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We obtained pre-operative and six-month post-operative Oxford hip (OHS) and knee scores (OKS) for 1523 patients who underwent total hip replacement and 1784 patients who underwent total knee replacement. They all also completed a six-month satisfaction question. Scatter plots showed no relationship between pre-operative Oxford scores and six-month satisfaction scores. Spearman's rank correlation coefficients were -0.04 (95% confidence interval (CI) -0.09 to 0.01) between OHS and satisfaction and 0.04 (95% CI -0.01 to 0.08) between OKS and satisfaction. A receiver operating characteristic (ROC) curve analysis was used to identify a cut-off point for the pre-operative OHS/OKS that identifies whether or not a patient is satisfied with surgery. We obtained an area under the ROC curve of 0.51 (95% CI 0.45 to 0.56) for hip replacement and 0.56 (95% CI 0.51 to 0.60) for knee replacement, indicating that pre-operative Oxford scores have no predictive accuracy in distinguishing satisfied from dissatisfied patients. In the NHS widespread attempts are being made to use patient-reported outcome measures (PROMs) data for the purpose of prioritising patients for surgery. Oxford hip and knee scores have no predictive accuracy in relation to post-operative patient satisfaction. This evidence does not support their current use in prioritising access to care.

Original publication

DOI

10.1302/0301-620x.93b12.27046

Type

Journal article

Journal

The Journal of bone and joint surgery. British volume

Publication Date

12/2011

Volume

93

Pages

1660 - 1664

Addresses

Oxford NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Windmill Road, Headington, Oxford OX3 7LD, UK.

Keywords

Humans, Treatment Outcome, Arthroplasty, Replacement, Hip, Arthroplasty, Replacement, Knee, Health Status Indicators, Prospective Studies, Predictive Value of Tests, ROC Curve, Patient Selection, Aged, State Medicine, Patient Satisfaction, Outcome Assessment (Health Care), Female, Male, Surveys and Questionnaires, United Kingdom