Application research of visual self-rating system for hip joint function evaluation

doi:10.3877/cma.j.issn.1674-134X.2024.03.004

Abstract

Abstract:

Objective

To design a visual hip joint function rating system presented through pictures and videos for self-evaluation by patients based on the Harris score, and to verify its feasibility and accuracy.

Methods

An observational randomized crossover design study was conducted on patients discharged from hospital after unilateral hip replacement or core decompression at Sun Yat-sen Memorial Hospital from January 2020 to December 2023. Severe senile dementia or other psychological diseases, and incompleted data were excluded. The consistency of the Harris score, simplified Harris score, and visual hip joint score were evaluated by analysis of variance, Kendall rank correlation analysis, and Bland-Altman plot. The feasibility of visual hip joint sore by patients was assessed through analysis of evaluation process time and response rate.

Results

Compared to the simplified Harris score, the visual hip joint score had a more concentrated distribution of scores within the 95% consistency limits (-4.25, 9.47). The visual hip joint score had lower misjudgment rate compared to the simplified Harris score (38% vs. 23%, χ²=4.309, P=0.038) in terms of grade assessment. The evaluation process time for the visual hip joint score was shorter than that for the Harris score(F=19.753, P<0.001). The satisfaction survey showed the highest satisfaction with the visual hip joint score(F=20.659, P<0.001).

Conclusions

The visual hip joint score for self-evaluation by patients is consistent and highly correlated with the Harris score. It provides more accurate grade assessment compared to the simplified Harris score previously used for self-evaluation by patients, and has good accessibility. It can meet the needs of accurate and convenient self-assessment by patients and better promote the development of remote follow-up.

Key words: Hip joint, Comparative study of curative effect, Data correlation, Patients reported outcome evaluations

Meiyi Chen, Yiyao Li, Mengyuan Zhang, Jie Xu, Ruofan Ma, Deng Li, Jing Gu. Application research of visual self-rating system for hip joint function evaluation[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2024, 18(03): 320-328.

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URL: https://zhgjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-134X.2024.03.004

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Figures/Tables 13

Figure 1 Comparison of items and presentation forms in three hip joint function assessments

Figure 2　Mild claudication　Figure 3　Moderate claudication　Figure 4　Severe claudication

Figure 5 Assessment of the degree of flexion deformity of the hip Note: Estimate the distance between the bed and the popliteal fossa in the supine position using daily objects (such as mineral water bottles), indicating the degree of flexion deformity of the hip (about 30°)

Figure 6 Assessment of limb shortening deformity Note: The difference in heel distance between two legs in supine neutral state was used to evaluate limb shortening deformity (three fingers about 3.2 cm)

Figure 7 Hip flexion was determined by lateral sitting posture

Figure 8 Assessment of hip abduction degree Note: In supine hip abduction, the distance difference between the knees is used to assess the degree of hip abduction (the length of A4 paper between the knees is about 30°)

Figure 9 Assessment of hip adduction range of motion Note: Supine position, lower limb cross assessment of hip adduction motion (cross and knee about 15° adduction)

Figure 10 Assessing the internal rotation angle of the hip in the position of calf cross-overability

Figure 11 Bland-Altman plot of Harris score and simplified Harris score Note: A - Harris score; B - Simplified Harris score

Figure 12 Bland-Altman plot of Harris score and visual hip joint score Note: A - Harris score; C - visual hip joint score

Figure 13 Sankey diagram of patient grade differences between three evaluation scores

Table 1 Correlation of grade assessment for three types of scores

量表 Evaluation methods	Harris评分Harris score		简版Harris评分Simplified Harris score		图示化髋关节评分Visual hip joint score
量表 Evaluation methods	r值	P值	r值	P值	r值	P值
Harris评分 Harris score	1.000	<0.001	0.805	<0.001	0.862	<0.001
简版Harris评分 Simplified Harris score	0.805	<0.001	1.000	<0.001	0.884	<0.001
图示化髋关节评分 Visual hip joint score	0.862	<0.001	0.884	<0.001	1.000	<0.001

Table 2 Satisfaction survey

量表 Evaluation methods	满意度 Satisfaction	题干可理解度 Question comprehensibility	选项可理解度 Option comprehensibility	填表时间 Filling time
Harris评分 Harris score	4.4± 1.3	-	-	6.2±1.5
简版Harris评分 Simplified Harris score	4.3 ± 1.3	4.4 ± 1.1	3.8 ± 1.4	2.1±0.8
图示化髋关节评分 Visual hip joint score	4.7 ± 1.5	4.4 ± 1.7	4.8 ± 1.5	3.2±1.8
统计值 Statistical values	F=20.659	t=0.232	t=4.699	F=19.753
P值	<0.001	>0.05	<0.001	<0.001

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