Hip Disability and Osteoarthritis Outcome Score: Difference between revisions

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'''Original Editor '''- [[User:Sanne Delporte|Sanne Delporte]]  
'''Original Editor '''- [[User:Sanne Delporte|Sanne Delporte]] as part of the [[Vrije Universiteit Brussel Evidence-based Practice Project|Vrije Universiteit Brussel's Evidence-based Practice project]]
 


'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}
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== Objective  ==
== Objective  ==
[[File:3D model expressing hip pain.jpg|thumb|Hip Pain]]
The [[hip]] disability and [[Hip Osteoarthritis|osteoarthritis]] outcome score (HOOS) is a questionnaire intended to be used to assess patient’s opinions about their hip and associated problems and to evaluate their symptoms and functional limitations during a therapeutic process <ref name="Nilsdotter et al">Nilsdotter AK, Lohmander LS, Klässbo M, Roos EM. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC161815/ Hip disability and osteoarthritis outcome score (HOOS)--validity and responsiveness in total hip replacement.] BMC Musculoskelet Disord. 2003 May 30;4:10</ref><ref name="HOOS">Koos.nu. What is the HOOS? Available from: http://www.koos.nu/ (Last accessed 08/09/2022)</ref>.


The hip disability and osteoarthritis outcome score (HOOS) is a questionnaire intended to be used to assess the patient’s opinion about their hip and associated problems and to evaluate symptoms and functional limitations related to the hip during a therapeutic process <ref name="Nilsdotter et al">NILSDOTTER A.K., LOHMANDER L.S., KLÄSSBO M., ROOS E.M., Hip disability and osteoarthritis outcome score (HOOS) – validity and responsiveness in total hip replacement, BMC Musculoskeletal Disord., May 2003, level of quality C</ref><ref name="HOOS">Pain symptoms ADL, Hip disability and osteoarthritis outcome score (HOOS). www.koos.nu (accessed 23 October)</ref>.&nbsp;Other questionnaires that can be presented are the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Algo Functional Index (AFI) and the Intermittent and Constant Osteoarthritis Pain Index (ICOAP) <ref name="KNGF-guideline">KNGF-guidline, osteoarthritis of the hip and knee. https://www.kngfrichtlijnen.nl/downloads/Osteoarthritis_of_the_hip_and_knee_V06-2010_PRL_ENG.pdf (accessed 23 October)</ref>. <br>  
Other versions of the HOOS have been developed based on the original 40-question questionnaire, for example, the HOOS PS (five items), HOOS JR (six items) and the HOOS-12 (see below).<ref>Putman S, Preda C, Girard J, Duhamel A, Migaud H. Mapping and crosswalk of the Oxford Hip Score and different versions of the Hip Disability and Osteoarthritis Outcome Score. Clinical Orthopaedics and Related Research®. 2021 Jul 1;479(7):1534-44. Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208448/ (accessed 7.12.2022)</ref>
 
The HOOS is an extension of the [[WOMAC Osteoarthritis Index|Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC]]) and [[Knee Injury and Osteoarthritis Outcome Score|Knee Injury and Osteoarthritis Outcome Score (KOOS)]] <ref name="Nilsdotter et al" />.<br>  


== Intended Population  ==
== Intended Population  ==
[[File:Hip Replacement.png|thumb|260x260px|HOOS, outcome measure for eg THR]]
This measuring instrument is recommended when there are symptoms of hip disability, with or without [[osteoarthritis]] (OA).<br>[[Hip Osteoarthritis|Hip osteoarthritis]] is a common, chronic musculoskeletal condition and a cause of [[Pain Assessment|pain]], functional disability and reduced quality of life <ref name="Poulsen">Poulsen E, Christensen HW, Roos EM, Vach W, Overgaard S, Hartvigsen J. [https://pubmed.ncbi.nlm.nih.gov/21542914/ Non-surgical treatment of hip osteoarthritis. Hip school, with or without the addition of manual therapy, in comparison to a minimal control intervention: protocol for a three-armed randomized clinical trial]. BMC Musculoskelet Disord. 2011 May 4;12:88</ref>.


This measuring instrument, judging functions and anatomical qualities combined with activities and participation, is recommended when there is talk of hip disability with or without osteoarthritis (OA).<br>Hip osteoarthritis is a common and chronic musculoskeletal condition and a cause of pain, functional disability and reduced quality of life <ref name="Poulsen">POULSEN E., Conservative treatment of hip osteoarthritis: effect of manual therapy and hip school on pain, function and quality of life – a single-blind randomized controlled trial (abstract), December 2009</ref>.<br>The HOOS is meant to be used over short and long-term intervals to assess changes induced by treatment (medication, physical therapy, operation) or over years due to the primary injury or post-traumatic osteoarthritis <ref name="HOOS" />.<br>
The HOOS is meant to be used over short and long-term intervals to assess changes over time or the effect of treatment ([[Medication and Older People|medication]], physiotherapy, [[Total Hip Replacement|operations]]) <ref name="HOOS" />.


== Method of Use  ==
Factors that should be considered when using the HOOS include age, sex, weight, geographic location, other [[Chronic Disease|chronic diseases]], history of an inactive hip problem, contralateral hip disease, and active [[knee]], [[Ankle Joint|ankle]], or [[Foot Anatomy|foot]] problems<ref>Yu RW, McLean JM, Bahl JS, Solomon LB. [https://pubmed.ncbi.nlm.nih.gov/30668884/ Hip Disability and Osteoarthritis Outcome Score and Western Ontario and McMaster Universities Osteoarthritis Index Values in Asymptomatic and Arthritic Cohorts.] Orthopedics. 2019 Mar 1;42(2):e216-e224.</ref><ref>Raja A, Jenkins A, Reams M, Horst PK. [https://pubmed.ncbi.nlm.nih.gov/30879873/ Normative Data of the Hip Disability and Osteoarthritis Outcome Score, JR in a Healthy United States Population.] J Arthroplasty. 2019 Jun;34(6):1122-1126.</ref><ref>Katakam A, Florissi IS, Colon Iban YE, Bragdon CR, Chen AF, Melnic CM, Bedair HS. [https://pubmed.ncbi.nlm.nih.gov/32773271/ Class III Obesity Increases Risk of Failure to Achieve the 1-Year Hip Disability and Osteoarthritis Outcome Score-Physical Function Short Form Minimal Clinically Important Difference Following Total Hip Arthroplasty.] J Arthroplasty. 2021 Jan;36(1):187-192</ref>.


The HOOS questionnaire is self-explanatory, user-friendly, patient-administered and takes 7 to 10 minutes to complete.<br>The outcome score consists of 40 items assessing 5 subscales. The 5 separate patient-relevant dimensions are Pain (P), Symptoms (S), Activity limitations daily living (ADL), Function in sport and recreation (SP) and hip related quality of life (QOL).<br>Pain (P) includes 10 items with a total score of 40 points, Symptoms (S) includes 5 items with a total score of 20, Activity limitations daily living (ADL) includes 17 items with a total score of 68 and finally Function in sport and recreation (SP) and hip related quality of life both include 4 items with a total score of 16 each.
== Implementation ==


To answer the questions, standardized answer options are given in 5 Likert-boxes with scores from 0 to 4 (no, mild, moderate, severe and extreme).<br>
The HOOS questionnaire is a patient-administered self-report questionnaire and takes 7 to 10 minutes to complete. It is designed to be self-explanatory and user-friendly<ref name="Nilsdotter et al" />. The HOOS includes 40 items with five possible responses, graded from 0 to 4 (0 points = worst possible score; 100 points = best possible score). Standardized answer options are given in 5 Likert boxes with scores from 0 to 4 (no, mild, moderate, severe and extreme) to answer the questions. The HOOS has five subcategories: 


To interpret the score, the outcome measure is transformed in a worst to best scale from 0 to 100, with 100 indicating no symptoms and 0 indicating extreme symptoms.<br>
# Pain (10 items with a total score of 40 points)
# Symptoms and stiffness (five items with a total score of 20)
# Activities of daily living (17 items with a total score of 68)
# Function in sports and recreational activities (four items with a total score of 16)
# Quality of life (four items with a total score of 16)


To calculate the total HOOS score the subscales need to be summed up, using following formula for all dimension.  
== HOOS 12 ==
The HOOS-12 is a 12-item measure derived from the original HOOS. HOOS-12 contains


100 – [(patient's score of the subscale x 100)/(total score of the subscale)]
* 4 HOOS Pain items,
* 4 HOOS Function (Activities of Daily Living and Sport/Recreation) items
* 4 HOOS Quality of Life (QOL) items.


The subscales can be plotted as a HOOS profile, by connecting the mean scores for all 5 dimensions with a line<ref name="Nilsdotter et al" /><ref name="HOOS" />. <br>  
HOOS-12 is easier to complete than the original HOOS. As with the full-length HOOS survey, HOOS12 is intended to elicit people’s opinions about the difficulties they experience due to problems with their hips. It covers aspects of pain, functional limitations and hip-related quality of life.<ref name=":2">KOOS What is HOOS 12? Available:http://www.koos.nu/hoos12userguide.pdf (accessed 7.12.2022)</ref>


== Evidence  ==
# The HOOS-12 is a reliable and valid alternative to HOOS in THR patients with moderate to severe OA and provided three domain-specific and summary hip impact scores with substantially reduced respondent burden.<ref>Gandek B, Roos EM, Franklin PD, Ware Jr JE. A 12-item short form of the Hip disability and Osteoarthritis Outcome Score (HOOS-12): tests of reliability, validity and responsiveness. Osteoarthritis and Cartilage. 2019 May 1;27(5):754-61.Available: https://www.oarsijournal.com/article/S1063-4584(18)31515-2/fulltext (accessed 7.12.2022)</ref>
# HOOS-12 scale scores are modified so 0 is the worst possible and 100 is the best possible, similar to the method used to score the original HOOS scales<ref name=":2" />. A HOOS-12 calculator is available at https://orthopowertools.com/HOOS12.


=== Reliability  ===
=== Results ===
Once the patient has completed the questionnaire, each subscale is calculated as a standardized score, using the following formula:


The Dutch hip disability and osteoarthritis outcome score questionnaire has a good internal consistency and reliability <ref name="De Groot et al">DE GROOT I.B., REIJMAN M., TERWEE C.B., BEIRMA-ZEINSTRA S.M.A., FAVEJEE M., ROOS E.M., VERHAAR J., Validation of the Dutch version of the hip disability and osteoarthritis outcome score, Osteoarthritis and cartilage, vol. 15 nr. 1, 2007, page. 104-109, level of quality C</ref>.<br>The HOOS score is entirely based on self-report of functional status and performance. This may be a disadvantage in comparison to instruments that include objective physical examination findings or an assessment of symptoms.<br>It is recommended to use the HOOS score as a tool to complete additional information <ref name="Martin et al">MARTIN R.L., PHILIPPON M.J., Evidence of validity for the hip outcome score in hip arthroscopy, The journal of arthroscopic and related surgery, vol. 23 nr. 8, August 2007, page. 822-826, level of quality B</ref>.<br>
* 100 – [(patient's score of the subscale x 100)/(total score of the subscale)]


=== Validity  ===
Each subscale will get a score of 0 to 100, with 0 indicating extreme symptoms and 100 indicating no symptoms. The subscales can be plotted as a HOOS profile, by connecting the mean scores for all 5 dimensions with a line<ref name="Nilsdotter et al" /><ref name="HOOS" />.


The construct validity is good with absence of floor and ceiling effects <ref name="De Groot et al" />.<br>The hip osteoarthritis outcome score is valid in a sample of subject at a mean of 3 years after hip arthroscopy and for patients with different stadia of hip OA <ref name="De Groot et al" /><ref name="Martin et al" />.<br>  
See this video for more information 
{{#ev:youtube|7jZJOaYborY|300}}<ref>Hoag  Health. Latest Advancements for Treating Hip Pain and Arthritis. Available from: http://www.youtube.com/watch?v=7jZJOaYborY [last accessed 19/01/2024]</ref>


=== Responsiveness ===
== Evidence ==
 
The HOOS has undergone psychometric testing with evaluating hip osteoarthritis assessment but needs further testing in different varieties of patients with other hip disabilities.
Thanks to the addition of two subscales, sport and recreation function (SP) and hip related quality of life (QOL), the HOOC shows a higher sensitivity and responsiveness, compared to the Western Ontario and McMaster Universities osteoarthritis index (WOMAC).<br>Patients younger than 66 years report higher responsiveness in all five subscales than patients older than 66 years <ref name="Nilsdotter et al" />.<br>
 
=== Miscellaneous  ===


The hip disability and osteoarthritis outcome score (HOOS) is an extension of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) <ref name="Nilsdotter et al" />.
Overall, the HOOS is a well-regarded measure for the evaluation of patients following a total hip replacement. The time required to complete the survey aside, it is a solid patient-reported [[Outcome Measures|outcome measure]] to consider<ref>HOOS Code technology Available:https://www.codetechnology.com/blog/hoos-hip-tool/ (accessed 7.12.2022)</ref>.  


The HOOS questionnaire is also useful compared with the [https://www.preventivehip.org/images/non_arthritic_hip_score.pdf Nonarthritic Hip Score] and the modified [[Harris Hip Score|Harris hip score]] (MHHS) <ref name="Martin et al" />.<br>  
It is recommended to use the HOOS in conjunction with other outcome measures<ref name="KNGF-guideline">KNGF Guideline. Osteoarthritis of the hip-knee. 2018. Available from: https://www.kngf2.nl/binaries/content/assets/kennisplatform/onbeveiligd/guidelines/artrose-heup-knie-2018-prl-en-toelichting-eng_def.pdf (Last accessed 08/09/2022)</ref>. It is useful compared with the [https://www.preventivehip.org/images/non_arthritic_hip_score.pdf Nonarthritic Hip Score] and the modified [[Harris Hip Score|Harris hip score]] (MHHS) <ref name="Martin et al">Martin RL, Philippon MJ. [https://pubmed.ncbi.nlm.nih.gov/17681202/ Evidence of validity for the hip outcome score in hip arthroscopy.] Arthroscopy. 2007 Aug;23(8):822-6.</ref>, and when used alongside the Patient-Specific Complaints Instrument, the [[Numeric Pain Rating Scale]] and the [[Six Minute Walk Test / 6 Minute Walk Test|Six Minute Walk Test]]<ref>van Doormaal MCM, Meerhoff GA, Vliet Vlieland TPM, Peter WF. [https://pubmed.ncbi.nlm.nih.gov/32643252/ A clinical practice guideline for physical therapy in patients with hip or knee osteoarthritis.] Musculoskeletal Care. 2020 Dec;18(4):575-595</ref>.


== Links  ==
== Links  ==
*[http://www.orthoscores.com/scorepages/hip_disability_osteoarthritis_outcome_score_hoos.html Hip Disability and Osteoarthritis Outcome Score]<br>
The HOOS survey does not require a license. To access the HOOS form, please visit [http://www.orthoscores.com/scorepages/hip_disability_osteoarthritis_outcome_score_hoos.html Hip Disability and Osteoarthritis Outcome Score]<br>
 
== References  ==
== References  ==


<references />  
<references />  


[[Category:Outcome_Measures]]
 
[[Category:Hip]]  
[[Category:Hip]]  
[[Category:Osteoarthritis]]  
[[Category:Osteoarthritis]]  
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[[Category:Vrije_Universiteit_Brussel_Project]]
[[Category:Vrije_Universiteit_Brussel_Project]]
[[Category:Older People/Geriatrics]]
[[Category:Older People/Geriatrics]]
[[Category:Outcome_Measures]]
[[Category:Hip - Outcome Measures]]
[[Category:Older People/Geriatrics - Outcome Measures]]
[[Category:Arthroplasty]]

Latest revision as of 14:50, 19 January 2024

Original Editor - Sanne Delporte as part of the Vrije Universiteit Brussel's Evidence-based Practice project


Top Contributors - Sanne Delporte, Lucinda hampton, Chloe Waller, Admin, Kim Jackson, Evan Thomas, Scott Buxton, WikiSysop, Uchechukwu Chukwuemeka, Bridgit A Finley and Lauren Lopez

Objective[edit | edit source]

Hip Pain

The hip disability and osteoarthritis outcome score (HOOS) is a questionnaire intended to be used to assess patient’s opinions about their hip and associated problems and to evaluate their symptoms and functional limitations during a therapeutic process [1][2].

Other versions of the HOOS have been developed based on the original 40-question questionnaire, for example, the HOOS PS (five items), HOOS JR (six items) and the HOOS-12 (see below).[3]

The HOOS is an extension of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) [1].

Intended Population[edit | edit source]

HOOS, outcome measure for eg THR

This measuring instrument is recommended when there are symptoms of hip disability, with or without osteoarthritis (OA).
Hip osteoarthritis is a common, chronic musculoskeletal condition and a cause of pain, functional disability and reduced quality of life [4].

The HOOS is meant to be used over short and long-term intervals to assess changes over time or the effect of treatment (medication, physiotherapy, operations) [2].

Factors that should be considered when using the HOOS include age, sex, weight, geographic location, other chronic diseases, history of an inactive hip problem, contralateral hip disease, and active knee, ankle, or foot problems[5][6][7].

Implementation[edit | edit source]

The HOOS questionnaire is a patient-administered self-report questionnaire and takes 7 to 10 minutes to complete. It is designed to be self-explanatory and user-friendly[1]. The HOOS includes 40 items with five possible responses, graded from 0 to 4 (0 points = worst possible score; 100 points = best possible score). Standardized answer options are given in 5 Likert boxes with scores from 0 to 4 (no, mild, moderate, severe and extreme) to answer the questions. The HOOS has five subcategories:

  1. Pain (10 items with a total score of 40 points)
  2. Symptoms and stiffness (five items with a total score of 20)
  3. Activities of daily living (17 items with a total score of 68)
  4. Function in sports and recreational activities (four items with a total score of 16)
  5. Quality of life (four items with a total score of 16)

HOOS 12[edit | edit source]

The HOOS-12 is a 12-item measure derived from the original HOOS. HOOS-12 contains

  • 4 HOOS Pain items,
  • 4 HOOS Function (Activities of Daily Living and Sport/Recreation) items
  • 4 HOOS Quality of Life (QOL) items.

HOOS-12 is easier to complete than the original HOOS. As with the full-length HOOS survey, HOOS12 is intended to elicit people’s opinions about the difficulties they experience due to problems with their hips. It covers aspects of pain, functional limitations and hip-related quality of life.[8]

  1. The HOOS-12 is a reliable and valid alternative to HOOS in THR patients with moderate to severe OA and provided three domain-specific and summary hip impact scores with substantially reduced respondent burden.[9]
  2. HOOS-12 scale scores are modified so 0 is the worst possible and 100 is the best possible, similar to the method used to score the original HOOS scales[8]. A HOOS-12 calculator is available at https://orthopowertools.com/HOOS12.

Results[edit | edit source]

Once the patient has completed the questionnaire, each subscale is calculated as a standardized score, using the following formula:

  • 100 – [(patient's score of the subscale x 100)/(total score of the subscale)]

Each subscale will get a score of 0 to 100, with 0 indicating extreme symptoms and 100 indicating no symptoms. The subscales can be plotted as a HOOS profile, by connecting the mean scores for all 5 dimensions with a line[1][2].

See this video for more information

[10]

Evidence[edit | edit source]

The HOOS has undergone psychometric testing with evaluating hip osteoarthritis assessment but needs further testing in different varieties of patients with other hip disabilities.

Overall, the HOOS is a well-regarded measure for the evaluation of patients following a total hip replacement. The time required to complete the survey aside, it is a solid patient-reported outcome measure to consider[11].

It is recommended to use the HOOS in conjunction with other outcome measures[12]. It is useful compared with the Nonarthritic Hip Score and the modified Harris hip score (MHHS) [13], and when used alongside the Patient-Specific Complaints Instrument, the Numeric Pain Rating Scale and the Six Minute Walk Test[14].

Links[edit | edit source]

The HOOS survey does not require a license. To access the HOOS form, please visit Hip Disability and Osteoarthritis Outcome Score

References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 1.3 Nilsdotter AK, Lohmander LS, Klässbo M, Roos EM. Hip disability and osteoarthritis outcome score (HOOS)--validity and responsiveness in total hip replacement. BMC Musculoskelet Disord. 2003 May 30;4:10
  2. ↑ 2.0 2.1 2.2 Koos.nu. What is the HOOS? Available from: http://www.koos.nu/ (Last accessed 08/09/2022)
  3. ↑ Putman S, Preda C, Girard J, Duhamel A, Migaud H. Mapping and crosswalk of the Oxford Hip Score and different versions of the Hip Disability and Osteoarthritis Outcome Score. Clinical Orthopaedics and Related Research®. 2021 Jul 1;479(7):1534-44. Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208448/ (accessed 7.12.2022)
  4. ↑ Poulsen E, Christensen HW, Roos EM, Vach W, Overgaard S, Hartvigsen J. Non-surgical treatment of hip osteoarthritis. Hip school, with or without the addition of manual therapy, in comparison to a minimal control intervention: protocol for a three-armed randomized clinical trial. BMC Musculoskelet Disord. 2011 May 4;12:88
  5. ↑ Yu RW, McLean JM, Bahl JS, Solomon LB. Hip Disability and Osteoarthritis Outcome Score and Western Ontario and McMaster Universities Osteoarthritis Index Values in Asymptomatic and Arthritic Cohorts. Orthopedics. 2019 Mar 1;42(2):e216-e224.
  6. ↑ Raja A, Jenkins A, Reams M, Horst PK. Normative Data of the Hip Disability and Osteoarthritis Outcome Score, JR in a Healthy United States Population. J Arthroplasty. 2019 Jun;34(6):1122-1126.
  7. ↑ Katakam A, Florissi IS, Colon Iban YE, Bragdon CR, Chen AF, Melnic CM, Bedair HS. Class III Obesity Increases Risk of Failure to Achieve the 1-Year Hip Disability and Osteoarthritis Outcome Score-Physical Function Short Form Minimal Clinically Important Difference Following Total Hip Arthroplasty. J Arthroplasty. 2021 Jan;36(1):187-192
  8. ↑ 8.0 8.1 KOOS What is HOOS 12? Available:http://www.koos.nu/hoos12userguide.pdf (accessed 7.12.2022)
  9. ↑ Gandek B, Roos EM, Franklin PD, Ware Jr JE. A 12-item short form of the Hip disability and Osteoarthritis Outcome Score (HOOS-12): tests of reliability, validity and responsiveness. Osteoarthritis and Cartilage. 2019 May 1;27(5):754-61.Available: https://www.oarsijournal.com/article/S1063-4584(18)31515-2/fulltext (accessed 7.12.2022)
  10. ↑ Hoag Health. Latest Advancements for Treating Hip Pain and Arthritis. Available from: http://www.youtube.com/watch?v=7jZJOaYborY [last accessed 19/01/2024]
  11. ↑ HOOS Code technology Available:https://www.codetechnology.com/blog/hoos-hip-tool/ (accessed 7.12.2022)
  12. ↑ KNGF Guideline. Osteoarthritis of the hip-knee. 2018. Available from: https://www.kngf2.nl/binaries/content/assets/kennisplatform/onbeveiligd/guidelines/artrose-heup-knie-2018-prl-en-toelichting-eng_def.pdf (Last accessed 08/09/2022)
  13. ↑ Martin RL, Philippon MJ. Evidence of validity for the hip outcome score in hip arthroscopy. Arthroscopy. 2007 Aug;23(8):822-6.
  14. ↑ van Doormaal MCM, Meerhoff GA, Vliet Vlieland TPM, Peter WF. A clinical practice guideline for physical therapy in patients with hip or knee osteoarthritis. Musculoskeletal Care. 2020 Dec;18(4):575-595
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