Validating existing crosswalks between legacy PROMs and PROMIS measuring physical functioning in patients undergoing total hip and total knee arthroplasty

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Objectives Several crosswalks are available for frequently used legacy patient-reported outcome measures (PROMs) in orthopedic surgery evaluating outcomes after total hip arthroplasty (THA) or total knee arthroplasty (TKA). This multicenter study validates crosswalks of the Hip disability and Osteoarthritis Outcome Score Physical function Shortform (HOOS-PS), the Knee injury and Osteoarthritis Outcome Score -Physical function Shortform (KOOS-PS), and the KOOS Function in daily living (ADL) subscale to Patient-Reported Outcomes Measurement Information System (PROMIS) SF10a physical function (PROMIS PF) scores. Methods Patients of three orthopedic departments completed online questionnaires: HOOS-PS, KOOS-PS, KOOS ADL and PROMIS PF. After converting the legacy PROM scores towards PROMIS metric using the crosswalk tables, the Pearson's correlation and the intraclass correlation coefficient (ICC) between the predicted and observed PROMIS scores were calculated. The level of agreement between the predicted and observed PROMIS scores was assessed using a Bland-Altman plot, and the Limits of Agreement (LoA) were calculated. Last, the percentage of patients for whom the predicted score was considered acceptably comparable to the observed score (difference ≤2 points) was determined. Results 422 patients were included. Adequate correlations (≥0.70) and ICC values (≥0.70) were found between observed and predicted PROMIS scores, indicating good performance of the crosswalks and suggesting good agreement on group level. Mean differences between predicted and observed PROMIS scores based on the HOOS-PS, KOOS-PS, and KOOS ADL were respectively 1.4, -0.3 and 1.0. The LoA varied between -10.8 and 12.4, indicating substantial differences between observed and predicted PROMIS score on individual patient level. Only 25.7%-39.8% of the patients had a predicted PROMIS score acceptably comparable to the observed PROMIS score. Conclusion The existing HOOS-PS, KOOS-PS and KOOS-ADL crosswalks towards PROMIS PF seem to be appropriate for group-level use but are not suitable for individual-level predictions of PROMIS scores.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.