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Patient-reported outcome measures for hip-related pain: a review of the available evidence and a consensus statement from the International Hip-related Pain Research Network, Zurich 2018
  1. Franco M Impellizzeri1,
  2. Denise M Jones2,
  3. Damian Griffin3,
  4. Marcie Harris-Hayes4,5,
  5. Kristian Thorborg6,
  6. Kay M Crossley2,
  7. Michael P Reiman7,
  8. Mark James Scholes2,
  9. Eva Ageberg8,
  10. Rintje Agricola9,
  11. Mario Bizzini10,
  12. Nancy Bloom11,12,
  13. Nicola C Casartelli10,13,
  14. Laura E Diamond14,
  15. Hendrik Paulus Dijkstra15,16,
  16. Stephanie Di Stasi17,
  17. Michael Drew18,
  18. Daniel Jonah Friedman19,
  19. Matthew Freke20,
  20. Boris Gojanovic21,22,
  21. Joshua J Heerey2,
  22. Per Hölmich6,
  23. Michael A Hunt23,
  24. Lasse Ishøi6,
  25. Ara Kassarjian24,25,
  26. Matthew King2,
  27. Peter R Lawrenson26,
  28. Michael Leunig27,
  29. Cara L Lewis28,
  30. Kristian Marstrand Warholm29,
  31. Sue Mayes2,30,
  32. Håvard Moksnes31,
  33. Andrea Britt Mosler2,
  34. May Arna Risberg32,33,
  35. Adam Semciw2,
  36. Andreas Serner34,
  37. Pim van Klij9,
  38. Tobias Wörner35,
  39. Joanne Kemp2
  1. 1Human Performance Research Centre, Faculty of Health, University of Technology Sydney (UTS), Sydney, New South Wales, Australia
  2. 2La Trobe Sports Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia, Bundoora, Victoria, Australia
  3. 3Warwick Orthopaedics, University of Warwick, Coventry, Warwick, UK
  4. 4Physical Therapy, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
  5. 5Orthopaedic Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
  6. 6Sports Orthopedic Research Center - Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre Hospital, Hvidovre, Copenhagen, Denmark
  7. 7Orthopedic Surgery, Duke University Medical Center, Durham, North Carolina, USA
  8. 8Department of Health Sciences, Lund University, Lund, Sweden
  9. 9Department of Orthopaedic Surgery, University Medical Centre Rotterdam, Rotterdam, The Netherlands
  10. 10Human Performance Lab, Schulthess Clinic, Zurich, Switzerland
  11. 11Physical Therapy, Washington University, St Louis, Missouri, USA
  12. 12Orthopaedic Surgery, Washington University School of Medicine in Saint Louis, Saint Louis, Missouri, USA
  13. 13Laboratory of Exercise and Health, ETH Zurich, Schwerzenbach, Switzerland
  14. 14Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland Griffith University, School of Allied Health Sciences, Gold Coast, Queensland, Australia
  15. 15Aspetar Sports Medicine Hospital, Doha, Qatar
  16. 16Department for Continuing Education, University of Oxford, Oxford, UK
  17. 17Division of Physical Therapy, The Ohio State University, Columbus, Ohio, USA
  18. 18University of Canberra Research into Sport and Exercise (UCRISE), University of Canberra, Canberra, Australian Capital Territory, Australia
  19. 19Monash School of Medicine, Monash University, Melbourne, Victoria, Australia
  20. 20School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
  21. 21Swiss Olympic Medical Center, Hopital de la Tour, Meyrin, Geneva, Switzerland
  22. 22SportAdo consultation, University Hospital of Lausanne (CHUV) Multidisciplinary Unit of Adolescent Health, Lausanne, Switzerland
  23. 23Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
  24. 24Musculoskeletal Radiology, Corades, LLC, Brookline, Massachusetts, USA
  25. 25Musculoskeletal Radiology, Elite Sports Imaging, SL, Madrid, Spain
  26. 26School of Health & Rehabilitation Sciences, University of Queensland, St Lucia, Queensland, Australia
  27. 27Department of Orthopaedics, Schulthess Klinik, Zürich, Switzerland
  28. 28Physical Therapy & Athletic Training, Boston University, Boston, Massachusetts, USA
  29. 29Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
  30. 30The Australian Ballet, Southbank, Victoria, Australia
  31. 31Oslo Sports Trauma Research Center, Oslo, Norway
  32. 32Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
  33. 33Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway
  34. 34Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  35. 35Department of Health Sciences, Lunds University, Lund, Sweden
  1. Correspondence to Professor Franco M Impellizzeri, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia; franco.impellizzeri{at}


Hip-related pain is a well-recognised complaint among active young and middle-aged active adults. People experiencing hip-related disorders commonly report pain and reduced functional capacity, including difficulties in executing activities of daily living. Patient-reported outcome measures (PROMs) are essential to accurately examine and compare the effects of different treatments on disability in those with hip pain. In November 2018, 38 researchers and clinicians working in the field of hip-related pain met in Zurich, Switzerland for the first International Hip-related Pain Research Network meeting. Prior to the meeting, evidence summaries were developed relating to four prioritised themes. This paper discusses the available evidence and consensus process from which recommendations were made regarding the appropriate use of PROMs to assess disability in young and middle-aged active adults with hip-related pain. Our process to gain consensus had five steps: (1) systematic review of systematic reviews; (2) preliminary discussion within the working group; (3) update of the more recent high-quality systematic review and examination of the psychometric properties of PROMs according to established guidelines; (4) formulation of the recommendations considering the limitations of the PROMs derived from the examination of their quality; and (5) voting and consensus. Out of 102 articles retrieved, 6 systematic reviews were selected and assessed for quality according to AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews). Two showed moderate quality. We then updated the most recent review. The updated literature search resulted in 10 additional studies that were included in the qualitative synthesis. The recommendations based on evidence summary and PROMs limitations were presented at the consensus meeting. The group makes the following recommendations: (1) the Hip and Groin Outcome Score (HAGOS) and the International Hip Outcome Tool (iHOT) instruments (long and reduced versions) are the most appropriate PROMs to use in young and middle-aged active adults with hip-related pain; (2) more research is needed into the utility of the HAGOS and the iHOT instruments in a non-surgical treatment context; and (3) generic quality of life measures such as the EuroQoL-5 Dimension Questionnaire and the Short Form Health Survey-36 may add value for researchers and clinicians in this field. We conclude that as none of the instruments shows acceptable quality across various psychometric properties, more methods studies are needed to further evaluate the validity of these PROMS—the HAGOS and iHOT—as well as the other (currently not recommended) PROMS.

  • hip
  • questionnaire
  • consensus
  • quality of life
  • groin
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  • Contributors All authors were fully involved in the preparation and completion of the manuscript. Each author has read and concurs with the content of this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests Two members of the panel (DG, KT) belong to the research groups developing the instruments recommended in the current consensus. However, they did not take part in the literature update and the quality scoring of the studies and the psychometric properties.

  • Patient consent for publication Not required.

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

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