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J Am Acad Orthop Surg, Vol 18, No 2, February 2010, 72-82.
© 2010 the American Academy of Orthopaedic Surgeons
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Challenges With Health-related Quality of Life Assessment in Arthroplasty Patients: Problems and Solutions

Jasvinder Singh, MBBS, MPH, Jeff A. Sloan, PhD and Norman A. Johanson, MD

From the Rheumatology Section, Medicine, Minneapolis VA Medical Center, Minneapolis, MN, the Division of Rheumatology, University of Minnesota, Minneapolis, and the Department of Health Sciences Research, Mayo Clinic School of Medicine, Rochester, MN (Dr. Singh); the Department of Cancer Biostatistics, Mayo Clinic School of Medicine (Dr. Sloan); and the Department of Orthopaedics, Drexel University College of Medicine, Philadelphia, PA (Dr. Johanson).

Dr. Singh or an immediate family member has received research or institutional support from the Mayo Clinic Center for Clinical and Translational Research, the North Center Cancer Treatment Group, and the Cancer Center. Dr. Sloan or an immediate family member has received research or institutional support from the Mayo Clinic Center for Clinical and Translational Research, the North Center Cancer Treatment Group, and the Cancer Center. Dr. Johanson or an immediate family member has received royalties from Exactech, serves as a paid consultant to or is an employee of Stelkast, and has received research or institutional support from DePuy, Exactech, IsoTis Orthobiologics, Zimmer, the Mayo Clinic Center for Clinical and Translational Research, the North Center Cancer Treatment Group, and the Cancer Center.

Grant support was received from the NIH CTSA Award 1 KL2 RR024151-01 (Mayo Clinic Center for Clinical and Translational Research), North Central Cancer Treatment Group (CA25224-27), and Cancer Center grant CA 15083-32.

Assessment of health-related quality of life (HRQOL) using patient-reported outcomes in arthroplasty has become popular because it provides a unique perspective on successful elective procedures. However, challenges exist in the assessment of HRQOL in clinical practice and in clinical research. Patient compliance with multiple and sometimes lengthy HRQOL assessments administered at multiple follow-up visits is problematic. Many well-validated HRQOL instruments are available, and progress has been made in defining the minimal clinically important difference in hip and knee arthroplasty that denotes the minimal change perceived to be important by patients. Challenges in understanding the literature are attributable to the use of various HRQOL scales, with different scoring ranges and scoring algorithms, different interpretations of highest score, and differences in the presentation of raw versus transformed scores.






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Copyright © 2010 by the American Academy of Orthopaedic Surgeons.