Assessment of patient functional status after surgery

Martin McCarthy, Olga Jonasson, Chih Hung Chang, A. Simon Pickard, Anita Giobbie-Hurder, James Gibbs, Perry Edelman, Robert Joseph Fitzgibbons, Leigh Neumayer

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Improvement in day-to-day functioning is a valued outcome of surgical intervention. A new functional status assessment instrument, the Activities Assessment Scale (AAS), was designed for a randomized clinical trial evaluating laparoscopic versus open hernia repair procedures. STUDY DESIGN: The study data set included 2,164 patients at baseline and 1,562 patients at 3-month followup. Only male patients were enrolled in the trial. The psychometric characteristics of the AAS were examined in statistical analyses of cross-sectional and longitudinal data from the trial. Correlational analyses, factor analyses, and t-tests were used to evaluate scale performance. RESULTS: We found that the AAS was a reliable measure (Cronbach's Coefficient Alpha = 0.85) in the patient population studied. Factor analyses identified three subscales (sedentary activities; ambulatory activities; work and exercise activities). Construct validity was demonstrated by a correlation of 0.65 between the AAS and the physical functioning (PF) dimension of the SF-36 (p <0.001); comparisons between clinical subgroups further confirmed its validity (p <0.001). Patients reporting improvement on the physical functioning dimension after surgery showed an effect size of 1.20 for preoperative- postoperative change in their AAS scores. CONCLUSIONS: The AAS has been demonstrated to be a reliable, valid, and clinically responsive instrument that can be used to evaluate patient functioning after hernia surgery. It is easy to administer and requires less than 5 minutes of patient time to complete. This measurement system may prove useful in assessing surgical outcomes in both research and office practice settings.

Original languageEnglish
Pages (from-to)171-178
Number of pages8
JournalJournal of the American College of Surgeons
Volume201
Issue number2
DOIs
StatePublished - Aug 2005

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Statistical Factor Analysis
Herniorrhaphy
Hernia
Psychometrics
Randomized Controlled Trials
Cross-Sectional Studies
Exercise
Research
Population
Datasets

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

McCarthy, M., Jonasson, O., Chang, C. H., Pickard, A. S., Giobbie-Hurder, A., Gibbs, J., ... Neumayer, L. (2005). Assessment of patient functional status after surgery. Journal of the American College of Surgeons, 201(2), 171-178. https://doi.org/10.1016/j.jamcollsurg.2005.03.035

Assessment of patient functional status after surgery. / McCarthy, Martin; Jonasson, Olga; Chang, Chih Hung; Pickard, A. Simon; Giobbie-Hurder, Anita; Gibbs, James; Edelman, Perry; Fitzgibbons, Robert Joseph; Neumayer, Leigh.

In: Journal of the American College of Surgeons, Vol. 201, No. 2, 08.2005, p. 171-178.

Research output: Contribution to journalArticle

McCarthy, M, Jonasson, O, Chang, CH, Pickard, AS, Giobbie-Hurder, A, Gibbs, J, Edelman, P, Fitzgibbons, RJ & Neumayer, L 2005, 'Assessment of patient functional status after surgery', Journal of the American College of Surgeons, vol. 201, no. 2, pp. 171-178. https://doi.org/10.1016/j.jamcollsurg.2005.03.035
McCarthy M, Jonasson O, Chang CH, Pickard AS, Giobbie-Hurder A, Gibbs J et al. Assessment of patient functional status after surgery. Journal of the American College of Surgeons. 2005 Aug;201(2):171-178. https://doi.org/10.1016/j.jamcollsurg.2005.03.035
McCarthy, Martin ; Jonasson, Olga ; Chang, Chih Hung ; Pickard, A. Simon ; Giobbie-Hurder, Anita ; Gibbs, James ; Edelman, Perry ; Fitzgibbons, Robert Joseph ; Neumayer, Leigh. / Assessment of patient functional status after surgery. In: Journal of the American College of Surgeons. 2005 ; Vol. 201, No. 2. pp. 171-178.
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abstract = "BACKGROUND: Improvement in day-to-day functioning is a valued outcome of surgical intervention. A new functional status assessment instrument, the Activities Assessment Scale (AAS), was designed for a randomized clinical trial evaluating laparoscopic versus open hernia repair procedures. STUDY DESIGN: The study data set included 2,164 patients at baseline and 1,562 patients at 3-month followup. Only male patients were enrolled in the trial. The psychometric characteristics of the AAS were examined in statistical analyses of cross-sectional and longitudinal data from the trial. Correlational analyses, factor analyses, and t-tests were used to evaluate scale performance. RESULTS: We found that the AAS was a reliable measure (Cronbach's Coefficient Alpha = 0.85) in the patient population studied. Factor analyses identified three subscales (sedentary activities; ambulatory activities; work and exercise activities). Construct validity was demonstrated by a correlation of 0.65 between the AAS and the physical functioning (PF) dimension of the SF-36 (p <0.001); comparisons between clinical subgroups further confirmed its validity (p <0.001). Patients reporting improvement on the physical functioning dimension after surgery showed an effect size of 1.20 for preoperative- postoperative change in their AAS scores. CONCLUSIONS: The AAS has been demonstrated to be a reliable, valid, and clinically responsive instrument that can be used to evaluate patient functioning after hernia surgery. It is easy to administer and requires less than 5 minutes of patient time to complete. This measurement system may prove useful in assessing surgical outcomes in both research and office practice settings.",
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