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Why Are Patient-Reported Outcome Measures Important
for Patients with Osteoarthritis?
Because of the progressive, degenerative nature of OA, patient-reported outcome
measures (PROMs) play an important role in monitoring the course of the disease
over time and the effectiveness of treatment. This is particularly the case for younger
adults with OA, as the goal of management is to minimize symptoms, maximize
function, and prolong the time until joint replacement surgery is required. Therefore,
clinicians should use PROMs that can capture the natural course of the disease,
from early or mild OA to severe end-stage joint disease, and to joint replacement
and beyond. This will help to identify whether nonsurgical interventions are effec-
tive in managing symptoms, and may provide guidance when deciding whether a
patient with OA is suitable for total joint replacement [ 7 ].
PROMs are also useful for OA patients to:
- Direct the focus of clinical appointments, goal setting, and management plans
toward aspects that are of most concern to the patient - Empower the patient to monitor their own health profi le over time, by providing
benchmarks for their ideal health state, their peers, and normative cohorts - Provide a method of standardizing health status reporting, to allow pooling of
data from international cohorts (e.g., joint replacement registries) and detection
of clinical patterns that may impact on prognosis and treatment response
In parallel with our increased awareness that OA starts earlier than previously
thought, and underpinned by the last 20 years of intensive research, treatment for
OA has developed from joint replacement surgery for late stage disease to treatment
guidelines recommending education, exercise, and weight loss as fi rst-line treat-
ment, followed by pharmacological treatments and, fi nally, surgical treatments.
PROMs for use in OA should be able to pick up changes in symptoms, function, and
quality of life relating to contemporary OA treatment.
Selecting PROMs for Use with Patients with Osteoarthritis
When selecting PROMs for clinical use , it is important to consider attributes that
make a “good” PROM for patients with OA [ 8 ]:
- Is it easy to use in the clinical setting?
- Does it evaluate dimensions that are relevant for my OA patient? ( content
validity ) - Does it measure what it is intended to measure? ( construct validity )
- Can I trust that the PROM is detecting true change in my patient, and is free from
error? ( reliability ) - Is the PROM sensitive enough to detect real change in my patient’s condition?
( responsiveness, fl oor/ceiling effects )
N.J. Collins and E.M. Roos