Age and Gender Confound PROMIS Scores in Spine Patients With Back and Neck Pain

Jevotovsky, David; Tishelman, Jared C.; Stekas, Nicholas; Moses, Michael J.; Karia, Raj; Ayres, Ethan W.; Fischer, Charla R.; Buckland, Aaron J.; Errico, Thomas J.; Protopsaltis, Themistocles S.

doi:10.1177/2192568220903030

Cited by 12 publications

(10 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Categorical variables were compared using the Chi-square test. Differences in baseline disability (NDI) were also adjusted for covariates previously reported to be associated to the dependent variable using a general linear model [21][22][23][24] . The covariates were: ASA > II (yes/no), gender (male/female), obesity (BMI ≥ 30, yes/no), smoking (yes/no), educational level (≥ 4 years of college or university, yes/no), cervical myelopathy (yes/no) and paid sick leave (yes/no).…”

Section: Patient Reported Outcome Measures (Proms)mentioning

confidence: 99%

A nationwide study of patients operated for cervical degenerative disorders in public and private hospitals

Danielsen

Mjåset

Ingebrigtsen

et al. 2022

Sci Rep

View full text Add to dashboard Cite

During the last decades, there has been an increase in the rate of surgery for degenerative disorders of the cervical spine and in the use of supplementary private health insurance. Still, there is limited knowledge about the differences in characteristics of patients operated in public and private hospitals. Therefore, we aimed at comparing sociodemographic-, clinical- and patient management data on patients operated for degenerative cervical radiculopathy and degenerative cervical myelopathy in public and private hospitals in Norway. This was a cross-sectional study on patients in the Norwegian Registry for Spine Surgery operated for degenerative cervical radiculopathy and degenerative cervical myelopathy between January 2012 and December 2020. At admission for surgery, we assessed disability by the following patient reported outcome measures (PROMs): neck disability index (NDI), EuroQol-5D (EQ-5D) and numerical rating scales for neck pain (NRS-NP) and arm pain (NRS-AP). Among 9161 patients, 7344 (80.2%) procedures were performed in public hospitals and 1817 (19.8%) in private hospitals. Mean age was 52.1 years in public hospitals and 49.7 years in private hospitals (P < 0.001). More women were operated in public hospitals (47.9%) than in private hospitals (31.6%) (P < 0.001). A larger proportion of patients in private hospitals had high education (≥ 4 years of college or university) (42.9% vs 35.6%, P < 0.001). Patients in public hospitals had worse disease-specific health problems than those in private hospitals: unadjusted NDI mean difference was 5.2 (95% CI 4.4 – 6.0; P < 0.001) and adjusted NDI mean difference was 3.4 (95% CI 2.5 – 4.2; P < 0.001), and they also had longer duration of symptoms (P < 0.001). Duration of surgery (mean difference 29 minutes, 95% CI 27.1 – 30.7; P < 0.001) and length of hospital stay (mean difference 2 days, 95% CI 2.3 – 2.4; P < 0.001) were longer in public hospitals. In conclusion, patients operated for degenerative cervical spine in private hospitals were healthier, younger, better educated and more often men. They also had less and shorter duration of symptoms and seemed to be managed more efficiently. Our findings indicate that access to cervical spine surgery in private hospitals could be skewed in favour of patients with higher socioeconomic status.

show abstract

Section: Patient Reported Outcome Measures (Proms)mentioning

confidence: 99%

A nationwide study of patients operated for cervical degenerative disorders in public and private hospitals

Danielsen

Mjåset

Ingebrigtsen

et al. 2022

Sci Rep

View full text Add to dashboard Cite

show abstract

“…8 However, previous research indicates that PROMIS and other comparable metrics such as the DASH and Knee Injury and Osteoarthritis Outcomes Score differ by age, so this reference score presents potential limitations. [16][17][18][19] Determining age-calibrated PROMIS reference scores is therefore important in evaluating patient candidacy for surgical procedures and better interpreting MCID.…”

Section: Introductionmentioning

confidence: 99%

Establishing Age-calibrated Normative PROMIS Scores for Hand and Upper Extremity Clinic

Yedulla

Wilmouth

Franovic

et al. 2021

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background:The purpose of our study is to investigate differences in normative PROMIS upper extremity function (PROMIS-UE), physical function (PROMIS-PF), and pain interference (PROMIS-PI) scores across age cohorts in individuals without upper extremity disability. Methods: Individuals without upper extremity disability were prospectively enrolled. Subjects were administered PROMIS-UE, PROMIS-PF, and PROMIS-PI forms. Retrospective PROMIS data for eligible subjects were also utilized. The enrolled cohort was divided into age groups: 20-39, 40-59, and 60-79 years old. ANOVA, ceiling and floor effect analysis, and kurtosis and skewness statistics were performed to assess PROMIS scores trends with age. Results: This study included 346 individuals. In the 20-39 age group, mean

show abstract

“…The use of PROMIS scores has been previously validated in orthopaedic settings. [12][13][14][15][16][17] PROMIS scores have been found to correlate strongly with more traditional and directed health-related quality-of-life measures used in orthopaedic clinics, but are comparatively less confounded by age and sex. 14,15 The scores have a minor floor and ceiling effects as well as a favorable time to completion and question burden, which aids in their use for treating and counseling patients with musculoskeletal disorders.…”

mentioning

confidence: 99%

“…The patient-reported outcomes measurement information system (PROMIS) assesses patient fulfillment and may yield new insights into presurgical status and improvements in pain and physical function, which are not reflected in radiographic measurements. The use of PROMIS scores has been previously validated in orthopaedic settings 12–17. PROMIS scores have been found to correlate strongly with more traditional and directed health-related quality-of-life measures used in orthopaedic clinics, but are comparatively less confounded by age and sex 14,15.…”

mentioning

confidence: 99%

“…[12][13][14][15][16][17] PROMIS scores have been found to correlate strongly with more traditional and directed health-related quality-of-life measures used in orthopaedic clinics, but are comparatively less confounded by age and sex. 14,15 The scores have a minor floor and ceiling effects as well as a favorable time to completion and question burden, which aids in their use for treating and counseling patients with musculoskeletal disorders. 16,18 In this study, we retrospectively report on a cohort of individuals who underwent guided growth correction for idiopathic genu valgum.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Patient-reported Outcomes of Adolescents Treated With Guided Growth to Correct Idiopathic Genu Valgum

Carroll

Stotts

Pearson

et al. 2023

Journal of Pediatric Orthopaedics

View full text Add to dashboard Cite

Background: Guided growth is commonly used to treat frontal plane alignment deformities in skeletally immature individuals. Treatment aims are to correct the biomechanical loading of the knee and to avoid more invasive surgery that would be required after skeletal maturity. There is little published evidence of pain perception or functional limitations in this population. In addition, the intervention has the potential to worsen pain and function with hardware implantation, and symptoms may not fully resolve after removal. Understanding of pain and function limitations in this population is important to guide the clinical expectations. Methods: Individuals with idiopathic knee genu valgum who underwent hemiepiphysiodesis with tension plate constructs were identified through a medical records database search. Patient-reported outcomes measurement information system Physical Function/Mobility and Pain Interference domain scores were assessed before hemiepiphysiodesis, immediately before hardware removal, and after hardware removal. Radiographs were also assessed at these times to record the zones and angles of deformity and correction. Results: Twenty-eight subjects (53 operative limbs) contributed to the analysis. Mobility and pain interference as measured by the patient-reported outcomes measurement information system were below typical values in a small percentage of the population studied, only 3.6% scored in the moderate and none in the severe categories for both domains. Valgus by radiographic zone was corrected in all patients without significant rebound at follow-up. Compared with preoperative levels, mobility scores improved before hardware removal. Pain Interference scores improved both before hardware removal and at the final follow-up. Conclusions: Frontal plane knee deformities in the idiopathic population do not cause pain or limit mobility in most subjects. This is critical information, emphasizing that surgical decisions may be made based on the deformity alone, presence of symptoms, and possible future morbidity secondary to valgus deformity. If surgery is postponed because an individual is asymptomatic, the window for correction with guided growth may be lost. Individuals undergoing hemiepiphysiodesis can expect that their pain and function will not be worse during the time that hardware is in place and that surgery is likely to improve any pain they may be experiencing. Level of Evidence: Level III; retrospective comparative study.

show abstract

Age and Gender Confound PROMIS Scores in Spine Patients With Back and Neck Pain

Cited by 12 publications

References 27 publications

A nationwide study of patients operated for cervical degenerative disorders in public and private hospitals

A nationwide study of patients operated for cervical degenerative disorders in public and private hospitals

Establishing Age-calibrated Normative PROMIS Scores for Hand and Upper Extremity Clinic

Patient-reported Outcomes of Adolescents Treated With Guided Growth to Correct Idiopathic Genu Valgum

Contact Info

Product

Resources

About