TY - JOUR
T1 - Reliability, Validity, and Responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index for Elderly Patients with a Femoral Neck Fracture
AU - Burgers, Paul T. P. W.
AU - Poolman, Rudolf W.
AU - van Bakel, Theodorus M. J.
AU - Tuinebreijer, Wim E.
AU - Zielinski, Stephanie M.
AU - Bhandari, Mohit
AU - Patka, Peter
AU - van Lieshout, Esther M. M.
AU - AUTHOR GROUP
AU - Devereaux, P. J.
AU - Guyatt, Gordon H.
AU - Einhorn, Thomas A.
AU - Thabane, Lehana
AU - Schemitsch, Emil H.
AU - Koval, Kenneth J.
AU - Frihagen, Frede
AU - Tetsworth, Kevin
AU - Guerra-Farfan, Ernesto
AU - Walter, Stephen D.
AU - Sprague, Sheila
AU - Swinton, Marilyn
AU - Scott, Taryn
AU - McKay, Paula
AU - Madden, Kim
AU - Heels-Ansdell, Diane
AU - Buckingham, Lisa
AU - Duraikannan, Aravin
AU - Silva, Heather
AU - Heetveld, Martin J.
AU - Burgers, T. P. W.
AU - Zura, Robert D.
AU - Avram, Victoria
AU - Eygendaal, Denise
AU - Krips, Rover
AU - Raven, Eric E. J.
AU - Haverlag, Robert
AU - Mutsaerts, Eduard L. A. R.
AU - Haverkamp, Daniel
AU - van den Bekerom, Michel P. J.
AU - Beimers, Lijkele
AU - de Vries, Jasper
AU - Zurcher, Arthur W.
AU - Bulstra, Gythe H.
AU - Campo, Martin M.
AU - Somford, Mathijs P.
AU - Schep, Niels W. L.
AU - Festen, Sebastiaan
AU - Geeraedts, Leo M. G.
AU - Peters, Rolf
AU - Goslings, J. Carel
AU - Ponsen, Kees Jan
PY - 2015
Y1 - 2015
N2 - Background: The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been extensively evaluated in groups of patients with osteoarthritis, yet not in patients with a femoral neck fracture. This study aimed to determine the reliability, construct validity, and responsiveness of the WOMAC compared with the Short Form-12 (SF-12) and the EuroQol 5D (EQ-5D) questionnaires for the assessment of elderly patients with a femoral neck fracture. Methods: Reliability was tested by assessing the Cronbach alpha. Construct validity was determined with the Pearson correlation coefficient. Change scores were calculated from ten weeks to twelve months of follow-up. Standardized response means and floor and ceiling effects were determined. Analyses were performed to compare the results for patients less than eighty years old with those for patients eighty years of age or older. Results: The mean WOMAC total score was 89 points before the fracture in the younger patients and increased from 70 points at ten weeks to 81 points at two years postoperatively. In the older age group, these scores were 86, 75, and 78 points. The mean WOMAC pain scores before the fracture and at ten weeks and two years postoperatively were 92, 76, and 87 points, respectively, in the younger age group and 92, 84, and 93 points in the older age group. Function scores were 89, 68, and 79 points for the younger age group and 84, 71, and 73 points for the older age group. The Cronbach alpha for pain, stiffness, function, and the total scale ranged from 0.83 to 0.98 for the younger age group and from 0.79 to 0.97 for the older age group. Construct validity was good, with 82% and 79% of predefined hypotheses confirmed in the younger and older age groups, respectively. Responsiveness was moderate. No floor effects were found. Moderate to large ceiling effects were found for pain and stiffness scales at ten weeks and twelve months in younger patients (18% to 36%) and in the older age group (38% to 53%). Conclusions: The WOMAC showed good reliability, construct validity, and responsiveness in both age groups of elderly patients with a femoral neck fracture who had been physically and mentally fit before the fracture. The instrument is suitable for use in future clinical studies in these populations
AB - Background: The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been extensively evaluated in groups of patients with osteoarthritis, yet not in patients with a femoral neck fracture. This study aimed to determine the reliability, construct validity, and responsiveness of the WOMAC compared with the Short Form-12 (SF-12) and the EuroQol 5D (EQ-5D) questionnaires for the assessment of elderly patients with a femoral neck fracture. Methods: Reliability was tested by assessing the Cronbach alpha. Construct validity was determined with the Pearson correlation coefficient. Change scores were calculated from ten weeks to twelve months of follow-up. Standardized response means and floor and ceiling effects were determined. Analyses were performed to compare the results for patients less than eighty years old with those for patients eighty years of age or older. Results: The mean WOMAC total score was 89 points before the fracture in the younger patients and increased from 70 points at ten weeks to 81 points at two years postoperatively. In the older age group, these scores were 86, 75, and 78 points. The mean WOMAC pain scores before the fracture and at ten weeks and two years postoperatively were 92, 76, and 87 points, respectively, in the younger age group and 92, 84, and 93 points in the older age group. Function scores were 89, 68, and 79 points for the younger age group and 84, 71, and 73 points for the older age group. The Cronbach alpha for pain, stiffness, function, and the total scale ranged from 0.83 to 0.98 for the younger age group and from 0.79 to 0.97 for the older age group. Construct validity was good, with 82% and 79% of predefined hypotheses confirmed in the younger and older age groups, respectively. Responsiveness was moderate. No floor effects were found. Moderate to large ceiling effects were found for pain and stiffness scales at ten weeks and twelve months in younger patients (18% to 36%) and in the older age group (38% to 53%). Conclusions: The WOMAC showed good reliability, construct validity, and responsiveness in both age groups of elderly patients with a femoral neck fracture who had been physically and mentally fit before the fracture. The instrument is suitable for use in future clinical studies in these populations
U2 - https://doi.org/10.2106/JBJS.N.00542
DO - https://doi.org/10.2106/JBJS.N.00542
M3 - Article
C2 - 25948522
SN - 0021-9355
VL - 97A
SP - 751
EP - 757
JO - Journal of bone and joint surgery. American volume
JF - Journal of bone and joint surgery. American volume
IS - 9
ER -