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Patient-Reported Outcome (PRO) questionnaires for young to middle-aged adults with hip and groin disability: a systematic review of the clinimetric evidence
  1. K Thorborg1,
  2. M Tijssen2,
  3. B Habets2,
  4. E M Bartels3,
  5. E M Roos4,
  6. J Kemp5,
  7. K M Crossley6,
  8. P Hölmich1
  1. 1Sports Orthopedic Research Centre—Copenhagen, Arthroscopic Centre Amager, Copenhagen University Hospital, Copenhagen, Denmark
  2. 2Sports Medical Centre Papendal, Arnhem, The Netherlands
  3. 3The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
  4. 4Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
  5. 5Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Australia
  6. 6School of Health and Rehabilitation Science, The University of Queensland, Brisbane, Australia
  1. Correspondence to Dr K Thorborg, Department of Orthopaedic Surgery, Amager Hospital, Faculty of Health Sciences, University of Copenhagen, Denmark, Italiensvej 1, Copenhagen S 2300, Denmark; kristianthorborg{at}


Background/aim To recommend Patient-Reported Outcome (PRO) questionnaires to measure hip and groin disability in young-aged to middle-aged adults.

Methods A systematic review was performed in June 2014. The methodological quality of the studies included was determined using the COnsensus-based Standards for the selection of health Measurement INstruments list (COSMIN) together with standardised evaluations of measurement properties of each PRO.

Results Twenty studies were included. Nine different questionnaires for patients with hip disability, and one for hip and groin disability, were identified. Hip And Groin Outcome Score (HAGOS), Hip Outcome Score (HOS), International Hip Outcome Tool-12 (IHOT-12) and IHOT-33 were the most thoroughly investigated PROs and studies including these PROs reported key aspects of the COSMIN checklist. HAGOS and IHOT-12 were based on studies with the least ratings of poor study methodology (23% and 31%, respectively), whereas IHOT-33 and HOS had a somewhat larger distribution (46%). These PROs all contain adequate measurement qualities for content validity (except HOS), test–retest reliability, construct validity, responsiveness and interpretability. No information or poor quality rating on methodological aspects made it impossible to fully evaluate the remaining PROs at present.

Conclusions HAGOS, HOS, IHOT-12 and IHOT-33 can be recommended for assessment of young-aged to middle-aged adults with pain related to the hip joint, undergoing non-surgical treatment or hip arthroscopy. At present, HAGOS is the only PRO also aimed for young-aged to middle-aged adults presenting with groin pain and is recommended for use in this population.

Trial registration number CRD42014009995.

  • Hip
  • Groin
  • Evidence based review
  • Sports medicine
  • Orthopaedics

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