title: Outcome assessment after hip fracture: is EQ-5D the answer?
abstract: OBJECTIVE
  To study the measurement properties of a joint specific patient reported outcome measure, a measure of capability and a general health-related quality of life (HRQOL) tool in a large cohort of patients with a hip fracture.
  
  
  METHODS
  Responsiveness and associations between the Oxford Hip Score (a hip specific measure: OHS), ICEpop CAPability (a measure of capability in older people: ICECAP-O) and EuroQol EQ-5D (general health-related quality of life measure: EQ-5D) were assessed using data available from two large prospective studies. The three outcome measures were assessed concurrently at a number of fixed follow-up time-points in a consecutive sequence of patients, allowing direct assessment of change from baseline, inter-measure associations and validity using a range of statistical methods.
  
  
  RESULTS
  ICECAP-O was not responsive to change. EQ-5D was responsive to change from baseline, with an estimated standardised effect size for the two datasets of 0.676 and 0.644 at six weeks and four weeks respectively; this was almost as responsive to change as OHS (1.14 at four weeks). EQ-5D correlated strongly with OHS; Pearson correlation coefficients were 0.74, 0.77 and 0.70 at baseline, four weeks and four months. EQ-5D is a moderately good predictor of death at 12 months following hip fracture. Furthermore, EQ-5D reported by proxies (relatives and carers) behaves similarly to self-reported scores.
  
  
  CONCLUSIONS
  Our findings suggest that a general HRQOL tool such as EQ-5D could be used to measure outcome for patients recovering from hip fracture, including those with cognitive impairment. Cite this article: Bone Joint Res 2014;3:69-75.
authors.affiliation: University of Warwick, Statisticsand Epidemiology, Warwick Medical School, Coventry, CV47AL, UK.
authors.forename: N
authors.initials: N
authors.lastname: Parsons
authors.forename: X L
authors.initials: XL
authors.lastname: Griffin
authors.forename: J
authors.initials: J
authors.lastname: Achten
authors.forename: M L
authors.initials: ML
authors.lastname: Costa
keywords: EQ-5D; Oxford Hip Score; Fragility Fractures; Proximal Femur; ICECAP-O; Outcome assessment