go through surgery again. A “good deal better” defined the positive CID. WOMAC change scores for transition ratings and willingness to go through surgery again were evaluated using receiver operating characteristic curves. Patient characteristics within transition rating categories were examined. Results For THR, the positive CIDs were 41 of 100 for pain and 34 of 100 for function. The negative CIDs were 35 and 33, respectively. For TKR, the positive CIDs were 36 for pain and 33 for function. The negative CIDs were 30 and 25, respectively. Change scores for willingness to go through surgery again validated CID values. Postoperative complications decreased the likelihood of a positive CID. Conclusion Improvement that is “a good deal better” is an appropriate threshold for the THR/TKR positive CID. Attaining a positive CID is negatively related to postoperative complications.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>18687289</pmid><doi>10.1016/j.jclinepi.2007.10.014</doi><tpages>12</tpages></addata></record>
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subjects Aged
Arthritis
Arthroplasty
Arthroplasty, Replacement, Hip - psychology
Arthroplasty, Replacement, Hip - rehabilitation
Arthroplasty, Replacement, Knee - psychology
Arthroplasty, Replacement, Knee - rehabilitation
Biological and medical sciences
Clinically important difference
Data collection
Epidemiology
Female
Health sciences
Health Status
Health Status Indicators
Humans
Internal Medicine
Joint surgery
Male
Medical sciences
Ontario - epidemiology
Orthopedic surgery
Osteoarthritis
Osteoarthritis - epidemiology
Osteoarthritis - psychology
Osteoarthritis - rehabilitation
Pain
Pain Measurement - methods
Pain, Postoperative - psychology
Patient Satisfaction
Probability
Quality of Life - psychology
Ratings & rankings
Reoperation - psychology
Severity of Illness Index
Studies
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surveys and Questionnaires
Total hip replacement
Total knee replacement
Validation
WOMAC
title Willingness to go through surgery again validated the WOMAC clinically important difference from THR/TKR surgery
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