Background:

The use of patient-reported outcomes (PROs) is common practice in the treatment of patients undergoing hip arthroscopy. While the prospective collection of PROs is preferred, retrospective collection involving patient recall is not uncommon and may be subject to bias.

Purpose:

To assess the presence of recall bias between prospectively and retrospectively collected PRO scores in hip arthroscopy.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Patients who underwent hip arthroscopy between 2015 and 2021 and provided preoperative baseline responses for the International Hip Outcome Tool–12 (iHOT-12), the Hip disability and Osteoarthritis Outcome Score–Physical Shortform (HOOS-PS), and the modified Harris Hip Score (mHHS) were eligible for recruitment. After surgery, participants were asked to complete a study-specific survey and the same preoperative PROs retrospectively. Agreements between the prospective and retrospective scores were assessed, and associations between score discrepancies and patient characteristics were identified.

Results:

A total of 94 patients (43.3% participation rate) completed study requirements and were included for analysis. The mean ± standard deviation duration of symptoms before surgery was 25.3 ± 32.8 months, and the mean duration to recall (from the day of surgery) for the PROs was 29.6 ± 22.2 months. The iHOT-12 (intraclass correlation coefficient [ICC], 0.409; P < .001) and HOOS-PS (ICC, 0.415; P < .001) scores had low agreement between prospectively and retrospectively collected scores. The mHHS showed moderate agreement (ICC, 0.598; P < .001). The mean scores for the iHOT-12 (41.4 ± 22.6 vs 34.6 ± 16.3; P < .01), HOOS-PS (29.7 ± 18.5 vs 40.9 ± 17.1; P < .001), and mHHS (62.7 ± 16.5 vs 54.5 ± 14.8; P < .001) were all significantly different prospectively versus retrospectively. The average changes in score for the iHOT-12, HOOS-PS, and mHHS were −6.8, 11.2, and −8.2, respectively. Duration to recall and female sex were predictors of the difference between prospectively and retrospectively collected iHOT-12 data, while no predictors were significant for the HOOS-PS or mHHS.

Conclusion:

The retrospective collection of PROs for hip arthroscopy procedures is subject to bias. On average, retrospective (recalled) PROs reflected worse pain/function than their prospectively recorded counterpoints; therefore, retrospective patient recall is an unreliable source of clinical data, and the prospective collection of iHOT-12, mHHS, and HOOS-PS data should be prioritized.

中文翻译：

---

回顾性收集髋关节镜检查中常见患者报告结果评分的偏倚

背景：

使用患者报告结果 (PROs) 是治疗接受髋关节镜检查的患者的常见做法。虽然 PROs 的前瞻性收集是首选，但涉及患者回忆的回顾性收集并不少见，并且可能存在偏见。

目的：

评估髋关节镜检查中前瞻性和回顾性收集的 PRO 评分之间是否存在回忆偏差。

学习规划：

队列研究；证据水平，2。

方法：

在 2015 年至 2021 年期间接受髋关节镜检查并提供国际髋关节结果工具-12 (iHOT-12)、髋关节残疾和骨关节炎结果评分 - 物理简表 (HOOS-PS) 以及改良的哈里斯髋关节评分的术前基线反应的患者(mHHS) 有资格被招募。手术后，参与者被要求回顾性地完成一项研究特定的调查和相同的术前 PROs。评估了前瞻性和回顾性评分之间的一致性，并确定了评分差异与患者特征之间的关联。

结果：

共有 94 名患者（43.3% 的参与率）完成了研究要求并被纳入分析。手术前症状的平均±标准差持续时间为 25.3±32.8 个月，PROs 的平均回忆持续时间（从手术当天开始）为 29.6±22.2 个月。iHOT-12（组内相关系数 [ICC]，0.409；P < .001）和 HOOS-PS（ICC，0.415；P < .001）得分在前瞻性和回顾性收集的得分之间的一致性较低。mHHS 显示出适度的一致性（ICC，0.598；P < .001）。iHOT-12（41.4 ± 22.6 vs 34.6 ± 16.3；P < .01）、HOOS-PS（29.7 ± 18.5 vs 40.9 ± 17.1；P < .001）和 mHHS（62.7 ± 16.5 vs 54.5 ± 14.8；P < .001）在前瞻性和回顾性方面均存在显着差异。iHOT-12、HOOS-PS 和 mHHS 的平均得分变化分别为 -6.8、11.2 和 -8.2。回忆持续时间和女性性别是前瞻性和回顾性收集的 iHOT-12 数据之间差异的预测因素，而 HOOS-PS 或 mHHS 没有显着预测因素。

结论：

用于髋关节镜手术的 PRO 的回顾性收集存在偏差。平均而言，回顾性（召回）PROs 反映的疼痛/功能比其前瞻性记录的对位点更差；因此，回顾性患者回忆是临床数据的不可靠来源，应优先考虑前瞻性收集 iHOT-12、mHHS 和 HOOS-PS 数据。