Table 1

Summary of the Criteria and Score Development for the Western Canada Waiting List Project Hip and Knee Replacement Priority Form

Revised tool Jan. 29, 2000^*		Pilot testing analysis (N = 405) R² = 0.681, R² (adj) = 0.676^†			Tool refinement June 26, 2000

Criteria, items/levels		No.	%	Score	Weight	Criteria, items/levels
1.	Pain on motion^*	405	100			1.	Pain on motion

	None	0	0	0	0		None/mild

	Mild	31	8	0

	Moderate	249	61	6	6		Moderate

	Severe	125	31	13	13		Severe

2.	Pain at rest^*	405	100			2.	Pain at rest

	None	29	7	0	0		No change

	Mild	160	40	3	3

	Moderate	191	47	8	8

	Severe	25	6	11	11

3.	Ability to walk	405	100			3.	Ability to walk without significant pain

	> 20 blocks	13	3	0	0		> 5 blocks

	11–20 blocks	25	6	0	0		1–5 blocks

	5–10 blocks	86	21	4	4		< 1 block

	< 5 blocks	281	70	7	7		Household ambulator

4.	Other functional limitations	405	100			4.	Other functional limitations

	No limitations	4	1	0	0		No limitations

	Mild limitations	99	24	4	4		Mild limitations (able to do most activities with minor modifications or difficulty)

	Moderate limitations	218	54	11	11		Moderate limitations (able to do most activities but with modification or assistance)

	Severe limitations	84	21	19	19		Severe limitations (unable to perform most activities)

5.	Abnormal findings (orthopedic only)^*	401	100			5.	Abnormal findings on physical examination related to affected joint

	None	16	4	0	0		None/mild

	Mild	122	30	0

	Moderate	178	44	5	5		Moderate

	Severe	85	21	8	10		Severe

6.	Potential for progression of disease^‡	183	100			6.	Potential for progression of disease documented by radiographic findings

	None	16	9	0	0		No Change

	Mild	70	38	4	4

	Moderate	68	37	11	11

	Severe	29	16	21	20

7.	Ability to work, give care to dependants, live independently (difficulty must be related to affected joint)	405	100			7.	Threat to patient role and independence in society

	Not threatened or no difficulties	14	3	0	0		Not threatened but more difficult

	Not threatened but more difficult	145	36	0

	Threatened but not immediately	177	44	10	10		Threatened but not immediately

	Immediately threatened or unable	69	17	21	20		Immediately threatened or unable

These items were revised in January 2000. The original items and wording were as follows:
- Q1. Pain on motion: none; mild/slight/or occasional; mild–moderate; moderate; moderate–severe; severe.
- Q2. Pain at rest: none; mild/slight/or occasional; mild–moderate; moderate; moderate–severe; severe.
- Q5. Range of motion on examination: no restriction; mild restriction; moderate restriction; severe restriction.
- Q6. Other abnormal findings: none; mild; moderate; severe. (Q5 and Q6 were combined.)
- Q7. Multiple joint disease: none; multiple, mild–moderate; multiple, severe. (Deleted from criteria form.)
↵† Regression analysis based on 390 cases with complete data on all variables. In an analysis restricted to primary patients (n = 308), R² = 0.712, R² (adjusted) = 0.706.
↵‡ Based on 183 patients scored with the revised tool.