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Knee osteoarthritis (OA) represents a heavy burden for patients and the society as a whole. The Oxford Knee Score (OKS) is a well known tool to assess the quality of life in patients with Knee OA. The purpose of this study was to analyze the psychometric properties of the Spanish version of the OKS, including its reliability, validity, and responsiveness.
Prospective observational study that included 397 patients diagnosed with knee OA according to the criterion of the American Rheumatism Association, which were recruited in 3 different Spanish regions. Their self-perceived health-related quality of life (HRQL) was assessed through 3 questionnaires: a generic one (the EQ-5D-5 L) and two specific ones adapted to Spanish (the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Oxford Knee Score (OKS). The follow-up period was 6 months, and the acceptability of the OKS was evaluated, together with its psychometric properties, presence of ceiling and floor effects, validity, reliability, and sensitivity to change.
The OKS was fully answered in 99.5% of cases, with no evidence of ceiling or floor effects. Its factor structure can be explained in a single dimension. Its discriminating capacity was very good compared to the groups generated by the WOMAC and the EQ-5D-5 L. The correlation of the OKS with the dimensions of the latter questionnaires was around 0.7. The test-retest reliability was excellent (ICC 0.993; CI 95%: 0.990-0.995) and so was its internal consistency (Cronbach’s α = 0.920). The effect size was 0.7 for moderate improvements in the HQRL, which is similar to that of the dimensions of the WOMAC and greater than for the EQ-5D-5 L. The minimum clinically significant difference that was detected by the questionnaire was 6.1 points, and the minimum detectable change was 4.4 points.
The Spanish-adapted version of the OKS is a useful, valid tool for assessing the perceived HRQL in patients suffering from knee OA, with psychometric properties similar to the WOMAC, and that allows for discriminating the patient’s condition at a particular moment as well as for appraising changes over time.
Electronic supplementary material
The online version of this article (10.1186/s12955-017-0761-2) contains supplementary material, which is available to authorized users.
Quality of life, Health status, Osteoarthritis, knee, Validation studies
Validation of the Spanish version of the Oxford knee score and assessment of its utility to characterize quality of life of patients suffering from knee osteoarthritis: a multicentric study
Jes?s Martin-Fernandez,corresponding author1,2,3 Roberto Garcia-Maroto,4 Fco Javier Sanchez-Jimenez,5 Alonso Bau-Gonzalez,6 Homero Valencia-Garcia,7 Blanca Gutierrez-Teira,8 Juan Carlos Arenaza,9,3 Lidia Garcia-Perez,10,3 Renata Linertova,10,3 and Amaia Bilbao11,3
This paper examines the Willingness to Pay (WTP) for a quality-adjusted life year (QALY) expressed by people who attended the healthcare system as well as the association of attitude towards risk and other personal characteristics with their response.
Health-state preferences, measured by EuroQol (EQ-5D-3L), were combined with WTP for recovering a perfect health state. WTP was assessed using close-ended, iterative bidding, contingent valuation method. Data on demographic and socioeconomic characteristics, as well as usage of health services by the subjects were collected. The attitude towards risk was evaluated by collecting risky behaviors data, by the subject’s self-evaluation, and through lottery games.
Six hundred and sixty two subjects participated and 449 stated a utility inferior to 1. WTP/QALY ratios varied significantly when payments with personal money (mean €10,119; median €673) or through taxes (mean €28,187; median €915) were suggested. Family income, area income, higher education level, greater use of healthcare services, and the number of co-inhabitants were associated with greater WTP/QALY ratios. Age and female gender were associated with lower WTP/QALY ratios. Risk inclination was independently associated with a greater WTP/QALY when “out of pocket” payments were suggested. Clear discrepancies were demonstrated between linearity and neutrality towards risk assumptions and experimental results.
WTP/QALY ratios vary noticeably based on demographic and socioeconomic characteristics of the subject, but also on their attitude towards risk. Knowing the expression of preferences by patients from this outcome measurement can be of interest for health service planning.
Economics, Willingness to pay, Quality-adjusted life year, Risk-taking, Contingent valuation, Primary care
Willingness to pay for a quality-adjusted life year: an evaluation of attitudes towards risk and preferences
Jesus Martin-Fernandez,corresponding author1 Elena Polentinos-Castro,2 Ma Isabel del Cura-Gonzalez,3 Gloria Ariza-Cardiel,4 Victor Abraira,5 Ana Isabel Gil-LaCruz,6 and Sonia Garcia-Perez7
Occupation was assessed as possible risk factors for prostate (PCa) and pancreatic cancer in a large Canadian worker cohort.
The Canadian Census Health and Environment Cohort (CanCHEC) was derived from linking the 1991 Canadian Census Cohort to the Canadian Cancer Database (1969-2010), Canadian Mortality Database (1991-2011), and Tax Summary Files (1981-2011). From the total sample of 1,931,110 persons, we identified and derived two samples of 28,610 men and 3,220 men and women with a past history of PCa and pancreatic cancer diagnoses, respectively. Cox proportional hazards models were used to estimate hazards ratios and 95% confidence intervals for occupation.
In Canadian men aged 24-64 years, the highest elevated risks of PCa were observed for library clerks (HR = 2.36, 95% CI:1.12-4.97), medical radiation technologists (HR = 1.66, 95% CI:1.04-2.65), telecommunications and line cable workers (HR = 1.62, 95% CI: 1.22-3.16) and commissioned police officers (HR = 1.54, 95% CI: 1.10-2.16. The highest elevated risk for pancreatic cancer were observed for commissioned police officers (HR = 4.34, 95% CI: 1.85-10.21), photographic and film processors (HR = 3.97, 95% CI:1.69-9.34), railway and motor transport labourers (HR = 3.94, 95% CI: 1.67-9.29), and computer engineers (HR = 3.82, 95%CI: 1.52-9.61).
These findings emphasize the need for further study of job-related exposures and the potential influence of non-occupational factors such as screening practices.
An examination of the association between lifetime history of prostate and pancreatic cancer diagnosis and occupation in a population sample of Canadians
Smriti Singh, Conceptualization, Formal analysis, Writing - original draft, Writing - review & editing,1 James Ted McDonald, Conceptualization, Data curation, Formal analysis, Funding acquisition, Methodology, Project administration, Validation, Writing - review & editing,2 Gabriela Ilie, Conceptualization, Supervision, Writing - original draft, Writing - review & editing,3,* and Anil Adisesh, Conceptualization, Data curation, Formal analysis, Methodology, Supervision, Writing - review & editing4