Oxford knee score

Last updated

The Oxford Knee Score (OKS) is a Patient Reported Outcome questionnaire that was developed to specifically assess the patient's perspective of outcome following Total Knee Arthroplasty. The OKS has subsequently been validated for use in assessing other non-surgical therapies applied to those suffering from issues with the knee. [1] The OKS consists of twelve questions covering function and pain associated with the knee. It was designed and developed by researchers within the department of Public Health and Primary Health Care [2] at the University of Oxford in association with surgical colleagues at the Nuffield Orthopaedic Centre. [3] The benefit to this questionnaire is that it is short, practical, reliable, valid and sensitive to clinically important changes over time. [4]

Contents

The Oxford Knee Score is owned, managed and supported by Isis Outcomes, an activity within Isis Innovation Ltd, the Technology Transfer Company for the University of Oxford.

Score Evaluation

The original evaluation [5] of the Oxford Knee Score was as follows:

First, each of the 12 answers are  assigned the previously defined number of points. They range from 1 = least difficult to 5 = most difficult. The 12 ratings are then added together  to give a total score used to assess the patient. The possible total score ranges from 12 to 60 points. Here, a low score (e.g. 12 points) indicates good outcomes and vice versa.

Because of misunderstandings concerning this, the right holders proposed a different system where response points range from 0 to 4 with a total score range from 0 to 48. Here, a high score (e.g. 48) indicates satisfactory joint function and vice versa.

Both scoring systems remain valid. To avoid misinterpretation one should always show the scoring system used.

Related Research Articles

Sex reassignment therapy or medical transition is the medical aspect of gender transition, that is, modifying one's sex characteristics to better suit one's gender identity. It can consist of hormone therapy to alter secondary sex characteristics, sex reassignment surgery to alter primary sex characteristics, and other procedures altering appearance, such as permanent hair removal for trans women.

<span class="mw-page-title-main">Prothrombin time</span> Assay for evaluating the extrinsic pathway & common pathway of coagulation

The prothrombin time (PT) – along with its derived measures of prothrombin ratio (PR) and international normalized ratio (INR) – is an assay for evaluating the extrinsic pathway and common pathway of coagulation. This blood test is also called protime INR and PT/INR. They are used to determine the clotting tendency of blood, in such things as the measure of warfarin dosage, liver damage, and vitamin K status. PT measures the following coagulation factors: I (fibrinogen), II (prothrombin), V (proaccelerin), VII (proconvertin), and X.

Dual-eligible beneficiaries refers to those qualifying for both Medicare and Medicaid benefits. In the United States, approximately 9.2 million people are eligible for "dual" status. Dual-eligibles make up 14% of Medicaid enrollment, yet they are responsible for approximately 36% of Medicaid expenditures. Similarly, duals total 20% of Medicare enrollment, and spend 31% of Medicare dollars. Dual-eligibles are often in poorer health and require more care compared with other Medicare and Medicaid beneficiaries.

A pain scale measures a patient's pain intensity or other features. Pain scales are a common communication tool in medical contexts, and are used in a variety of medical settings. Pain scales are a necessity to assist with better assessment of pain and patient screening. Pain measurements help determine the severity, type, and duration of the pain, and are used to make an accurate diagnosis, determine a treatment plan, and evaluate the effectiveness of treatment. Accurately measuring pain is a necessity in medical settings, especially if the pain measurement is going to be used as a screening tool, either for potential diseases or medical problems, or as a type of triage to determine urgency of one patient over another. Pain scales are based on trust, cartoons (behavioral), or imaginary data, and are available for neonates, infants, children, adolescents, adults, seniors, and persons whose communication is impaired. Pain assessments are often regarded as "the 5th Vital Sign".

<span class="mw-page-title-main">Knee replacement</span> Surgical procedure

Knee replacement, also known as knee arthroplasty, is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability, most commonly offered when joint pain is not diminished by conservative sources and also for other knee diseases such as rheumatoid arthritis and psoriatic arthritis. In patients with severe deformity from advanced rheumatoid arthritis, trauma, or long-standing osteoarthritis, the surgery may be more complicated and carry higher risk. Osteoporosis does not typically cause knee pain, deformity, or inflammation and is not a reason to perform knee replacement.

In the healthcare industry, pay for performance (P4P), also known as "value-based purchasing", is a payment model that offers financial incentives to physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures. Clinical outcomes, such as longer survival, are difficult to measure, so pay for performance systems usually evaluate process quality and efficiency, such as measuring blood pressure, lowering blood pressure, or counseling patients to stop smoking. This model also penalizes health care providers for poor outcomes, medical errors, or increased costs. Integrated delivery systems where insurers and providers share in the cost are intended to help align incentives for value-based care.

A patient-reported outcome (PRO) is a health outcome directly reported by the patient who experienced it. It stands in contrast to an outcome reported by someone else, such as a physician-reported outcome, a nurse-reported outcome, and so on. PRO methods, such as questionnaires, are used in clinical trials or other clinical settings, to help better understand a treatment's efficacy or effectiveness. The use of digitized PROs, or electronic patient-reported outcomes (ePROs), is on the rise in today's health research setting.

Ankle replacement, or ankle arthroplasty, is a surgical procedure to replace the damaged articular surfaces of the human ankle joint with prosthetic components. This procedure is becoming the treatment of choice for patients requiring arthroplasty, replacing the conventional use of arthrodesis, i.e. fusion of the bones. The restoration of range of motion is the key feature in favor of ankle replacement with respect to arthrodesis. However, clinical evidence of the superiority of the former has only been demonstrated for particular isolated implant designs.

Linguistic validation is the process of investigating the reliability, conceptual equivalence, and content validity of translations of patient-reported outcome (PRO) measures.

The Patient Health Questionnaire (PHQ) is a multiple-choice self-report inventory that is used as a screening and diagnostic tool for mental health disorders of depression, anxiety, alcohol, eating, and somatoform disorders. It is the self-report version of the Primary Care Evaluation of Mental Disorders (PRIME-MD), a diagnostic tool developed in the mid-1990s by Pfizer Inc. The length of the original assessment limited its feasibility; consequently, a shorter version, consisting of 11 multi-part questions - the Patient Health Questionnaire was developed and validated.

The Diabetes Health Profile (DHP) is a diabetes-specific patient reported outcome measure (PROM) developed to evaluate the health-related quality of life (HRQoL) of people living with Type 1 and Type 2 diabetes aged 16 years and older. It has been used in community surveys, research studies, clinical trials, and educational interventions both in Europe and completed globally by more than 10,000 patients. The DHP was the diabetes-specific PROM selected by the UK Department of Health for their Long Terms Conditions PROM Pilot Study being carried out by Oxford University.

Andrew Jonathan Carr is a British surgeon and has been the sixth Nuffield Professor of Orthopaedics and head of the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences at the University of Oxford since 2001.

<span class="mw-page-title-main">Nebraska Orthopaedic Hospital</span> Hospital in Nebraska, United States

Nebraska Orthopaedic Hospital is the Omaha, Nebraska region's first hospital dedicated to the complete care and treatment of orthopaedic patients. The hospital is licensed as an acute care hospital by the State of Nebraska and fully accredited by The Joint Commission. OrthoNebraska's legal name is Nebraska Orthopaedic Hospital, LLC. OrthoNebraska has also obtained Disease Specific Care Certification by the Joint Commission for both total hip and total knee replacement—the only hospital in Nebraska to hold this level of certification. The hospital is also certified by the Centers for Medicare and Medicaid Services (CMS), and is therefore able to provide care for individuals who participate in those government sponsored programs.


The Oxford Hip Score (OHS) is a standard patient-reported outcome (PRO) measure, or PROM, developed to assess function and pain in patients undergoing total hip replacement (THR) surgery, particularly in the context of clinical trials. The OHS has also been used for the assessment of patient outcomes, including physical therapy, and use of joint supplements(disease specific and general health measure are two other outcome measures)

Health care quality is a level of value provided by any health care resource, as determined by some measurement. As with quality in other fields, it is an assessment of whether something is good enough and whether it is suitable for its purpose. The goal of health care is to provide medical resources of high quality to all who need them; that is, to ensure good quality of life, cure illnesses when possible, to extend life expectancy, and so on. Researchers use a variety of quality measures to attempt to determine health care quality, including counts of a therapy's reduction or lessening of diseases identified by medical diagnosis, a decrease in the number of risk factors which people have following preventive care, or a survey of health indicators in a population who are accessing certain kinds of care.

The Quality of Well-Being Scale (QWB) is a general health quality of life questionnaire which measures overall status and well-being over the previous three days in four areas: physical activities, social activities, mobility, and symptom/problem complexes.

EQ-5D is a standardised measure of health-related quality of life developed by the EuroQol Group to provide a simple, generic questionnaire for use in clinical and economic appraisal and population health surveys. EQ-5D assesses health status in terms of five dimensions of health and is considered a ‘generic’ questionnaire because these dimensions are not specific to any one patient group or health condition. EQ-5D can also be referred to as a patient-reported outcome (PRO) measure, because patients can complete the questionnaire themselves to provide information about their current health status and how this changes over time. ‘EQ-5D’ is not an abbreviation and is the correct term to use when referring to the instrument in general.

Functional Assessment of Cancer Therapy - General (FACT-G) is a patient-reported outcome measure used to assess health-related quality of life in patients undergoing cancer therapy. The FACT-G is the original questionnaire that led to the development of the larger Functional Assessment of Chronic Illness Therapy (FACIT) collection of quality of life instruments. The survey assesses the impacts of cancer therapy in four domains: physical, social/family, emotional, and functional. The FACT-G is also offered with additional questions measuring cancer-specific factors that may affect quality of life, leading to the creation of the Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N), the Functional Assessment of Cancer Therapy - Lung (FACT-L), and 18 others.

The 9-question Patient Health Questionnaire (PHQ-9) is a diagnostic tool introduced in 2001 to screen adult patients in a primary care setting for the presence and severity of depression. It rates depression based on the self-administered Patient Health Questionnaire (PHQ). The PHQ is part of Pfizer's larger suite of trademarked products, called the Primary Care Evaluation of Mental Disorders (PRIME-MD). The PHQ-9 takes less than 3 minutes to complete and simply scores each of the 9 DSM-IV criteria for depression based on the mood module from the original PRIME-MD. Primary care providers frequently use the PHQ-9 to screen for depression in patients.

References

  1. Xie F, Ye H, Zhang Y, Liu X, Lei T, Li SC (2011). "Extension from inpatients to outpatients: validity and reliability of the Oxford Knee Score in measuring health outcomes in patients with knee osteoarthritis". Int J Rheum Dis. 14 (2): 206–10. doi:10.1111/j.1756-185X.2010.01580.x. PMID   21518321. S2CID   6498018.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  2. Department of Public Health and Primary Health Care
  3. Nuffield Orthopaedic Centre
  4. Dawson, J; Fitzpatrick R; Murray D; Carr A (January 1998). "Questionnaire on the perceptions of patients about total knee replacement". Journal of Bone and Joint Surgery. 80 (1): 63–69. doi:10.1302/0301-620X.80B1.7859. PMID   9460955.
  5. "Oxford Knee Score • heartbeat medical | Patient Reported Outcome Measures". heartbeat medical | Patient Reported Outcome Measures. Retrieved 2020-07-29.