Background: Patient acceptable symptom state (PASS) thresholds for the EuroQol-5 Dimension-3 Level (EQ-5D-3L) questionnaire have been established for patients being evaluated 1 year following total hip arthroplasty (THA) but with varying derivation cohorts and methods. The aim of this study was to (1) generate an EQ-5D PASS threshold 1 year following THA on the basis of an international patient cohort, (2) validate preexisting and newly generated PASS thresholds 1 year following THA using the institutional registry of an academic care center, and (3) assess whether THA PASS thresholds vary by patient age and sex.
Methods: The derivation cohort for the THA PASS threshold consisted of 774 patients (after exclusions) who were enrolled in an international, multicenter study from 2007 to 2012 and who completed the EQ-5D and a numerical rating scale (NRS) for satisfaction 1 year postoperatively. With the NRS dichotomized at 2.5 as the anchor, a PASS cutoff for the EQ-5D was generated using the 80% specificity method. The Youden method and 75th percentile approach served as sensitivity analyses. The external validation cohort comprised 1,472 patients who had undergone THA. PASS thresholds were used to dichotomize the external validation sample. The ability of the threshold to predict satisfaction was evaluated with receiver operating characteristic (ROC) curve analysis. Patient subcohorts were stratified by age (>65 and ≤65 years) and sex.
Results: Three THA PASS thresholds of 0.77 (our newly defined threshold), 0.82, and 0.92 were validated in this study. The EQ-5D PASS threshold of 0.77 (area under the curve [AUC] = 0.816) best predicted satisfaction 1 year after THA. Subcohort analyses yielded comparable 1-year PASS thresholds for THA between age cohorts and between sex cohorts.
Conclusions: This study identifies PASS thresholds that best predict patient satisfaction 1 year following THA. Although the varied methodology and patient cohorts used to derive PASS values complicate the comparison of these thresholds, this analysis can help surgeons understand the level of health-related quality of life associated with patient satisfaction following THA.
Level Of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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http://dx.doi.org/10.2106/JBJS.20.00184 | DOI Listing |
Arthroscopy
December 2024
Department of Orthopedic Surgery, University of California San Francisco, San Francisco, CA, USA. Electronic address:
Purpose: To assess whether capsular closure during hip arthroscopy with periportal capsulotomy affects 2-year postoperative outcomes for femoroacetabular impingement syndrome (FAIS) patients without hypermobility.
Methods: A matched-cohort retrospective analysis of a single institutional database of patients who underwent hip arthroscopy with periportal capsulotomy for management of FAIS between 2014-2022 was performed. Study inclusion criteria consisted of FAIS patients who exhibited no signs of generalized ligamentous laxity (GLL) (Beighton score 0).
Foot Ankle Surg
December 2024
Department of Trauma Surgery, Orthopaedics and Plastic Surgery, University of Göttingen, Robert-Koch-Str. 40, Göttingen 37075, Germany. Electronic address:
Background: Free chatbots powered by large language models offer lateral ankle sprains (LAS) treatment recommendations but lack scientific validation.
Methods: The chatbots-Claude, Perplexity, and ChatGPT-were evaluated by comparing their responses to a questionnaire and their treatment algorithms against current clinical guidelines. Responses were graded on accuracy, conclusiveness, supplementary information, and incompleteness, and evaluated individually and collectively, with a 60 % pass threshold.
J Shoulder Elbow Surg
December 2024
Barnet and Chase Farm Hospitals, Royal Free London NHS Foundation Trust, London, UK.
Background: The optimal treatment of 3- and 4-part proximal humeral fractures in older adults remains controversial. This aim of this study was compare patient reported outcomes following reverse shoulder arthroplasty (RSA) or non-operative management in patients over 60 years old.
Methods: A retrospective review was undertaken of patients following 3- or 4-part proximal humeral fractures treated with RSA or non-operative treatment with minimum 2-year follow-up.
Background: Mid-term results following surgical hip dislocation (SHD) for healed slipped capital femoral epiphysis (SCFE) and Perthes-related deformities are limited. This study aimed to characterize patient-reported outcome measures [including rates of achieving the minimal clinically important difference (MCID) and patient-acceptable symptomatic state (PASS)], report survivorship free from conversion to arthroplasty, and identify risk factors associated with composite failure.
Methods: Twenty-seven patients (n=13 SCFE, n=14 Perthes) with minimum 2-year follow-up (mean 5.
Pediatrics
December 2024
Children's National Hospital, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
Critical congenital heart disease (CCHD) screening was added to the US Recommended Uniform Screening Panel in 2011 and adopted by all US states and territories by 2018. In addition to reviewing key developments in CCHD screening since the initial American Academy of Pediatrics (AAP) endorsement in 2011, this clinical report provides 3 updated recommendations. First, a new AAP algorithm has been endorsed for use in CCHD screening.
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