The Oxford Hip Score (OHS)

The Oxford Hip Score (OHS) is a short 12-item patient-reported PRO specifically designed and developed to assess function and pain with patients undergoing hip replacement surgery. It is short, reproducible, valid and sensitive to clinically important changes.

Background

The OHS was designed to be completed by the patient thus minimizing potential bias unwittingly introduced by surgeons when assessing the results themselves.

The PRO was designed and developed by researchers within the Nuffield Department of Population Health at the University of Oxford in association with surgical colleagues at the Nuffield Orthopaedic Centre.

Some of the attributes of the Oxford Hip Score are:

  • a simple scoring and summing system provides an overall scale for assessing outcome of hip interventions
  • the PRO is completed by the patient, independent of the clinical team/surgeon
  • the PRO can be completed anywhere, can be delivered by post to patients’ homes or deployed by various electronic platforms such as web or PDA. This makes follow-up of large study populations much more feasible (and cheaper) than conducting clinical assessments, requiring a return visit to the hospital.

The PRO

The OHS is a patient self-completion PRO containing 12 questions on activities of daily living. The OHS has been developed and validated specifically to assess function and pain for patients undergoing total hip replacement (THR) surgery. The OHS is the most evaluated hip specific measure available.

Example Studies

The OHS is primarily used to assess outcomes of THR surgery. Examples of such use and other applications of the OHS include:

  • Assessment of patient outcomes following alternative non-surgical interventions, including physical therapy, joint supplements and anti-inflammatory medications.
  • The Oxford Hip Score and the Oxford Knee Score (OKS) have recently been adopted by the UK Department of Health (DoH) for the assessment of approximately 120,000 hip and knee operations which are carried out each year in National Health Service (NHS) hospitals. The OHS and OKS form part of the nationwide Patient Reported Outcome Measure program launched by the UK DoH in April this year.
  • Private healthcare providers have also been interested in using the Oxford orthopaedic scores, including the OHS, to develop care pathways that achieve the best possible results for the patients. Nuffield Health (UK) is just one of our user community to obtain benefit from the OHS in this way.
  • Public and private healthcare providers have used the OHS to assess patient outcomes across multiple facilities as a measure of the performance of individual treatment centres, which can be used to identify high-performing centres and to raise standards through sharing best practices.

 

Scoring System:

The OHS provides a single summed score which reflects the severity of problems that the respondent has with his or her hip. Details of the scoring system for the OHS can be downloaded in Dossier Extracts section.

Development:

Prior to the development of the OHS, only crude measures of surgical failure, such as the need to perform revision surgery, had been employed in the assessment of patient outcomes. The development of the OHS was driven by the need to conduct more systematic and accurate monitoring of patient outcomes following THR.

Details of the development protocol and scoring system for the OHS are described in:

Dawson J, Fitzpatrick R, Carr A, Murray D. Questionnaire on the perceptions of patients about total hip replacement J Bone Joint Surg Br. 1996(a) Mar;78(2):185-90

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