How Well is the Hip Rehab Working for the Patient? Consider Measuring it

What is HOOS-12?

HOOS (Hip disability and Osteoarthritis Outcome Score) was developed to assess an individuals perception of the impact of their hip problem. However, with 40 questions the HOOS can be a little impractical, and so the short form, HOOS-12, was developed. HOOS-12 can be used among individuals with hip complaints, with or without hip osteoarthritis (OA).

Average completion time of the HOOS-12 is only a few minutes compared to the average 10 minutes completing the HOOS.

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When using HOOS-12 instead of the full HOOS the respondent burden decreases by 70%

It covers 3 domains:

• Pain
• Function/ADL
• Quality of Life (QOL)

It also allows separate scoring for each domain providing useful insight into the patient's experiences and domains most affected.

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When and how to use HOOS-12?

HOOS-12 can be used among individuals with hip complaints, with or without hip osteoarthritis (OA). In clinical practice HOOS-12 can be used to monitor the impact of hip issues within a population, e.g. to assess the effectiveness of a specific hip rehab program your clinic provides. In addition, it can be used to monitor how individual patients are doing and responding to treatment.

HOOS-12 has been validated in adults (mean age 65) with hip OA who underwent a total hip replacement (THR). It was found to have satisfactory reliability (ability to produce consistent results), and similar validity (measures what is intended) and responsiveness (ability to detect change) to the full HOOS.

When used post-THR a ceiling effect was identified, which means that more than 15% of patients scored the best possible score. Lowest ceiling effect was seen when the summary impact score was used (17 % of the patients got the best possible score). In summary, following THR many individuals are likely to score close to, or at the upper limit, making it difficult to detect further improvement especially if using domain-specific scores. It is therefore recommended that, if the HOOS-12 is used among younger, more active populations, then the ‘sports and recreation’ domain contained in the 40-question HOOS is used in conjunction with the HOOS-12. Note that the above mentioned measurement properties have not to our knowledge yet been established for the HOOS-12 in other than THR populations.

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HOOS-12 and Physitrack

When the HOOS-12 is administered using the PhysiApp the domain specific scores for Pain, Function and QOL, as well as a summary hip impact score (which is an average of the domain scores) are automatically calculated. In both, domain-specific as well as the summary impact score, the score ranges between 0 to 100, with 0 the worst possible score and 100 the best possible score. When using the summary impact score to compare HOOS responses from the same patient on different occasions, if the change in score is 28.0 or more then the change can be interpreted as clinically significant i.e. a change large enough that it matters to the patient.

In case you need to administer the HOOS-12 using a paper print out, which is available in Physitrack, you can find an easy-to-use scoring excel from www.koos.nu, along with more detailed information about the measure.

In addition to the full length HOOS we have recently added the HOOS-12 and ‘HOOS-12+ Sports and recreation domain’ into the Physitrack Outcome measures library. Search ‘HOOS-12’ to find both.

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References:

• HOOS-12 Introduction and User’s guide, www.koos.nu
• Chen, J., Ou, L. & Hollis, S.J. A systematic review of the impact of routine collection of patient reported outcome measures on patients, providers and health organisations in an oncologic setting. BMC Health Serv Res 13 , 211 (2013). https://doi.org/10.1186/1472-6963-13-211
• Gandek B, Roos EM, Franklin PD, Ware JE Jr. A 12-item short form of the Hip disability and Osteoarthritis Outcome Score (HOOS-12): tests of reliability, validity and responsiveness. Osteoarthritis Cartilage. 2019;27(5):754-761. doi:10.1016/j.joca.2018.09.017
• Soh SE, Harris IA, Cashman K, et al. Minimal Clinically Important Changes in HOOS-12 and KOOS-12 Scores Following Joint Replacement. J Bone Joint Surg Am . 2022;104(11):980-987. doi:10.2106/JBJS.21.00741
• Ackerman IN, Soh SE, Harris IA, et al. Performance of the HOOS-12 and KOOS-12 instruments for evaluating outcomes from joint replacement surgery. Osteoarthritis Cartilage. 2021;29(6):815-823. doi:10.1016/j.joca.2021.03.003

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