Preoperative predictors of health-related quality of life changes (EQ-5D and EQ VAS) after total hip and knee replacement: a systematic review
Abstract Background Patient-reported outcomes are of ever-increasing importance in medical decision-making. The EQ-5D is one of the generic instruments measuring health-related quality of life (HRQoL) in arthroplasty. This review aimed to identify possible predictors of HRQoL changes for patients un...
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| Format: | Article |
| Language: | English |
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BMC
2022-01-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-021-04981-4 |
| _version_ | 1818332924400893952 |
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| author | Caroline Schatz Nina Klein Antonia Marx Peter Buschner |
| author_facet | Caroline Schatz Nina Klein Antonia Marx Peter Buschner |
| author_sort | Caroline Schatz |
| collection | DOAJ |
| description | Abstract Background Patient-reported outcomes are of ever-increasing importance in medical decision-making. The EQ-5D is one of the generic instruments measuring health-related quality of life (HRQoL) in arthroplasty. This review aimed to identify possible predictors of HRQoL changes for patients undergoing total knee replacements (TKR) or total hip replacements (THR). Methods A systematic literature review according to the PRISMA guidelines was conducted, searching several databases. Preoperative to postoperative HRQoL changes were evaluated in patients undergoing THR or TKR, using the EQ-5D visual analog scale (VAS) or the preference-based EQ-5D Index were evaluated. Articles were considered with prospectively or retrospectively collected data, as well as registry data, each with statistical analyses of patient-related factors. Results Eight hundred eighty-two articles were found, of which 21 studies met the inclusion criteria. Predictors were distinguished in alterable and non-alterable ones. The EQ-5D Index indicated a tendency towards beneficial improvements for patients with a high body mass index (BMI) (> 40) and no significant results for the VAS. Additionally, one study found that patient education and preoperative physiotherapy appeared to enhance HRQoL. Some evidence indicated that male gender was negatively associated with changes in the VAS and the EQ-5D Index, but one study reported the opposite. Changes in VAS and EQ-5D Index were lower for older patients, whereas a higher educational level seemed to be advantageous. A high Charnley class led to deteriorating changes in VAS, although a high Kellgren Lawrence classification was positively associated with the EQ-5D Index, in a limited number of studies. For all results, clinical relevance was calculated differently and mainly reported as uncertain or small. Conclusions The literature on this topic was weak and offers only limited guidance. Results for alterable predictors, such as the BMI, indicated valuable improvements for highly obese patients. Further, high-quality research is required to support medical decision-making. Level of evidence Level IV, according to the OCEBM Levels of Evidence Working Group. |
| first_indexed | 2024-12-13T13:43:28Z |
| format | Article |
| id | doaj.art-3b4c06a11f08455c9635a3f1d0266775 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-13T13:43:28Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-3b4c06a11f08455c9635a3f1d02667752022-12-21T23:43:31ZengBMCBMC Musculoskeletal Disorders1471-24742022-01-0123111210.1186/s12891-021-04981-4Preoperative predictors of health-related quality of life changes (EQ-5D and EQ VAS) after total hip and knee replacement: a systematic reviewCaroline Schatz0Nina Klein1Antonia Marx2Peter Buschner3Ludwig-Maximilians-Universität München, LMU Munich School of Management, Institute of Health Economics and Health Care ManagementHelmholtz Zentrum München, Institute of Health Economics and Health Care ManagementHelmholtz Zentrum München, Institute of Health Economics and Health Care ManagementKrankenhaus Barmherzige Brüder München, Akademisches Lehrkrankenhaus der Technischen Universität MünchenAbstract Background Patient-reported outcomes are of ever-increasing importance in medical decision-making. The EQ-5D is one of the generic instruments measuring health-related quality of life (HRQoL) in arthroplasty. This review aimed to identify possible predictors of HRQoL changes for patients undergoing total knee replacements (TKR) or total hip replacements (THR). Methods A systematic literature review according to the PRISMA guidelines was conducted, searching several databases. Preoperative to postoperative HRQoL changes were evaluated in patients undergoing THR or TKR, using the EQ-5D visual analog scale (VAS) or the preference-based EQ-5D Index were evaluated. Articles were considered with prospectively or retrospectively collected data, as well as registry data, each with statistical analyses of patient-related factors. Results Eight hundred eighty-two articles were found, of which 21 studies met the inclusion criteria. Predictors were distinguished in alterable and non-alterable ones. The EQ-5D Index indicated a tendency towards beneficial improvements for patients with a high body mass index (BMI) (> 40) and no significant results for the VAS. Additionally, one study found that patient education and preoperative physiotherapy appeared to enhance HRQoL. Some evidence indicated that male gender was negatively associated with changes in the VAS and the EQ-5D Index, but one study reported the opposite. Changes in VAS and EQ-5D Index were lower for older patients, whereas a higher educational level seemed to be advantageous. A high Charnley class led to deteriorating changes in VAS, although a high Kellgren Lawrence classification was positively associated with the EQ-5D Index, in a limited number of studies. For all results, clinical relevance was calculated differently and mainly reported as uncertain or small. Conclusions The literature on this topic was weak and offers only limited guidance. Results for alterable predictors, such as the BMI, indicated valuable improvements for highly obese patients. Further, high-quality research is required to support medical decision-making. Level of evidence Level IV, according to the OCEBM Levels of Evidence Working Group.https://doi.org/10.1186/s12891-021-04981-4PROMHealth-related quality of lifeEQ-5DHipKnee |
| spellingShingle | Caroline Schatz Nina Klein Antonia Marx Peter Buschner Preoperative predictors of health-related quality of life changes (EQ-5D and EQ VAS) after total hip and knee replacement: a systematic review BMC Musculoskeletal Disorders PROM Health-related quality of life EQ-5D Hip Knee |
| title | Preoperative predictors of health-related quality of life changes (EQ-5D and EQ VAS) after total hip and knee replacement: a systematic review |
| title_full | Preoperative predictors of health-related quality of life changes (EQ-5D and EQ VAS) after total hip and knee replacement: a systematic review |
| title_fullStr | Preoperative predictors of health-related quality of life changes (EQ-5D and EQ VAS) after total hip and knee replacement: a systematic review |
| title_full_unstemmed | Preoperative predictors of health-related quality of life changes (EQ-5D and EQ VAS) after total hip and knee replacement: a systematic review |
| title_short | Preoperative predictors of health-related quality of life changes (EQ-5D and EQ VAS) after total hip and knee replacement: a systematic review |
| title_sort | preoperative predictors of health related quality of life changes eq 5d and eq vas after total hip and knee replacement a systematic review |
| topic | PROM Health-related quality of life EQ-5D Hip Knee |
| url | https://doi.org/10.1186/s12891-021-04981-4 |
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