An investigation of the extended application of the Oxford Knee Score in research and clinical practice

<p>The Oxford Knee Score (OKS) is a popular single summary questionnaire developed to measure the effect of knee replacement surgery from the patients' perspective. There has been a recent interest in the use of the OKS in populations of patients and in roles it has not been originally de...

Full description

Bibliographic Details
Main Authors: Kristina, K, Kristina Knezevic Harris
Other Authors: David, B
Format: Thesis
Language:English
Published: 2014
Subjects:
_version_ 1797075880818769920
author Kristina, K
Kristina Knezevic Harris
author2 David, B
author_facet David, B
Kristina, K
Kristina Knezevic Harris
author_sort Kristina, K
collection OXFORD
description <p>The Oxford Knee Score (OKS) is a popular single summary questionnaire developed to measure the effect of knee replacement surgery from the patients' perspective. There has been a recent interest in the use of the OKS in populations of patients and in roles it has not been originally developed for. To date, no evidence has been provided about the measurement properties of the OKS when it is used outside the context or purpose for which it was originally designed.</p> <p>The general aim of this thesis is to investigate the measurement properties of the OKS when used in extended roles: a) within the population for which the OKS was originally intended and developed for (knee replacement) and, b) when applied on a different population, viz. patients undergoing non-operative treatment for knee osteoarthritis (OA).</p> <p>Four existing large-scale databases of patients undergoing knee replacement surgery and a database obtained from a prospective study on patients undergoing non-surgical management for knee OA were analyzed. The results demonstrate that: 1) it is possible to extract separate information on pain and functional disability from the OKS in a meaningful way (in the form of subscales). 2) For the first time, anchor-based Minimal Important Change (MIC) of 9 points and Minimal Important Difference (MID) of 5 points were established for joint replacement surgery. 3) The OKS demonstrated satisfactory evidence reliability, validity, responsiveness, and interpretability, when used in patients who are undergoing non-operative management for their knee OA. 4) Further evidence of validity was demonstrated by fitting the OKS to the Rasch model. 5) Lastly, it was demonstrated that thresholds can be applied on the OKS to distinguish between patients who consider their knee problem to be severe enough to warrant joint replacement surgery versus patients who do not. This supports the potential use of the OKS in decision making aids for secondary care referral.</p> <p>Overall the thesis provides critical evidence, not previously existing, to support the continued use, and extended use, of the OKS in orthopaedic medicine.</p>
first_indexed 2024-03-06T23:56:29Z
format Thesis
id oxford-uuid:74642889-0433-4ba1-9deb-19be9a9274fd
institution University of Oxford
language English
last_indexed 2024-03-06T23:56:29Z
publishDate 2014
record_format dspace
spelling oxford-uuid:74642889-0433-4ba1-9deb-19be9a9274fd2022-03-26T20:02:30ZAn investigation of the extended application of the Oxford Knee Score in research and clinical practiceThesishttp://purl.org/coar/resource_type/c_db06uuid:74642889-0433-4ba1-9deb-19be9a9274fdOrthopaedicsHealth Service ResearchPsychometricsPatient Reported OutcomesEnglishOxford University Research Archive - Valet2014Kristina, KKristina Knezevic HarrisDavid, BAndrew, PJill, D<p>The Oxford Knee Score (OKS) is a popular single summary questionnaire developed to measure the effect of knee replacement surgery from the patients' perspective. There has been a recent interest in the use of the OKS in populations of patients and in roles it has not been originally developed for. To date, no evidence has been provided about the measurement properties of the OKS when it is used outside the context or purpose for which it was originally designed.</p> <p>The general aim of this thesis is to investigate the measurement properties of the OKS when used in extended roles: a) within the population for which the OKS was originally intended and developed for (knee replacement) and, b) when applied on a different population, viz. patients undergoing non-operative treatment for knee osteoarthritis (OA).</p> <p>Four existing large-scale databases of patients undergoing knee replacement surgery and a database obtained from a prospective study on patients undergoing non-surgical management for knee OA were analyzed. The results demonstrate that: 1) it is possible to extract separate information on pain and functional disability from the OKS in a meaningful way (in the form of subscales). 2) For the first time, anchor-based Minimal Important Change (MIC) of 9 points and Minimal Important Difference (MID) of 5 points were established for joint replacement surgery. 3) The OKS demonstrated satisfactory evidence reliability, validity, responsiveness, and interpretability, when used in patients who are undergoing non-operative management for their knee OA. 4) Further evidence of validity was demonstrated by fitting the OKS to the Rasch model. 5) Lastly, it was demonstrated that thresholds can be applied on the OKS to distinguish between patients who consider their knee problem to be severe enough to warrant joint replacement surgery versus patients who do not. This supports the potential use of the OKS in decision making aids for secondary care referral.</p> <p>Overall the thesis provides critical evidence, not previously existing, to support the continued use, and extended use, of the OKS in orthopaedic medicine.</p>
spellingShingle Orthopaedics
Health Service Research
Psychometrics
Patient Reported Outcomes
Kristina, K
Kristina Knezevic Harris
An investigation of the extended application of the Oxford Knee Score in research and clinical practice
title An investigation of the extended application of the Oxford Knee Score in research and clinical practice
title_full An investigation of the extended application of the Oxford Knee Score in research and clinical practice
title_fullStr An investigation of the extended application of the Oxford Knee Score in research and clinical practice
title_full_unstemmed An investigation of the extended application of the Oxford Knee Score in research and clinical practice
title_short An investigation of the extended application of the Oxford Knee Score in research and clinical practice
title_sort investigation of the extended application of the oxford knee score in research and clinical practice
topic Orthopaedics
Health Service Research
Psychometrics
Patient Reported Outcomes
work_keys_str_mv AT kristinak aninvestigationoftheextendedapplicationoftheoxfordkneescoreinresearchandclinicalpractice
AT kristinaknezevicharris aninvestigationoftheextendedapplicationoftheoxfordkneescoreinresearchandclinicalpractice
AT kristinak investigationoftheextendedapplicationoftheoxfordkneescoreinresearchandclinicalpractice
AT kristinaknezevicharris investigationoftheextendedapplicationoftheoxfordkneescoreinresearchandclinicalpractice