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Interpretation threshold values for patient-reported outcomes in patients participating in a digitally delivered first-line treatment program for hip or knee osteoarthritis
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Department of Health Sciences, Lund University, Sweden.ORCID iD: 0000-0002-3282-6320
Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Denmark.
Department of Clinical Sciences Lund, Orthopedics, Lund University, Sweden.ORCID iD: 0000-0002-3850-7283
Department of Clinical Sciences Lund, Orthopedics, Lund University, Sweden; Arthro Therapeutics AB, Malmö, Sweden.ORCID iD: 0000-0002-5424-9448
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2023 (English)In: Osteoarthritis and Cartilage Open, ISSN 2665-9131, Vol. 5, no 3, article id 100375Article in journal (Refereed) Published
Abstract [en]

Objective: Establish proportions of patients reporting important improvement, acceptable symptoms and treatment failure and define interpretation threshold values for pain, patient-reported function and quality-of-life after participating in digital first-line treatment including education and exercise for hip and knee osteoarthritis (OA).

Methods: Observational study. Responses to the pain Numeric Rating Scale (NRS, 0-10 best to worst), Knee injury and Osteoarthritis Outcome Score 12 (KOOS-12) and Hip disability and Osteoarthritis Outcome Score 12 (HOOS-12, both 0-100 worst to best) were obtained for 4383 (2987) and 20341 (1264) participants with knee (hip) OA at 3 and 12 months post intervention.. Threshold values for Minimal Important Change (MIC), Patient Acceptable Symptom State (PASS) and Treatment Failure (TF) were estimated using anchor-based predictive modeling.

Results: 70–85% reported an important improvement in pain, function and quality of life after 3 and 12 months follow-up. 42% (3 months) and 51% (12 months) considered their current state as satisfactory, whereas 2-4% considered treatment failed. MIC values were -1 (NRS) and 0-4 (KOOS/HOOS-12) across follow-ups and joint affected. PASS threshold value for NRS was 3, and 53–73 for the KOOS/HOOS-12 subscales Corresponding values for TF were 5 (NRS) and 34–55 (KOOS/HOOS-12). Patients with more severe pain at baseline had higher MIC scores and accepted poorer outcomes at follow-ups.

Conclusion: Threshold estimates aid in the interpretation of outcomes after first-line OA interventions assessed with NRS Pain and KOOS/HOOS-12. Baseline pain severity is important to consider when interpreting threshold values after first-line interventions in these patients.

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 5, no 3, article id 100375
Keywords [en]
Osteoarthritis, minimal important change, patient acceptable symptom state, treatment failure
National Category
Physiotherapy Orthopaedics
Research subject
physiotherapy
Identifiers
URN: urn:nbn:se:umu:diva-208362DOI: 10.1016/j.ocarto.2023.100375PubMedID: 37275788Scopus ID: 2-s2.0-85162510328OAI: oai:DiVA.org:umu-208362DiVA, id: diva2:1758327
Funder
Foundation for Assistance to Disabled People in SkaneAvailable from: 2023-05-22 Created: 2023-05-22 Last updated: 2023-07-07Bibliographically approved

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Cronström, Anna

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