title: Can the pre-operative Western Ontario and McMaster score predict patient satisfaction following total hip arthroplasty?
abstract: In this study we evaluated whether pre-operative Western Ontario and McMaster Universities (WOMAC) osteoarthritis scores can predict satisfaction following total hip arthroplasty (THA). Prospective data for a cohort of patients undergoing THA from two large academic centres were collected, and pre-operative and one-year post-operative WOMAC scores and a 25-point satisfaction questionnaire were obtained for 446 patients. Satisfaction scores were dichotomised into either improvement or deterioration. Scatter plots and Spearman's rank correlation coefficient were used to describe the association between pre-operative WOMAC and one-year post-operative WOMAC scores and patient satisfaction. Satisfaction was compared using receiver operating characteristic (ROC) analysis against pre-operative, post-operative and δ WOMAC scores. We found no relationship between pre-operative WOMAC scores and one-year post-operative WOMAC or satisfaction scores, with Spearman's rank correlation coefficients of 0.16 and -0.05, respectively. The ROC analysis showed areas under the curve (AUC) of 0.54 (pre-operative WOMAC), 0.67 (post-operative WOMAC) and 0.43 (δ WOMAC), respectively, for an improvement in satisfaction. We conclude that the pre-operative WOMAC score does not predict the post-operative WOMAC score or patient satisfaction after THA, and that WOMAC scores can therefore not be used to prioritise patient care.
authors: Brighton and Sussex University Hospitals NHS Trust, Eastern Road, Brighton, BN25BE, UK.
authors: B A
authors: BA
authors: Rogers
authors: Hamilton General Hospital, McMaster University, Hamilton, Ontario, Canada.
authors: B
authors: B
authors: Alolabi
authors: Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's and The Rosie Hospitals, Cambridge CB2 0QQ, UK.
authors: A D
authors: AD
authors: Carrothers
authors: Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, M4N 3M5, Canada.
authors: H J
authors: HJ
authors: Kreder
authors: Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, M4N 3M5, Canada.
authors: R J
authors: RJ
authors: Jenkinson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D017060:Patient Satisfaction; D011446:Prospective Studies; D012372:ROC Curve
keywords: Hip replacement; Patient reported outcome measures; Patient satisfaction; WOMAC score