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. 2021 Mar 31;13(1):9062. doi: 10.4081/or.2021.9062

Table 3.

Comparison of objective methods of outcome assessment.

Strengths Weaknesses
Surgical outcomes e.g. mortality, peri-operative complications - Easy to measure -May not be appropriate in the MBD population
- Infrastructure already in place to record these
Performance-based outcome measures - Improved sensitivity versus PROMs e.g. ability to distinguish pain from function73 - Ecological validity – do they measure real-world function?9
- Improved validity to PROMs9 - Hawthorne effect: participant acts differently because they are being observed73,74
- Don’t show ceiling effects9
Physician-reported outcome measures - Gold standard for measuring function9 - Expensive and not broadly available9
- Measure objective surgical outcomes e.g. strength, range of movement (ROM)57 - Doesn’t necessarily consider outcomes important to patients
- Minimise ceiling effects9 - Clinicians overestimate outcome vs patients30
- No educational/language barriers - Poor inter-observer reliability73
Quality indicators of treatment outcome - Allow comparison between different centres/countries8,75 - Significant effort required to develop77
- Can be used to identify complex patients who may benefit from tertiary orthopaedic oncology opinion76 - Need to be validated for specific population77
- Constantly changing78
- Can only measure outcomes that are routinely recorded in practice77