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Validity, Reliability And Responsiveness Of Patient-Reported Outcome Questionnaires When Assessing Hip And Groin Disability: A Systematic Review
  1. Kristian Thorborg (kristianthorborg{at}
  1. Department of Orthopaedic Surgery, Amager Hospital, Denmark
    1. Ewa M Roos (eroos{at}
    1. Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
      1. Else Marie Bartels (emb{at}
      1. Parker Institute, Frederiksberg Hospital, Denmark
        1. Jesper Petersen (jesper.petersen{at}
        1. Department of Orthopaedic Surgery, Amager Hospital, Denmark
          1. Per Hölmich (per.holmich{at}
          1. Department of Orthopaedic Surgery, Amager Hospital, Denmark


            Background: Novel treatment interventions are advancing rapidly in the management of hip and groin disability, in the physically active young to middle-aged population.

            Objective: To recommend the most suitable patient-reported outcome questionnaires for the assessment of hip and groin disability based on a systematic review of evidence of validity, reliability and responsiveness of these instruments.

            Methods: MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, PsycINFO, SportsDiscus and Web of Science, were all searched up to January 2009. Two reviewers independently rated measurement properties of the patient-reported outcome questionnaires in the included studies, according to a standardised criteria list.

            Results: The computerized search identified 2737 publications. Forty-one publications investigating measurement properties of patient-reported outcome questionnaires assessing hip or groin disability were included in the study. Twelve different questionnaires designed for patients with hip disability and one questionnaire for patients with groin disability were identified. Hip dysfunction and Osteoarthritis Outcome Score (HOOS) contains adequate measurement qualities to evaluate patients with hip osteoarthritis or total hip replacement. Hip Outcome Score (HOS) is the best available questionnaire for evaluating hip arthroscopy, but the Inguinal Pain Questionnaire (IPQ), the only identified questionnaire evaluating groin disability, does not contain adequate measurement qualities.

            Conclusions: HOOS is recommended for evaluating patients with hip osteoarthritis undergoing non-surgical treatment and surgical interventions such as total hip replacement. HOS is recommended for evaluating patients undergoing hip arthroscopy. Current and new patient-reported outcome questionnaires should also be evaluated in younger patients (age<50) with hip and/or groin disability, including both surgical and non-surgical patients.

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