What clinimetric evidence exists for using hip-specific patient-reported outcome measures in pediatric hip impingement?

Abstract

Background: Patient-reported outcomes (PROs) are an increasingly popular research tool used to evaluate the outcomes of surgical intervention. If applied appropriately, they can be useful both for disease monitoring and as a method of assessing the efficacy of treatment. Many disorders can lead to impingement in children and adolescents, but it is not clear if any PROs have been validated to evaluate outcomes in these populations.

Questions/purposes: We performed a systematic review of the literature to answer the following research questions: (1) Which hip-specific PROs are used in pediatric populations with impingement? (2) What clinimetric evidence exists for the use of these specific PROs in this population?

Methods: We performed two systematic searches of three databases (Medline, EMBASE, and Ovid All EBM Reviews). The first search aimed to identify specific PROs that have been applied to pediatric impingement populations. The second search aimed to find clinimetric evaluations of the PROs from the first search in this population.

Results: We found six hip-specific PROs applied in pediatric impingement: Harris Hip Score, modified Harris Hip Score, Iowa Hip Score, Merle d'Aubigné Hip Score, Hip Outcome Score, and Non-arthritic Hip Score. However, we found no papers validating any of these PROs in this population. Furthermore, we found no papers validating any of these PROs in any pediatric population.

Conclusions: A number of adult PROs have been applied in pediatric impingement disorders without evidence of validation in any pediatric population. Further work to develop and validate a hip-specific pediatric PRO is required.

Fig. 1

The flowchart diagram shows the number citations at each stage for the first search strategy. Terms for children and adolescents, hip impingement and related disorders, and scores, surveys, and indices were used in the search (Table 1). EBM = evidence-based medicine.

Fig. 2A–B

The flowchart diagram shows the number of citations at each stage for the second search strategy. Terms for the specific PROs found in the first search were combined with terms for children and adolescents and terms for clinimetric properties and used in the second search (Table 1). The first flowchart (A) shows the results for the search when we included terms for hip impingement and related disorders. The second flowchart (B) shows the search results for only the combination of specific PROs, pediatric terms, and clinimetric properties with no terms for any specific hip pathology. EBM = evidence-based medicine.