Preoperative patient-reported scores can predict postoperative outcomes after shoulder arthroplasty

Wong, Stephanie E.; Zhang, Alan L.; Berliner, Jonathan L.; Benjamin, C.; Feeley, Brian T.

doi:10.1016/j.jse.2016.01.029

Cited by 105 publications

(51 citation statements)

References 34 publications

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“…The average change in score (or, in some studies, the minimum, 25th percentile, or median score) for all patients who indicated improvement is taken to be the MCID. On the basis of a number of such studies, 29,31 we considered a change in ASES score of 12 points to indicate true improvement for most cohorts, and this value was used as the MCID. Because the MCID reflects the patient's experience, we believe that the most appropriate way to understand the inherent uncertainty in the ASES instrument is to consider 2 measurements to be indistinguishable within the margin of error of the instrument when the observed difference is less than the MCID.…”

Section: Discussionmentioning

confidence: 99%

“…This close match in score distributions is particularly important given that the distributions were not normal. Furthermore, the inherent variability of the ASES shoulder survey, as reflected by the MCID of 12 points for the ASES score, 18,29,31 is substantially greater than the uncertainty introduced by the CAT prediction. The paired score differences were symmetrically and randomly distributed (ie, clustered around zero, with only insignificant bias toward the CAT or full-form score being consistently higher), and only 0.07% of the differences were greater than the MCID.…”

Section: Discussionmentioning

confidence: 99%

“…Previous reports have identified a 12-point change in score as the threshold of noticeability for the ASES score. 29,31 Several analyses were performed to confirm the validity of the ASES CAT score for assessing shoulder outcomes, inspired by the recommendations of Bland and Altman 4 for quantifying the agreement between 2 methods of measurement. 1 First, the mean and standard deviation of test scores were compared for the CAT vs. full ASES format.…”

Section: Methodsmentioning

confidence: 99%

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A concise shoulder outcome measure: application of computerized adaptive testing to the American Shoulder and Elbow Surgeons Shoulder Assessment

Plummer

Abboud

Bell

et al. 2019

Journal of Shoulder and Elbow Surgery

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Background: Patient-reported outcome measures enable quantitative and patient-centric assessment of orthopedic interventions; however, increased use of these forms has an associated burden for patients and practices. We examined the utility of a computerized adaptive testing (CAT) method to reduce the number of questions on the American Shoulder and Elbow Surgeons (ASES) instrument. Methods: A previously developed ASES CAT system was applied to the responses of 2763 patients who underwent shoulder evaluation and treatment and had answered all questions on the full ASES instrument. Analyses to assess the accuracy of the CAT score in replicating the full-form score included the mean and standard deviation of both groups of scores, frequency distributions of the 2 sets of scores and score differences, Pearson and intraclass correlation coefficients, and Bland-Altman assessment of patterns in score differences. Results: By tailoring questions according to prior responses, CAT reduced the question burden by 40%. The mean difference between CAT and full ASES scores was À0.14, and the scores were within 5 points in 95% of cases (a 12-point difference is considered the threshold for clinical significance) and were clustered around zero. The correlation coefficients were 0.99, and the frequency distributions of the CAT and full ASES scores were nearly identical. The differences between scores were independent of the overall score, and no significant bias for CAT scores was found in either a positive or negative direction. Conclusion: The ASES CAT system lessens respondent burden with a negligible effect on score integrity. No institutional review board approval was required.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

A concise shoulder outcome measure: application of computerized adaptive testing to the American Shoulder and Elbow Surgeons Shoulder Assessment

Plummer

Abboud

Bell

et al. 2019

Journal of Shoulder and Elbow Surgery

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“…Preoperative PROMIS scores have been shown to predict postoperative PROMIS scores in patients with foot and ankle abnormalities and in patients undergoing arthroplasty. 2 , 3 , 12 , 24 The growing body of literature supports the strength of the PROMIS as an orthopaedic PRO measurement. 5 , 19 However, the ability of preoperative PROMIS scores to predict postoperative PROMIS scores in patients who have undergone ACL reconstruction is currently unknown.…”

mentioning

confidence: 99%

Preoperative PROMIS Scores Predict Postoperative Outcomes After Primary ACL Reconstruction

Chen

Papuga

Voloshin

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background:PROMIS (Patient-Reported Outcomes Measurement Information System) scores in patients undergoing anterior cruciate ligament (ACL) reconstruction have not been fully described in the literature to date. The ability of preoperative patient-reported outcome scores to directly predict postoperative outcomes in patients who undergo primary ACL reconstruction is unknown.Hypothesis:Postoperative PROMIS physical function (PF), pain interference (PI), and depression (D) scores in patients who undergo ACL reconstruction will show improvement when compared with preoperative scores. Additionally, preoperative PROMIS PF, PI, and D scores will predict which patients will not achieve a minimal clinically important difference (MCID) postoperatively.Study Design:Cohort study; Level of evidence, 3.Methods:A total of 233 patients who underwent primary ACL reconstruction between 2015 and 2016 and had completed PROMIS measures both preoperatively (within 60 days of surgery) and postoperatively (100-240 days after surgery) were included in this study. PROMIS PF, PI, and D scores were compared. Accuracy analyses were performed to determine whether preoperative PROMIS scores from each domain could predict postoperative achievement of MCID in the same domain. Cutoff scores were then calculated.Results:PROMIS PF, PI, and D scores all showed a significant improvement after ACL reconstruction (all P < .001). Preoperative scores from all 3 PROMIS domains showed a strong ability to predict clinically meaningful improvement, as defined by MCID, with areas under the receiver operating characteristic curve from 0.72 to 0.84. Optimal cutoffs for preoperative PROMIS scores showed that patients with a PF score of <42.5, PI score of >56.2, or D score of >44.8 were more likely to achieve MCID.Conclusion:PROMIS PF, PI, and D scores improved significantly in patients who underwent primary ACL reconstruction. Preoperative PROMIS PF, PI, and D scores were highly predictive of outcome in the early postoperative period. The reported cutoff scores showed high probability in predicting which patients would and would not achieve a clinically meaningful improvement.

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“…11 Our institution has developed a prospective registry that includes PROMIS computer adaptive testing (CT) to comprehensively assess patients undergoing different orthopaedic surgical procedures. 12 While the growing body of literature supports the strength of PROMIS as a high-throughput orthopaedic PRO measurement in multiple orthopaedic populations, [13][14][15][16][17][18][19][20][21][22][23] there is limited data regarding the association between PROMIS measures and patient expectations.…”

mentioning

confidence: 99%

Preoperative Expectations of Patients Undergoing Knee Surgery

et al. 2019

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There is limited validated data regarding the relationship between preoperative expectations and patient-reported outcomes (PROs) in patients undergoing knee surgery. The purpose of this study was to (1) assess the preoperative expectations of patients undergoing knee surgery and (2) determine the relationship between preoperative patient demographics, PROs, and preoperative patient expectations. We hypothesized that younger patients with worse function and worse general health status would have greater expectations of knee surgery. We analyzed data from 399 patients undergoing knee surgery at an urban academic medical center. We utilized the Musculoskeletal Outcomes Data Evaluation and Management System to measure preoperative expectations. Multiple legacy PRO measures were recorded, as well as the new Patient-Reported Outcomes Measurement Information Systems (PROMIS) Computer Adaptive Testing. Nonparametric statistical analyses were performed to determine significance. Overall, patients undergoing knee surgery had high expectations, with a mean of 88.0 (95% confidence interval [CI], 86.7–89.3) and median of 91.7 (95% CI, 89.2–94.3). Greater preoperative expectations of knee surgery were associated with higher income, surgically naïve knee, lower Charlson Comorbidity Index, better PROMIS Depression and Anxiety scores, greater Marx knee activity scores, and lower total body pain (p < 0.05). Preoperative expectations of patients undergoing knee surgery are associated with a history of prior knee surgery, income, general and mental health, activity, and pain. Expectations were also found to be associated with PRO measures of function and psychological well-being. These findings may have implications for patient education and shared decision-making preoperatively. The Level of Evidence for the study is IV.

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Preoperative patient-reported scores can predict postoperative outcomes after shoulder arthroplasty

Cited by 105 publications

References 34 publications

A concise shoulder outcome measure: application of computerized adaptive testing to the American Shoulder and Elbow Surgeons Shoulder Assessment

A concise shoulder outcome measure: application of computerized adaptive testing to the American Shoulder and Elbow Surgeons Shoulder Assessment

Preoperative PROMIS Scores Predict Postoperative Outcomes After Primary ACL Reconstruction

Preoperative Expectations of Patients Undergoing Knee Surgery

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