Patient‐Reported Outcome Instruments for Femoroacetabular Impingement and Hip Labral Pathology: A Systematic Review of the Clinimetric Evidence
Why this work is in the frame
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Bibliographic record
Abstract
PURPOSE: The purpose of this study is to systematically review the content and clinimetric evidence (rigor of rating scales and indexes for the description of clinical phenomena) of published patient-reported outcome (PRO) instruments used to assess femoroacetabular impingement (FAI) and labral hip pathology. METHODS: We used Medical Subject Heading terms related to FAI and labrum/labral tears to search the Medline, Embase, and Cochrane databases for studies of FAI and labral hip pathology. Studies with hip-related PRO instruments, with any operative intervention except total hip arthroplasty, were included. We excluded studies with a skeletally immature population, revision surgeries in more than 10% of cases, or a primary diagnosis of hip osteoarthritis. We conducted a second review using the same databases for studies reporting clinimetric properties of at least 1 of the PRO instruments identified previously. Articles were selected in an independent, stepwise manner by 2 reviewers. Selected articles were evaluated to determine the presence and quality of measurement properties of the outcome instruments. RESULTS: We found 5 articles assessing 3 PRO instruments: the Hip Outcome Score (HOS), the Non-Arthritic Hip Score, and the 12-item modified Western Ontario and McMaster Universities Osteoarthritis Index. The HOS had the highest positive rating for internal consistency, construct validity, agreement, responsiveness, lack of floor/ceiling effect, and interpretability. The Non-Arthritic Hip Score showed evidence for validity and lack of floor/ceiling effect. The modified Western Ontario and McMaster Universities Osteoarthritis Index was only strong for internal consistency and was indeterminate for construct validity. CONCLUSIONS: Only 3 PRO instruments have shown clinimetric evidence to support their use to measure outcomes in FAI and labral pathology patients. The HOS has the greatest amount of clinimetric evidence and is the most proven instrument for use in this population. This review shows that further clinimetric evaluation of commonly used PRO instruments for nonarthritic hip pathology is warranted.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it