James Presents at the Annual UBC Orthopaedic Update

May, 2015

This month, James presented his preliminary findings from his international, multi-center cohort study comparing Patient-Reported Outcomes Measures (PROMs) in normal, pathology-free individuals.

A Preliminary report of an International, Multi-Center Cohort Study Comparing Patient-Reported Outcomes Measures in a Normal, Pathology-Free Population Using an Electronic Data-Collection System


The aim is to assess whether commonly used Patient-Reported Outcomes Measures (PROM) are equivalent in normal, healthy, pathology-free individuals of different ethnicity, nationality, sex and age. The clinical scores under investigation include PROMs of the hip, shoulder, knee and wrist/hand.


There is no difference in PROM clinical scores in a normal population when comparing sexes, age groups, ethnic groups and different nationalities.


American, Australian and Canadian citizens, free of pathology in the ipsilateral joint under investigation that corresponding to their dominant arm are invited to complete an electronic, web-based questionnaire on a mobile device or a laptop computer. The power calculation requires 600 participants in each hip, shoulder, knee and wrist/hand cohort.  The groups have been stratified to be sex and age matched. The questionnaires cover the subjective and objective components of the clinical scores under investigation. The PROM scores under investigation include:

  • Hip PROMs – Harris, Oxford, HOOS shoulder scores, and EQ-5d scores
  • Shoulder PROMs – ASES; CSS; OSS; UCLA; SPADI; and SPONSA shoulder scores
  • Knee PROMs – Knee Society, Oxford Knee Score; and the KOOS knee scores
  • Wrist/Hand PROMs – Mayo Wrist PRWE; and DASH wrist/hand scores


  • Hip cohort – Canada : 310/300 Australia : 317/300
  • Shoulder cohort – Canada : 220/300 Australia : 10/300
  • Knee cohort – Canada : 250/300  Australia : 230/300
  • Wrist/Hand cohort – Canada : 200/300  Australia : 10/300

Expected Conclusions

An electronic, PROM data collection system can be used effectively to assess separate cohorts across different continents. Differences in sex, age, ethnicity and nationality must be taken into consideration when using PROM hip scores to assess patient outcomes. Studies using an electronic, pre-established control group for a comparative group, should be sourced from the same country of origin and be age- and sex-matched. This study has established an electronic, normal control group for future OBERD-derived studies using PROM outcome measures in Australia, Canada and the United States.

Level of Evidence: Therapeutic Level II.