Osteoarthritis of the knee clinical care standard indicators: 1b-Proportion of patients newly diagnosed with knee osteoarthritis who have a comprehensive assessment

Collection and usage attributes

45 years

A ‘comprehensive assessment’ involves a clinician taking a detailed history of the patient that includes the presenting symptoms and other health conditions, a physical examination (including measurement of height and weight to calculate body mass index), and a psychosocial evaluation, to identify factors (especially level of pain) that may impact on the patient’s ability to do their usual daily activities and participate in work, leisure and social activities. A comprehensive assessment should use a clinically validated assessment tool to aid the assessment and support monitoring, tailored to the patient’s needs and goals. A range of clinically validated assessment tools is available (see list in the Comments section).

Both the numerator and the denominator, include patients newly diagnosed with knee osteoarthritis. 'Newly diagnosed' means that the patient was diagnosed or referred with knee osteoarthritis in the last three months.

Presented as a percentage.

(Numerator ÷ denominator) x 100

Number of patients newly diagnosed with knee osteoarthritis who have had a comprehensive assessment undertaken.

Number of patients newly diagnosed with knee osteoarthritis.

A comprehensive assessment should use clinically validated assessment tools, such as:

• Disease-specific - Knee injury and Osteoarthritis Outcome Score (KOOS) (Roos et al. 1998), see survey instrument http://www.koos.nu; OsteoArthritis Questionnaire (OA-Quest) (Busija, Buchbinder & Osborne 2016), see survey instrument http://iha.acu.edu.au/osteo-arthritis/
   
• Pain and function - Timed Up and Go Test and 30-second Chair Stand Test (OARSI 2013), see survey instrument https://www.oarsi.org/research/physical-performance-measures
   
• Pain - Verbal Numerical Rating Scale (VNRS) and Visual Analogue Scale (VAS) (NSW Agency for Clinical Innovation Pain Management Network 2017a, 2017b), see survey instrument http://www.aci.health.nsw.gov.au/
  chronic-pain/health-professionals/assessment
   
• Depression - Kessler (K10) Psychological Distress Scale (Kessler et al. 2016), see survey instrument http://www.gpcare.org/outcome%
  20measures/outcomemeasures.html and Depression, Anxiety and Stress Scale 21 (DASS 21) (Henry & Crawford 2005) see survey instrument http://www.depression-test.net/support-files/dass21-dmz.pdf
   
• Activities and quality of life - Workplace Activity Limitations Scale (WALS) (Gignac 2005; Gignac, Sutton & Badley 2007), see survey instrument http://www.acreu.ca/pdf/WALS.pdf; Assessment of Quality of Life (Richardson, Iezzi, Khan et al. 2014), see survey instrument http://www.aqol.com.au/.

This indicator has been adapted from the Osteoarthritis quality standard (NICE 2015).

Representational attributes

N[NN]

Accountability attributes

Applicable setting: all healthcare settings where care is provided to patients with knee osteoarthritis, including primary care, specialist care, hospitals and community settings.

Source and reference attributes

Busija L, Buchbinder R & Osborne RH 2016. Development and preliminary evaluation of the OsteoArthritis Questionnaire (OA-Quest): a psychometric study. Osteoarthritis and Cartilage 24(8):1357-66.

Gignac MA 2005. Arthritis and employment: an examination of behavioral coping efforts to manage workplace activity limitations. Arthritis & Rheumatism 53(3):328-36.

Gignac MA, Sutton D, & Badley EM 2007. Arthritis symptoms, the work environment, and the future: Measuring perceived job strain among employed persons with arthritis. Arthritis & Rheumatism 57(5):738-47.

Henry JD & Crawford JR 2005. The 21-item version of the Depression Anxiety Stress Scales (DASS–21): Normative data and psychometric evaluation in a large non-clinical sample. British Journal of Clinical Psychology 44:227–239.

Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand S-LT et al. 2016. Anxiety and depression checklist (K10). Melbourne: beyondblue. Viewed 9 April 2017, https://www.beyondblue.org.au/the-facts/anxiety-and-depression-checklist-k10.

NICE (National Institute for Health and Care Excellence) 2015. Osteoarthritis Quality standard 87. London: NICE.

NSW Agency for Clinical Innovation Pain Management Network 2017a. Verbal numerical rating scale (VNRS). Sydney: NSW ACI. Viewed 9 April 2017, http://www.aci.health.nsw.gov.au/__data/assets/
pdf_file/0017/212912/Verbal_Numerical_Rating_Scale.pdf.

NSW Agency for Clinical Innovation Pain Management Network 2017b. Visual analogue scale (VAS). Sydney: NSW ACI. Viewed 9 April 2017, http://www.aci.health.nsw.gov.au/__data/assets/
pdf_file/0018/212913/Visual_Analogue_Scale.pdf.

OARSI (Osteoarthritis Research Society International) 2013. Physical performance measures. Viewed 9 April 2017, https://www.oarsi.org/research/
physical-performance-measures.

Pencharz JN & MacLean CH 2004. Measuring quality in arthritis care: the Arthritis Foundation's Quality Indicator set for osteoarthritis. Arthritis & Rheumatism 51(4): 538-548.

Richardson J, Iezzi A, Khan MA & Maxwell A 2014. Validity and reliability of the Assessment of Quality of Life (AQoL-8D) multi attribute utility instrument. Patient 7(1):85-96.

Roos EM, Roos HP, Lohmander LS, Ekdahl C & Beynnon BD 1998. Knee Injury and Osteoarthritis Outcome Score (KOOS) - development of a self-administered outcome measure. Journal of Orthopaedic & Sports Physical Therapy 28:88–96.