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Algorithm finds predictors of minimally clinically important differences after hip arthroscopy
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BOSTON — Predictors of failure to achieve a minimally clinically important difference following hip arthroscopy include mental health, symptom duration length, non-intra-articular hip related pain and preoperative intra-articular injections, according to a presentation at the American Orthopaedic Society for Sports Medicine Annual Meeting.
Jourdan M. Cancienne, MD, and colleagues identified 1,194 patients who underwent hip arthroscopy for femoroacetabular impingement. Predictive models were created to achieve a minimally clinically important difference (MCID) with regard to hip outcome score-activity of daily living (HOS-ADL), HOS-sport-specific measures (HOS-SS) and the modified Harris Hip Score (mHHS). The Lasso algorithm was used to decrease data to meaningful features and overfitting. Investigators performed receiver operating characteristic (ROC) analyses on each model. There were 57 independent features used for binary logistic regression analysis. The PatientQ was used to analyze data.
Investigators noted the MCID cutoffs used included the following: HOS-ADL=9.8; HOS-SS=14.4; and mHHS=9.14. Results showed 71.7% of patients with data entered in the algorithm met the HOS-ADL MCID cutoff, 73.3% met the HOS-SS MCID cutoff and 77.7% mHHS MCID cutoff. ROC curves demonstrated the area under the curve was more than 0.84.
Psychiatric history, symptom duration for 2 years, age 30 to 45 years, obesity, low baseline HOS-ADL and preoperative injection were among the predictors that did not achieve HOS-ADL MCID. Anxiety, depression, proximal hamstring pain with palpation, symptom duration greater than 2 years, low preoperative HOS-SS and preoperative injection were among the predictors that did not achieve the HOS-SS MCID. Presence of asthma, prior narcotic use, preoperative physical therapy, presence of snapping IT band, low preoperative mHHS and preoperative injection were the predictors that did not achieve the mHHS MCID.
Trochanteric pain sign and higher preoperative mHHS were predictors that did achieve the HOS-ADL MCID. History of running was a predictor for achievement of the HOS-SS MCID. Female gender and digestive health history were predictors for achievement of the mHHS MCID. – by Monica Jaramillo
Reference:
Cancienne JM, et al. Abstract 22. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 11-14, 2019; Boston.
Disclosure: Cancienne reports no relevant financial disclosures.