Physical Function Short Form (HOOS)
An abbreviated evaluation of hip-associated health status
The Physical Function Short Form of the Hip Disability and Osteoarthritis Outcome Score (HOOS-PS) is a highly abbreviated but valid version of the longer original that focuses on the functional assessment of hip-associated health problems. With 5 questions, it is one of the shortest outcome tools, allowing a quick overview of the patient’s health status. The questionnaire has been used in patient groups with hip osteoarthritis and in the outcome evaluation after total hip arthroplasty.
Indication
Items - Dimensions - Completion time
The questionnaire includes just 5 items with 5 response options each. Only one answer can be selected.
The HOOS-PS focuses on one domain: physical functioning (descending stairs, getting out of bath, sitting, running, twisting/pivoting on the loaded leg).
There is no information in literature about the estimated time to complete the questionnaire. We estimate a short completion time of 3 minutes.
Scoring method of the Physical Function Short Form (HOOS)
Each of the items is scored from 0 (no health problems) to 4 (severe health problems). A raw score is generated by summing up all points of the 5 answers (maximum raw score = 20). The raw score can be transformed to a 0-100 score by using a given algorithm. If there is any missed question, the score should not be calculated.
scoring example:
question 1: answer 2 (1 point)
question 2: answer 4 (3 points)
question 3: answer 4 (3 points)
question 4: answer 3 (2 points)
question 5: answer 2 (1 point)
mean score = (1+3+3+2+1)/5 = 2,2
transformation to 0-100 score: 100-(2,2*100)/5 = 56 = HOOS-PS score
Score interpretation of the Physical Function Short Form (HOOS)
The tool can be scored in two directions – either with 100 as the score representing the highest health limitations or with 100 as the best possible outcome. The authors recommend to communicate clearly which interpretation mechanism is used.4
The HOOS-PS is license-free and can be used without any costs.
With just 5 questions the HOOS-PS represents a short tool that is quick to answer and easy to implement in clinical routine. Moreover the tool focuses on the hip related physical functioning which makes it a very specific outcome instrument.
A detailed health state measurement is not possible with the HOOS-PS due to the small number of items. Additionally, the missing clarity for the scoring direction can lead to misunderstandings.
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References
http://www.koos.nu/
Singh, Jasvinder A., et al. “Reliability and clinically important improvement thresholds for osteoarthritis pain and function scales: a multicenter study.” The Journal of rheumatology 41.3 (2014): 509-515.
Peters, Rinne M., et al. “Similar superior patient-reported outcome measures for anterior and posterolateral approaches after total hip arthroplasty: postoperative patient-reported outcome measure improvement after 3 months in 12,774 primary total hip arthroplasties using the anterior, anterolateral, straight lateral, or posterolateral approach.” The Journal of arthroplasty 33.6 (2018): 1786-1793.
Davis, A. M., et al. “The development of a short measure of physical function for hip OA HOOS-Physical Function Shortform (HOOS-PS): an OARSI/OMERACT initiative.” Osteoarthritis and cartilage 16.5 (2008): 551-559.
Davis, Aileen M., et al. “Comparative, validity and responsiveness of the HOOS-PS and KOOS-PS to the WOMAC physical function subscale in total joint replacement for osteoarthritis.” Osteoarthritis and Cartilage 17.7 (2009): 843-847.
Ornetti, P., et al. “Psychometric properties of the French translation of the reduced KOOS and HOOS (KOOS-PS and HOOS-PS).” Osteoarthritis and cartilage 17.12 (2009): 1604-1608.
Yilmaz, Ozlem, Ebru Demir Gul, and Hatice Bodur. “Cross-cultural adaptation and validation of the Turkish version of the Hip disability and Osteoarthritis Outcome Score–Physical function Short-form (HOOS-PS).” Rheumatology international 34.1 (2014): 43-49.