A systematic review of crosswalks for converting patient-reported outcome measure scores in hip, knee, and shoulder replacement surgery.

background and purposeWe aimed to systematically review studies of crosswalks for converting patient-reported outcome measure (PROM) scores used in joint replacement, and develop a database of published crosswalks.

methods4 electronic databases were searched from January 2000 to May 2023 to identify studies reporting the development and/or validation of crosswalks to convert PROM scores in patients undergoing elective hip, knee, or shoulder replacement surgery. Data on study and sample characteristics, source and target PROMs, and crosswalk development and validation methods were extracted from eligible studies. Study reporting was evaluated using the Mapping onto Preference-based measures reporting Standards (MAPS) checklist.

results17 studies describing 35 crosswalks were eligible for inclusion. Unidirectional crosswalks were available to convert hip-specific (Oxford Hip Score [OHS]) and knee-specific (Oxford Knee Score [OKS]) scores to the EQ-5D-3L/EQ-5D-5L. Similar crosswalks to convert disease-specific scores (WOMAC) to the EQ-5D-3L, EQ-5D-5L, and ICECAP-O Capability Index were identified. Bidirectional crosswalks for converting OHS and OKS to the HOOS-JR/HOOS-12 and KOOS-JR/KOOS-12, for converting WOMAC to the HOOS-JR/KOOS-JR, and for converting HOOS-Function/KOOS-Function to the PROMIS-Physical Function were also available. Additionally, crosswalks to convert generic PROM scores from the UCLA Activity Scale to the Lower Extremity Activity Scale in both directions were available. No crosswalks were identified for converting scores in shoulder replacement. Development methods varied with the type of target score; most studies used regression, item response theory, or equipercentile equating approaches. Reporting quality was variable, particularly for methods and results items, impacting crosswalk application.

conclusionThis is the first synthesis of published crosswalks for converting joint-specific (OHS, OKS, HOOS, KOOS), disease-specific (WOMAC), and generic PROMs scores (PROMIS-Physical Function, UCLA Activity Scale, Lower Extremity Activity Scale) used to assess joint replacement outcomes, providing a resource for data harmonization and pooled analysis. Crosswalks were developed using regression methods (9 studies), equipercentile equating methods (5 studies), a combination of equipercentile equating and item response theory methods (2 studies), and a combination of regression and equipercentile equating methods (1 study). A range of crosswalk validation approaches were adopted, including the use of external datasets, separate samples or subsets, follow-up data from additional time points, or bootstrapped samples. Efforts are needed to standardize crosswalk methodology and achieve consistent reporting.