Patient Reported Outcome Measures

The use of Patient Reported Outcomes (PROs) in clinical research is well documented. However, there is increasing evidence suggesting routine formal assessment of PROs in the clinical setting can lead to improved care in many ways. Today there is growing interest and great potential in using individual-level PRO data to improve patient care and aggregate-level PRO data for the purposes of accountability and performance improvement of health care providers.  In 2015 the Quality Outcomes Data (QOD) Work Group was convened to investigate and evaluate data collection tools (Patient Reported Outcome Measures or PROMs) in addition to other charges. On February 29, 2016, the AAOS Board of Directors approved the recommendations of the QOD work group including a recommended list of PROMs.    


The QOD work group considered the universe of PROMs and tools for collection of orthopaedic quality data using specific criteria* to evaluate each PROM. Specialty Society input was sought to refine the list of PROMs. Using the Specialty Society input the QOD work group identified a group of consensus-recommended PROMs for regional anatomical and diagnosis specific PROMs. The list called Instruments for Collection of Orthopaedic Quality Data. This list is not comprehensive, rather it is intended to steer data collection and reporting. We anticipate this list could change over time.  

Instruments for Collection of Orthopaedic Quality Data - pdf version


General Quality of Life
Veterans RAND 12
PROMIS (PROMIS 10 or CAT)
EuroQol-5D (EQ-5D)

Treatment Outcome
• Single Assessment Numeric Evaluation (SANE)

Foot and Ankle
Foot and Ankle Ability Measure (FAAM)
Foot and Ankle Disability Index (FADI)

Knee (Anterior Cruciate Ligament)
International Knee Documentation Committee (IKDC) Subjective Knee Form (Pedi-IKDC)
Marx Activity Rating Scale

Knee (Osteoarthritis)
Knee Injury and Osteoarthritis Outcome Score (KOOS)
Knee Injury and Osteoarthritis Outcome Score Jr. (KOOS Jr.)

Hip (Osteoarthritis)
Hip Disability and Osteoarthritis Outcomes Survey (HOOS)
Hip Disability and Osteoarthritis Outcomes Survey Jr. (HOOS Jr.)

Shoulder
American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES)
Oxford Shoulder Score (OSS)

Shoulder (Instability)
American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES)
Western Ontario Shoulder Instability Index (WOSI)

Elbow
Disabilities of the Arm, Shoulder, and Hand Score (DASH)
Quick-DASH

Wrist
Disabilities of the Arm, Shoulder, and Hand Score (DASH)
Quick-DASH

Hand
Disabilities of the Arm, Shoulder, and Hand Score (DASH)
Quick-DASH

Spine 
Oswestry Disability Index (ODI)
Neck Disability Index (NDI)

Criteria*

  • Open access to the PROM (i.e. no cost for the instrument itself)
  • Patient reported outcomes only (no surgeon entered data)
  • Multiple entry platforms (digital, paper, web)
  • Approximately 20 questions or less
  • Clinically meaningful (responsiveness)
  • One generic quality of life PROM
  • No more than 3 joint or disease specific PROMs
  • CAT version available (preferable)

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