Perspective: When the most popular outcome measure becomes a problem: a critical perspective on PROMs in orthopedics

Authors

  • Christian Fugl Hansen Department of Orthopaedic Surgery, Bispebjerg and Frederiksberg Copenhagen University Hospital, Copenhagen, Denmark
  • Michael Rindom Krogsgaard Institute of Sports Medicine Copenhagen ISMC, Department of Orthopaedic Surgery, Bispebjerg and Frederiksberg Copenhagen University Hospital, Copenhagen; Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark

DOI:

https://doi.org/10.2340/17453674.2026.47062

Keywords:

Arthroplasty, Statistics

Downloads

Download data is not yet available.

References

Hansen C F, Jensen J, Siersma V, Brodersen J, Comins J D, Krogsgaard M R. A catalogue of PROMs in sports science: quality assessment of PROM development and validation. Scand J Med Sci Sports 2021; 31(5): 991-8. doi: 10.1111/sms.13923. DOI: https://doi.org/10.1111/sms.13923

Mokkink L B, de Vet H C W, Prinsen C A C, Patrick D L, Alonso J, Bouter L M, et al. COSMIN Risk of Bias checklist for systematic reviews of Patient-Reported Outcome Measures. Qual Life Res 2018; 27(5): 1171-9. doi: 10.1007/s11136-017-1765-4. DOI: https://doi.org/10.1007/s11136-017-1765-4

Hansen C F, Krogsgaard M R, Varnum C, Overgaard S, Christensen K B. Inadequate structural validity of the Oxford Hip Score: evidence from Rasch and confirmatory factor analysis in a prospective, Danish total hip arthroplasty cohort. J Clin Epidemiol 2026; 199: 112456. doi 10.1016/j.jclinepi.2026.112456. DOI: https://doi.org/10.1016/j.jclinepi.2026.112456

Hansen C F, Krogsgaard M R, Morup-Petersen A, Odgaard A, Krogsgaard M R, Christensen K B. The structural validity of the Danish version of the Oxford Knee Score is not substantiated using Rasch analysis and confirmatory factor analysis. Bone Joint Res 2025; 14(11): 998-1005. doi: 10.1302/2046-3758.1411.BJR-2025-0060.R1, DOI: https://doi.org/10.1302/2046-3758.1411.BJR-2025-0060.R1

Wright B D, Linacre J M. Observations are always ordinal; measurements, however, must be interval. Arch Phys Med Rehabil 1989; 70(12): 857-60.

Hansen C F, Jensen J, Brodersen J, Siersma V, Comins J D, Krogsgaard M R. Are adequate PROMs used as outcomes in randomized controlled trials? an analysis of 54 trials. Scand J Med Sci Sports 2021; 31(5): 972-81. doi: 10.1111/sms.13896. DOI: https://doi.org/10.1111/sms.13896

O’Hara N N, Brodke D J, Levack A E, O’Toole R V, Slobogean G P. The fallacy of patient-reported outcome measures: why they often fail to detect clinically important differences. JB JS Open Access 2025; 10(3): e25.00172. doi: 10.2106/JBJS.OA.25.00172. DOI: https://doi.org/10.2106/JBJS.OA.25.00172

Mouelhi Y, Jouve E, Castelli C, Gentile S. How is the minimal clinically important difference established in health-related quality of life instruments? Review of anchors and methods. Health Qual Life Outcomes 2020; 18(1): 136. doi: 10.1186/s12955-020-01344-w. DOI: https://doi.org/10.1186/s12955-020-01344-w

Solomito M J, Carangelo R, Makanji H. The minimal clinically important difference (MCID) for total joint arthroplasty outcome measures varies substantially by calculation method. J Bone Joint Surg Am 2025; 107(9): 994-9. doi: 10.2106/JBJS.24.00916. DOI: https://doi.org/10.2106/JBJS.24.00916

Christensen K B, Comins J D, Krogsgaard M R, Brodersen J, Jensen J, Hansen C F, et al. Psychometric validation of PROM instruments. Scand J Med Sci Sports 2021; 31(6): 1225-38. doi: 10.1111/sms.13908. DOI: https://doi.org/10.1111/sms.13908

Additional Files

Published

2026-10-28

How to Cite

Hansen, C. F., & Krogsgaard, M. R. (2026). Perspective: When the most popular outcome measure becomes a problem: a critical perspective on PROMs in orthopedics. Acta Orthopaedica, 97, 779–780. https://doi.org/10.2340/17453674.2026.47062

PlumX (by Elsevier) is an altmetrics platform that tracks and visualizes the online attention, usage, captures, citations, and social media engagement.