{
  "abstract": "Background: Patient-reported outcome measures (PROMs) are important after hip fracture but can impose respondent burden. A simple global measure may provide complementary information about a patient’s overall perception of hip normality. The Normal Hip Score (NHS) is a single-item 0–100 measure of perceived hip normality. This study evaluated preliminary evidence of construct validity for the NHS following hip fracture surgery. Methods: This was a prospective observational study with cross-sectional validation analyses based on a single postoperative PROM assessment. Paired NHS–OHS and NHS–EQ-5D-5L data were available for 80 participants. The mean age was 79.3 years (SD 10.8), and 46 (57.5%) of these participants were female. Assessment occurred at a mean of 3.47 months (SD 0.75; range 2–7 months) following fracture surgery. The NHS was assessed in relation to the OHS and EQ-5D-5L index and dimensions. Convergent validity was assessed using Pearson and Spearman correlations, with exploratory analyses of individual OHS items and EQ-5D-5L dimensions. Known-groups validity was examined across OHS quartiles, and multivariable linear regression was performed. Results: The mean NHS was 60.4 (SD 25.4). NHS demonstrated a moderate correlation with OHS (Pearson r = 0.657, 95% CI 0.511–0.766; p < 0.001) and with the EQ-5D-5L index (r = 0.541, 95% CI 0.365–0.680; p < 0.001). All 12 OHS items and all five EQ-5D-5L dimensions were significantly associated with NHS. The strongest OHS item associations were pain when rising from a chair, pain, work/housework interference, limping, and washing/bathing. Mobility showed the strongest EQ-5D-5L dimension association. NHSs increased across OHS quartiles (Kruskal–Wallis H = 35.77; p < 0.001). In multivariable analysis, OHS remained associated with NHS (β = 1.54, 95% CI 0.80–2.28; p < 0.001). Conclusions: The NHS demonstrated preliminary evidence of cross-sectional construct and known-groups validity following hip fracture surgery. The findings support the NHS as a potentially useful complementary global measure of perceived hip normality, but do not establish test–retest reliability, responsiveness, clinically meaningful change, or suitability for standalone clinical use.",
  "abstract_shown": true,
  "affiliations": [
    "Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh EH16 4SA, UK",
    "Usher Institute, School of Population Health Sciences, University of Edinburgh, Edinburgh EH16 4UX, UK"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Brian Z. H. Lim",
      "orcid": "0009-0004-4948-1754"
    },
    {
      "affs": [
        0
      ],
      "name": "Gillian C. Leitch"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Thomas R. Williamson",
      "orcid": "0000-0002-9726-0209"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Andrew D. Duckworth"
    },
    {
      "affs": [
        0
      ],
      "name": "Nick D. Clement",
      "orcid": "0000-0001-8792-0659"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bbax8z2fyfpb6.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15208078",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705691/?tool=EBI",
  "id": "bbax8z2fyfpb6",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/20/8078",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Hip and Femur Fractures"
    ]
  ],
  "openalex": "W7222947693",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705691/pdf/?tool=EBI",
  "pmcid": "PMC13705691",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/bbax8z2fyfpb6.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:01Z",
      "native_id": "10.3390/jcm15208078",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/20/8078"
    },
    {
      "first_seen": "2026-10-30T12:21:25Z",
      "native_id": "PMC:PMC13705691",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13705691"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Hip and Femur Fractures",
      "subfield": "surgery"
    }
  ],
  "title": "The Normal Hip Score Following Hip Fracture: Preliminary Validation of a Single-Item Patient-Reported Outcome Measure",
  "title_text": "The Normal Hip Score Following Hip Fracture: Preliminary Validation of a Single-Item Patient-Reported Outcome Measure",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:25Z",
  "url": "https://research.draconitic.com/paper/bbax8z2fyfpb6",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}