A SANE Approach to Outcome Collection? Comparing the Performance of Single- Versus Multiple-Question Patient-Reported Outcome Measures After Total Hip Arthroplasty

Michael T Torchia; Daniel C Austin; Paul M Werth; Adriana P Lucas; Wayne E Moschetti; David S Jevsevar

doi:10.1016/j.arth.2020.01.015

A SANE Approach to Outcome Collection? Comparing the Performance of Single- Versus Multiple-Question Patient-Reported Outcome Measures After Total Hip Arthroplasty

J Arthroplasty. 2020 Jun;35(6S):S207-S213. doi: 10.1016/j.arth.2020.01.015. Epub 2020 Jan 16.

Authors

Michael T Torchia¹, Daniel C Austin¹, Paul M Werth¹, Adriana P Lucas¹, Wayne E Moschetti², David S Jevsevar²

Affiliations

¹ Department of Orthopaedics, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
² Department of Orthopaedics, Dartmouth-Hitchcock Medical Center, Lebanon, NH; Department of Orthopaedics, Geisel School of Medicine Dartmouth College, Hanover, NH.

PMID: 32008770
DOI: 10.1016/j.arth.2020.01.015

Abstract

Background: Several patient-reported outcome measures (PROMs) exist to measure outcomes after total hip arthroplasty (THA) but can be limited by patient-perceived burden and completion rates. We analyzed whether the modified single assessment numerical evaluation (M-SANE), a one-question PROM, would perform similarly to multiple-question PROMs among patients undergoing primary THA.

Methods: Patients undergoing THA completed the Patient-Reported Outcomes Measurement Information System-10 (PROMIS-10), the Hip Disability and Osteoarthritis Outcomes Score Junior (HOOS-Jr), and M-SANE questionnaires both preoperatively and postoperatively. The M-SANE assessment asked patients to assess their hip on a scale from 0 to 10, with 10 being the best possible score. Validity of M-SANE compared with other PROMs was determined by Spearman's correlation and floor and ceiling effects. Responsiveness was analyzed using standardized response mean (SRM).

Results: One hundred and thirty six patients with at least 1-year follow-up were reviewed. The average M-SANE score improved from 3.3 preoperatively to 7.1 at one year postoperatively. There was moderate to strong correlation at one-year follow-up between the M-SANE and HOOS-Jr (ρ = 0.75, P < .001) and PROMIS-10 physical component summary (ρ = 0.63, P < .001). Floor and ceiling effects of the M-SANE (floor 2.0%, ceiling 21.3%) were comparable to the HOOS-Jr (floor 0.0%, ceiling 20.8%). The responsiveness of the M-SANE after THA (SRM = 1.06, 95% CI: 0.79-1.33) was comparable to HOOS-Jr (SRM = 1.33, 95% CI: 1.08-1.59) and superior to PROMIS-10 physical component summary (SRM = 0.65, 95% CI: 0.55-0.74).

Conclusion: The M-SANE has performed similarly across multiple psychometric properties compared with more burdensome PROMs in assessing longitudinal patient-reported outcomes after THA.

Keywords: outcomes; patient-reported outcome measures; single assessment numeric evaluation; total hip arthroplasty; value.

MeSH terms

Arthroplasty, Replacement, Hip*
Humans
Patient Reported Outcome Measures
Psychometrics
Surveys and Questionnaires