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. 2014 Mar 19;3(3):69-75.
doi: 10.1302/2046-3758.33.2000250. Print 2014.

Outcome assessment after hip fracture: is EQ-5D the answer?

N Parsons  1 , X L Griffin, J Achten, M L Costa
Affiliations

Outcome assessment after hip fracture: is EQ-5D the answer?

N Parsons et al. Bone Joint Res. .

Abstract

Objectives: To study the measurement properties of a joint specific patient reported outcome measure, a measure of capability and a general health-related quality of life (HRQOL) tool in a large cohort of patients with a hip fracture.

Methods: Responsiveness and associations between the Oxford Hip Score (a hip specific measure: OHS), ICEpop CAPability (a measure of capability in older people: ICECAP-O) and EuroQol EQ-5D (general health-related quality of life measure: EQ-5D) were assessed using data available from two large prospective studies. The three outcome measures were assessed concurrently at a number of fixed follow-up time-points in a consecutive sequence of patients, allowing direct assessment of change from baseline, inter-measure associations and validity using a range of statistical methods.

Results: ICECAP-O was not responsive to change. EQ-5D was responsive to change from baseline, with an estimated standardised effect size for the two datasets of 0.676 and 0.644 at six weeks and four weeks respectively; this was almost as responsive to change as OHS (1.14 at four weeks). EQ-5D correlated strongly with OHS; Pearson correlation coefficients were 0.74, 0.77 and 0.70 at baseline, four weeks and four months. EQ-5D is a moderately good predictor of death at 12 months following hip fracture. Furthermore, EQ-5D reported by proxies (relatives and carers) behaves similarly to self-reported scores.

Conclusions: Our findings suggest that a general HRQOL tool such as EQ-5D could be used to measure outcome for patients recovering from hip fracture, including those with cognitive impairment. Cite this article: Bone Joint Res 2014;3:69-75.

Keywords: EQ-5D; Oxford Hip Score; Fragility Fractures; Proximal Femur; ICECAP-O; Outcome assessment.

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Conflict of interest statement

ICMJE Conflict of Interest:None declared

Figures

Fig. 1
Fig. 1
Receiver operating characteristic (ROC) curves for WHiT EQ-5D at six weeks and subsequent death and revision within 12 months; data (solid) and smoothed curves (dashed)
Fig. 2
Fig. 2
Boxplots for WHiTE for EQ-5D at baseline, four weeks and four months for demented and non-demented patients; symbols (●) and bars show means and 95% confidence intervals
Fig. 3
Fig. 3
Scatter-plots between pair-wise combinations of EQ-5D, Oxford Hip Score (OHS) and ICECAP-O from WHiTE at baseline (top row), four weeks (middle row) and four months (bottom row); solid lines show linear regression fit, with 95% prediction intervals shown as dashed lines
See this image and copyright information in PMC

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