Article Text

This article has a correction. Please see:

Download PDFPDF

The Copenhagen Hip and Groin Outcome Score (HAGOS): development and validation according to the COSMIN checklist
  1. K Thorborg1,
  2. P Hölmich1,
  3. R Christensen2,3,
  4. J Petersen1,
  5. E M Roos2
  1. 1Arthroscopic Centre Amager, Amager Hospital, University of Copenhagen, Copenhagen, Denmark
  2. 2Research Unit for Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
  3. 3The Parker Institute: Musculoskeletal Statistics Unit, Copenhagen University Hospital, Frederiksberg, Copenhagen, Denmark
  1. Correspondence to Kristian Thorborg, Faculty of Health Sciences, Department of Orthopaedic Surgery, University of Copenhagen, DK-2300 Copenhagen S, Denmark; kristianthorborg{at}


Background Valid, reliable and responsive Patient-Reported Outcome (PRO) questionnaires for young to middle-aged, physically active individuals with hip and groin pain are lacking.

Objective To develop and validate a new PRO in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) recommendations for use in young to middle-aged, physically active patients with long-standing hip and/or groin pain.

Methods Preliminary patient interviews (content validity) included 25 patients. Validity, reliability and responsiveness were evaluated in a clinical study including 101 physically active patients (50 women); mean age 36 years, range 18–63 years.

Results The Copenhagen Hip and Groin Outcome Score (HAGOS) consists of six separate subscales assessing Pain, Symptoms, Physical function in daily living, Physical function in Sport and Recreation, Participation in Physical Activities and hip and/or groin-related Quality of Life (QOL). Test–retest reliability was substantial, with intraclass correlation coefficients ranging from 0.82 to 0.91 for the six subscales. The smallest detectable change ranged from 17.7 to 33.8 points at the individual level and from 2.7 to 5.2 points at the group level for the different subscales. Construct validity and responsiveness were confirmed with statistically significant correlation coefficients (0.37–0.73, p < 0.01) for convergent construct validity and for responsiveness from 0.56 to 0.69, p < 0.01.

Conclusion HAGOS has adequate measurement qualities for the assessment of symptoms, activity limitations, participation restrictions and QOL in physically active, young to middle-aged patients with long-standing hip and/or groin pain and is recommended for use in interventions where the patient's perspective and health-related QOL are of primary interest.

Trial registration NCT00716729

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding This work was funded by the Arthroscopic Centre Amager, Department of Orthopaedic Surgery, Amager University Hospital, Denmark, The Association of Danish Physiotherapists, Danish Regions, The Lundbeck Foundation and the Danish Rheumatism Association. RC is funded by grants from the OAK foundation.

  • Competing interests None.

  • Ethics approval The Danish ethics committee of the capital region approved the trial protocol (H-C-2007-0129), which was registered with the Danish Data Protection Agency (2007-41-1606).

  • Provenance and peer review Not commissioned; externally peer reviewed.

Linked Articles

  • Corrections
    BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine