PMID- 24005872
OWN - NLM
STAT- MEDLINE
DCOM- 20140918
LR  - 20220330
IS  - 1552-3365 (Electronic)
IS  - 0363-5465 (Linking)
VI  - 41
IP  - 12
DP  - 2013 Dec
TI  - A comparison of the responsiveness of 4 commonly used patient-reported outcome 
      instruments at 5 years after matrix-induced autologous chondrocyte implantation.
PG  - 2791-9
LID - 10.1177/0363546513502314 [doi]
AB  - BACKGROUND: Patient-reported outcome (PRO) instruments are employed to assess 
      outcomes after matrix-induced autologous chondrocyte implantation (MACI), 
      although the PRO most responsive to change after surgery remains unknown. 
      PURPOSE: To compare the responsiveness of 4 commonly used PRO instruments at 5 
      years after MACI. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2. 
      METHODS: The Knee Injury and Osteoarthritis Outcome Score (KOOS), the Lysholm 
      score, the Tegner activity scale, and the 36-item Short Form Health Survey 
      (SF-36) were administered to 104 patients before and at 5 years after MACI knee 
      surgery. The Self-administered Patient Satisfaction Scale was employed at 5 years 
      to investigate each patient's overall level of satisfaction as well as 
      satisfaction with relieving pain and improving the ability to perform daily 
      activities, partake in recreational activities, and participate in sport. The 
      effect size (ES) and standardized response mean (SRM) were used to compare PRO 
      responsiveness. A receiver operating characteristic (ROC) curve analysis was 
      performed to evaluate the extent to which PRO changes were associated with 
      satisfaction. The minimal clinically important difference (MCID) according to the 
      criterion of patient satisfaction was identified as the PRO instrument change 
      score maximizing classification accuracy. RESULTS: The most responsive PRO 
      measures were the KOOS sport/recreation (ES, 1.63; SRM, 1.43) and quality of life 
      (QOL) (ES, 1.37; SRM, 1.18) subscales. The least responsive were the SF-36 mental 
      component summary (MCS) (ES, 0.38; SRM, 0.40) and the Tegner activity scale (ES, 
      0.91; SRM, 0.59). Of the 104 patients, 54 (51.9%) reported being "very 
      satisfied," 38 (36.5%) "somewhat satisfied," 8 (7.7%) "somewhat dissatisfied," 
      and 4 (3.9%) "very dissatisfied." A ROC curve analysis was performed using "very 
      satisfied" as the responder criterion. The strongest association was between the 
      change in KOOS sport/recreation with satisfaction in improving the ability to 
      perform recreational activities (area under the curve, 0.756; 95% confidence 
      interval, 0.663-0.849), and the change score maximizing prediction accuracy 
      (MCID) was 40 (sensitivity, 69%; specificity, 76%). CONCLUSION: The KOOS 
      sport/recreation and QOL subscales were the most responsive PRO measures and were 
      most predictive of satisfaction. This information will provide a guide as to the 
      improvements required in pertinent PRO measures to produce a satisfied patient, 
      while allowing researchers to better structure trials in these patients using the 
      most relevant PRO instruments.
FAU - Ebert, Jay R
AU  - Ebert JR
AD  - Jay R. Ebert, School of Sport Science, Exercise and Health (M408 The University 
      of Western Australia, 35 Stirling Highway, Crawley, 6009, Western Australia, 
      Australia. jay.ebert@uwa.edu.au).
FAU - Smith, Anne
AU  - Smith A
FAU - Wood, David J
AU  - Wood DJ
FAU - Ackland, Timothy R
AU  - Ackland TR
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130904
PL  - United States
TA  - Am J Sports Med
JT  - The American journal of sports medicine
JID - 7609541
SB  - IM
MH  - *Activities of Daily Living
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Arthralgia/etiology
MH  - Chondrocytes/*transplantation
MH  - Cohort Studies
MH  - Female
MH  - Fractures, Cartilage/surgery
MH  - Health Surveys
MH  - Humans
MH  - Knee Injuries/*surgery
MH  - Male
MH  - Middle Aged
MH  - Orthopedic Procedures
MH  - Osteoarthritis, Knee/*etiology
MH  - *Patient Outcome Assessment
MH  - *Patient Satisfaction
MH  - *Quality of Life
MH  - ROC Curve
MH  - Recreation
MH  - Self Report
MH  - Transplantation, Autologous
MH  - Young Adult
OTO - NOTNLM
OT  - articular cartilage
OT  - clinical assessment/grading scales
OT  - knee
OT  - matrix-induced autologous chondrocyte implantation
OT  - patient-reported outcome measures
EDAT- 2013/09/06 06:00
MHDA- 2014/09/19 06:00
CRDT- 2013/09/06 06:00
PHST- 2013/09/06 06:00 [entrez]
PHST- 2013/09/06 06:00 [pubmed]
PHST- 2014/09/19 06:00 [medline]
AID - 0363546513502314 [pii]
AID - 10.1177/0363546513502314 [doi]
PST - ppublish
SO  - Am J Sports Med. 2013 Dec;41(12):2791-9. doi: 10.1177/0363546513502314. Epub 2013 
      Sep 4.