Shorter Questionnaires Improves Patient Acceptance

Patients appear to dislike filling out long questionnaires about their experience with joint replacement surgery. Surgeons, who wanted feedback from patients, worried that the problem lay in the fact that the surveys were very long, “Our surgeons were worried that patients were not completely filling them out, ” said Stephen Lyman, director of the Hospital for Special Surgery’s (HSS) Healthcare Research Institute. “They needed a more efficient method.”

Sharing the dissatisfaction of the doctors over the low completion rates of patient outcome surveys, researchers at HSS in New York decided to change the instruments with which they were working.

They replaced the Hip Disability and Osteoarthritis Outcome Score or HOOS, which contained 40 questions, with a HOOS Junior questionnaire that contained only 7 questions. They replaced the Knee Injury and Osteoarthritis Outcome Score (KOOS), which asks 42 questions, with the seven-question KOOS Jr. instrument.

According to Karen Appold, who wrote about the effort for Hospitals and Health Networks, a multidisciplinary team from HSS used statistical modeling methods to drastically reduce the original number of questions on Medicare’s recommended surveys. The HSS team validated the shorter versions, affirmed that they would generate reliable scores and published its findings in Clinical Orthopaedics and Related Research. Although data are not yet available, Lyman expects the number of patients who complete the shortened surveys to increase substantially.

According to Appold, Medicare has designated the surveys as appropriate for surveying patients on outcomes within the program.