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Burgers PTPW, Poolman RW, Van Bakel TMJ, Tuinebreijer WE, Zielinski SM, Bhandari M, Patka P, Van Lieshout EMM, Devereaux PJ, Guyatt GH, Einhorn TA, Thabane L, Schemitsch EH, Koval KJ, Frihagen F, Poolman RW, Tetsworth K, Guerra-Farfan E, Walter SD, Sprague S, Swinton M, Scott T, McKay P, Madden K, Heels-Ansdell D, Buckingham L, Duraikannan A, Silva H, Heetveld MJ, Van Lieshout EMM, Burgers PT, Zura RD, Avram V, Manjoo A, Williams D, Antoniou J, Ramsay T, Bogoch ER, Trenholm A, Lyman S, Mazumdar M, Bozic KJ, Luborsky M, Goodman S, Muray S, Korley R, Buckley R, Duffy P, Puloski S, Carcary K, Lorenzo M, McKee MD, Hall JA, Nauth A, Whelan D, Daniels TR, Waddell JP, Ahn H, Vicente MR, Hidy JT, MacNevin MT, Kreder H, Axelrod T, Jenkinson R, Nousiainen M, Stephen D, Wadey V, Kunz M, Milner K, Cagaanan R, MacNevin M, O’Brien PJ, Blachut PA, Broekhuyse HM, Guy P, Lefaivre KA, Slobogean GP, Johal R, Leung I, Coles C, Leighton R, Richardson CG, Biddulph M, Gross M, Dunbar M, Amirault JD, Alexander D, Coady C, Glazebrook M, Johnston D, Oxner W, Reardon G, Wong I, Trask K, MacDonald S, Furey A, Stone C, Parsons M, Stone T, Zomar M, McCormack R, Apostle K, Boyer D, Moola F, Perey B, Viskontas D, Moon K, Moon R, Laflamme Y, Benoit B, Ranger P, Malo M, Fernandes J, Tardif K, Fournier J, Vendittoli PA, Massé V, Roy AG, Lavigne M, Lusignan D, Davis C, Stull P, Weinerman S, Weingarten P, Lindenbaum S, Hewitt M, Danielwicz R, Baker J, Mont M, Delanois DE, Kapadia B, Issa K, Mullen M, Sems A, Foreman B, Parvizi J, Morrison T, Lewis C, Caminiti S, Tornetta P, Creevy WR, Lespasio MJ, Carlisle H, Marcantonio A, Kain M, Specht L, Tilzey J, Garfi J, Mehta S, Esterhai JL, Ahn J, Donegan D, Horan A, McGinnis K, Roberson J, Bradbury T, Erens G, Webb K, Mullis B, Shively K, Parr A, Ertl J, Worman R, Webster M, Cummings J, Frizzell V, Moore M, Jones CB, Ringler JR, Sietsema DL, Walker JE, Kanlic E, Abdelgawad A, Shunia J, DePaolo C, Sutherland S, Alosky R, Zura R, Manson M, Strathy G, Peter K, Johnson P, Morton M, Shaer J, Schrickel T, Hileman B, Hanes M, Chance E, Heinrich EM, Dodgin D, LaBadie M, Zamorano D, Tynan M, Schwarzkopf R, Scolaro JA, Gupta R, Bederman S, Bhatia N, Hoang B, Kiester D, Jones N, Rafijah G, Alavekios D, Lee J, Mehta A, Schroder S, Chao T, Colin V, Dang P(P, Heng SK, Lopez G, Galle S, Pahlavan S, Phan DL, Tapadia M, Bui C, Jain N, Moore T, Moroski N, Pourmand D, Kubiak EN, Gililland J, Rothberg D, Peters C, Pelt C, Stuart AR, Corbey K, Shuler FD, Day J, Garabekyan T, Cheung F, Oliashirazi A, Salava J, Morgan L, Wilson-Byrne T, Cordle MB, Elmans LH, van den Hout JA, Joosten AJP, van Beurden AFA, Bolder SBT, Eygendaal D, Moonen AF, van Geenen RCI, Hoebink EA, Wagenmakers R, van Helden W, van Jonbergen HPW, Roerdink H, Reuver JM, Barnaart AFW, Flikweert ER, Krips R, Mullers JB, Schüller H, Falke MLM, Kurek FJ, Slingerland ACH, van Dijk JP, van Helden WH, Bolhuis HW, Bullens PHJ, Hogervorst M, de Kroon KE, Jansen RH, Steenstra F, Raven EEJ, Fontijne WPJ, Wiersma SC, Boetes B, ten Holder EJT, van der Heide HJL, Nagels J, van der Linden-van der Zwaag EH, Keizer SB, Swen JWA, den Hollander PHC, Thomassen BJW, Molekamp WJK, de Meulemeester FR, Kleipool AEB, Haverlag R, Simons MP, Mutsaerts EL, Kooijman R, Postema RR, Bleker RJ, Lampe HIH, Schuman L, Cheung J, van Bommel F, Winia WP, Haverkamp D, van der Vis H, Nolte PA, van den Bekerom MPJ, de Jong T, van Noort A, Vergroesen DA, Schutte BG, van der Vis HM, Beimers L, de Vries J, Zurcher AW, Albers GR, Rademakers M, Breugem S, van der Haven I, Jan Damen P, Bulstra GH, Campo MM, Somford MP, Haverkamp D, Liew S, Bedi H, Carr A, Chia A, Csongvay S, Donohue C, Doig S, Edwards E, Esser M, Freeman R, Gong A, Li D, Miller R, Ton L, Wang O, Young I, Dowrick A, Murdoch Z, Sage C, Page R, Bainbridge D, Angliss R, Miller B, Thomson A, Brown G, Williams S, Eng K, Bowyer D, Skelley J, Goyal C, Beattie S, Guerado E, Cruz E, Cano JR, Froufe MA, Serra LM, Al-dirra S, Martinez C, Tarazona Santabalbina FJ, Serra JT, Hernandez JT, Garcia MA, Garcia VM, Barrera S, Garrido M, Nordsletten L, Clarke-Jenssen J, Hjorthaug G, Brekke AC, Vesterhus EB, Skaugrud I, Tripathi P, Katiyar S, Shukla P, Swiontkowski M, Guyatt G, Jeray K, Walter S, Viveiros H, Truong V, Koo K, Zhou Q, Maddock D, Simunovic N, Agel J, Zielinski SM, Rangan A, Hanusch BC, Kottam L, Clarkson R, Della Rocca GJ, Slobogean G, Katz J, Gillespie B, Greendale GA, Hartman C, Rubin C, Waddell J, Lemke HM, Oatt A, Buckley RE, Korley R, Johnston K, Powell J, Sanders D, Lawendy A, Tieszer C, Murnaghan J, Nam D, Yee A, Whelan DB, Wild LM, Khan RM, Coady C, Amirault D, Richardson G, Dobbin G, Bicknell R, Yach J, Bardana D, Wood G, Harrison M, Yen D, Lambert S, Howells F, Ward A, Zalzal P, Brien H, Naumetz V, Weening B, Wai EK, Papp S, Gofton WT, Kingwell SP, Johnson G, O’Neil J, Roffey DM, Borsella V, Oliver TM, Jones V, Endres TJ, Agnew SG, Jeray KJ, Broderick JS, Goetz DR, Pace TB, Schaller TM, Porter SE, Tanner SL, Snider RG, Nastoff LA, Bielby SA, Switzer JA, Cole PA, Anderson SA, Lafferty PM, Li M, Ly TV, Marston SB, Foley AL, Vang S, Wright DM, Marcantonio AJ, Kain MSH, Iorio R, Specht LM, Tilzey JF, Lobo MJ, Garfi JS, Vallier HA, Dolenc A, Robinson C, Prayson MJ, Laughlin R, Rubino LJ, May J, Rieser GR, Dulaney-Cripe L, Gayton C, Gorczyca JT, Gross JM, Humphrey CA, Kates S, Noble K, McIntyre AW, Pecorella K, Davis CA, Lindenbaum S, Schwappach J, Baker JK, Rutherford T, Newman H, Lieberman S, Finn E, Robbins K, Hurley M, Lyle L, Mitchell K, Browner K, Whatley E, Payton K, Reeves C, Cannada LK, Karges D, Hill L, Esterhai J, Horan AD, Kaminski CA, Kowalski BN, Keeve JP, Anderson CG, McDonald MD, Hoffman JM, Tarkin I, Siska P, Gruen G, Evans A, Farrell DJ, Irrgang J, Luther A, Cross WW, Cass JR, Sems SA, Torchia ME, Scrabeck T, Jenkins M, Dumais J, Romero AW, Sagebien CA, Butler MS, Monica JT, Seuffert P, Hsu JR, Ficke J, Charlton M, Napierala M, Fan M, Tannoury C, Archdeacon M, Finnan R, Le T, Wyrick J, Hess S, Brennan ML, Probe R, Kile E, Mills K, Clipper L, Yu M, Erwin K, Horwitz D, Strohecker K, Swenson TK, Schmidt AH, Westberg JR, Aurang K, Zohman G, Peterson B, Huff RB, Baele J, Weber T, Edison M, McBeth J, Ertl JP, Parr JA, Moore MM, Tobias E, Thomas E, DePaolo CJ, Shell LE, Hampton L, Shepard S, Nanney T, Cuento C, Cantu RV, Henderson ER, Eickhoff LS, Hammerberg EM, Stahel P, Hak D, Mauffrey C, Gibula D, Gissel H, Henderson C, Zamorano DP, Tynan MC, Lawson D, Crist BD, Murtha YM, Anderson LK, Linehan C, Pilling L, Lewis CG, Sullivan RJ, Roper E, Obremskey W, Kregor P, Richards JE, Stringfellow K, Dohm MP, Zellar A, Segers MJM, Zijl JAC, Verhoeven B, Smits AB, de Vries JPPM, Fioole B, van der Hoeven H, Theunissen EBM, de Vries Reilingh TS, Govaert L, Wittich P, de Brauw M, Wille J, Go PM, Ritchie ED, Wessel RN, Hammacher ER, Visser GA, Stockmann H, Silvis R, Snellen JP, Rijbroek B, Scheepers JJG, Vermeulen EGJ, Siroen MPC, Vuylsteke R, Brom HLF, Rijna H, de Rijcke PAR, Koppert CL, Buijk SE, Groenendijk RPR, Dawson I, Tetteroo GWM, Bruijninckx MMM, Doornebosch PG, de Graaf EJR, van der Elst M, van der Pol CC, van’t Riet M, Karsten TM, de Vries MR, Stassen LPS, Schep NWL, Ben Schmidt G, Hoffman WH, van der Heijden FH, Willems WJ, van der Hart CP, Turckan K, Festen S, de Nies F, Out NJM, Bosma J, van Kampen A, Biert J, van Vugt AB, Edwards MJR, Blokhuis TJ, Frölke JPM, Geeraedts LMG, Gardeniers JWM, Tan ET, Poelhekke LM, de Waal Malefijt MC, Schreurs B, Roukema GR, Josaputra HA, Keller P, de Rooij PD, Kuiken H, Boxma H, Cleffken BI, Liem R, Rhemrev SJ, Bosman CHR, de Mol van Otterloo A, Hoogendoorn J, de Vries AC, Meylaerts SAG, Verhofstad MHJ, Meijer J, van Egmond T, van der Brand I, Patka P, Eversdijk MG, Peters R, Den Hartog D, Van Waes OJF, Oprel P, Campo M, Verhagen R, Albers GR, Simmermacher RKJ, van Mulken J, van Wessem K, van Gaalen SM, Leenen LPH, Bronkhorst MW, Guicherit OR, Goslings JC, Ponsen KJ, Bhatia M, Arora V, Tyagi V, Gupta A, Jain N, Khan F, Sharma A, Sanghavi A, Trivedi M, Rai A, Subash, Rai K, Yadav V, Singh S, Prasad AS, Mishra V, Sundaresh DC, Khanna A, Cherian JJ, Olakkengil DJ, Sharma G, Dadi A, Palla N, Ganguly U, Rai BS, Rajakumar J, Hull P, Lewis S, Evans S, Nanda R, Logishetty R, Anand S, Bowler C, Jennings A, Chuter G, Rose G, Horner G, Clark C, Eke K, Reed M, Herriott C, Dobb C, Curry H, Etherington G, Jain A, Moaveni A, Russ M, Donald G, Weinrauch P, Pincus P, Yang S, Halliday B, Gervais T, Holt M, Flynn A, Pirpiris M, Love D, Bucknill A, Farrugia RJ, Ianssen T, Amundsen A, Brattgjerd JE, Borch T, Bøe B, Flatøy B, Hasselund S, Haug KJ, Hemlock K, Hoseth TM, Jomaas G, Kibsgård T, Lona T, Moatshe G, Müller O, Molund M, Nicolaisen T, Nilsen F, Rydinge J, Smedsrud M, Stødle A, Trommer A, Ugland S, Karlsten A, Ekås G, Pape HC, Knobe M, Pfeifer R. Reliability, validity, and responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index for elderly patients with a femoral neck fracture. J Bone Joint Surg Am 2015; 97:751-7. [PMID: 25948522 DOI: 10.2106/jbjs.n.00542] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
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. CLINICAL RELEVANCE The results are based on two clinical trials. The questionnaires used concern pure, clinically relevant issues (ability to walk, climb stairs, etc.). Moreover, the results can be used for future research comparing clinical outcomes (or treatments) for populations with a femoral neck fracture.
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Affiliation(s)
- Paul T P W Burgers
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. E-mail address for P.T.P.W. Burgers: . E-mail address for T.M.J. Van Bakel: . E-mail address for W.E. Tuinebreijer: . E-mail address for S.M. Zielinski: . E-mail address for E.M.M. Van Lieshout:
| | - Rudolf W Poolman
- Joint Research, Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, P.O. Box 95500, 1090 HM Amsterdam, the Netherlands. E-mail address:
| | - Theodorus M J Van Bakel
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. E-mail address for P.T.P.W. Burgers: . E-mail address for T.M.J. Van Bakel: . E-mail address for W.E. Tuinebreijer: . E-mail address for S.M. Zielinski: . E-mail address for E.M.M. Van Lieshout:
| | - Wim E Tuinebreijer
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. E-mail address for P.T.P.W. Burgers: . E-mail address for T.M.J. Van Bakel: . E-mail address for W.E. Tuinebreijer: . E-mail address for S.M. Zielinski: . E-mail address for E.M.M. Van Lieshout:
| | - Stephanie M Zielinski
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. E-mail address for P.T.P.W. Burgers: . E-mail address for T.M.J. Van Bakel: . E-mail address for W.E. Tuinebreijer: . E-mail address for S.M. Zielinski: . E-mail address for E.M.M. Van Lieshout:
| | - Mohit Bhandari
- Department of Clinical Epidemiology and Biostatistics, McMaster University, HSC 2C, 1200 Main Street West, Hamilton, ON L8N 3Z5, Canada. E-mail address:
| | - Peter Patka
- Department of Emergency Medicine, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. E-mail address:
| | - Esther M M Van Lieshout
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands. E-mail address for P.T.P.W. Burgers: . E-mail address for T.M.J. Van Bakel: . E-mail address for W.E. Tuinebreijer: . E-mail address for S.M. Zielinski: . E-mail address for E.M.M. Van Lieshout:
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