Accepted for/Published in: JMIR Formative Research
Date Submitted: Nov 19, 2024
Open Peer Review Period: Mar 6, 2025 - May 1, 2025
Date Accepted: Mar 11, 2025
(closed for review but you can still tweet)
Convergent and Known-Groups Validity and Sensitivity to Change of a Virtual Performance Measure in Patients with Hip and Knee Osteoarthritis: A Longitudinal Study
ABSTRACT
Background:
Subsequent to COVID-19 pandemic in 2020, a different approach to health care utilization was required to improve safety and efficiency. In the post pandemic era, virtual care and remote assessment of musculoskeletal conditions has become more common, and examining the accuracy of the remote encounters remains vital. In 2023, an innovative video-based tool, the virtual performance measure (VPM) was introduced to assess the functional difficulties of patients with arthritis of the knee joint. Further validity of this tool is warranted to expand its application longitudinally, and in more diverse populations.
Objective:
The present study examined the longitudinal validity of the VPM, a digitally based outcome tool in patients with osteoarthritis of the hip and knee joints who had undergone arthroplasty surgery.
Methods:
Patients completed an online survey after watching ten videos that demonstrated ten functional tasks with increasing prior to and at approximately 3-5 months following surgery. The lower extremity functional score (LEFS) was used as the reference measure. Longitudinal convergent and known-groups validity, and sensitivity to change were assessed.
Results:
Data of 120 patients, 80 (67%) females, mean age: 67, SD=9, 58 (48%) hips and 62 (52%) knees were examined. There was a statistically significant improvement in total VPM score (t=13.92, p<0.0001) and LEFS (t=16.04, p<0.0001) over time. The correlation between the post-op LEFS and VPM was strong (r=0.66, p<0.0001). The correlation between the change scores was moderate (r=0.51, p<0.0001). The AUC value for the VPM’s ability to differentiate between urgent and non-urgent candidates for surgery was 0.71 CI 95% (0.57-84). Sensitivity to change as measured by the standardized response mean was 1.27, CI 95% (1.09-1.45), indicating good ability to detect change over time.
Conclusions:
The VPM demonstrated sufficient longitudinal convergent and known-groups validity and sensitivity to change in patients with hip and knee arthritis following arthroplasty. This tool has a potential to improve the delivery of care by increasing access, reducing the frequency of in-person visits, and improving the overall efficiency of the health care system following a major surgery. Clinical Trial: N/A Observational
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