Preoperative PROMIS Scores Predict Postoperative Success in Foot and Ankle Patients

Ho, Bryant S.; Houck, Jeff; Flemister, Adolph S.; Ketz, John; Oh, Irvin; DiGiovanni, Benedict F.; Baumhauer, Judith F.

doi:10.1177/1071100716665113

Cited by 199 publications

(232 citation statements)

References 18 publications

(32 reference statements)

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“…We then performed receiver operator characteristic analysis to determine whether preoperative PROMIS scores could predict the likelihood that a patient would obtain a clinically meaningful benefit from foot and ankle surgery. 4 We found that a patient with a PROMIS physical function T score above 42, for example, has a 94% chance of not experiencing a minimal clinically important difference in function after surgery. Similarly, a patient with a preoperative pain T score below 55 has a 95% chance of not obtaining a meaningful benefit in terms of pain interference.…”

Section: Patient-reported Outcomes -Are They Living Up To Their Potenmentioning

confidence: 74%

Patient-Reported Outcomes — Are They Living Up to Their Potential?

2017

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Section: Patient-reported Outcomes -Are They Living Up To Their Potenmentioning

confidence: 74%

Patient-Reported Outcomes — Are They Living Up to Their Potential?

2017

Self Cite

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“…We recommend that PROs should be collected at baseline, throughout the inpatient stay, and after hospital discharge. 4. At the current time we recommend that PROs should be collected using the QoR-15 during the immediate postoperative period (at a minimum on postoperative day #1 and at discharge) and either the WHODAS 2.0, or PROMIS at 30 days and 90 days after surgery.…”

Section: Consensus Statementsmentioning

confidence: 99%

“…3 PROs in patients undergoing ankle surgery and found that patients with low preoperative physical function and high pain interference experienced superior outcomes after surgery whereas patients with less profound perturbation in preoperative physical function and pain experienced a smaller benefit. 4 Accordingly, use of PROs within the perioperative setting has the potential to enhance shared decision making between surgeons and patients regarding treatment options that can be specific to the type of surgery that they are planning.…”

Section: Introduction: the Role Of Patient Reported Outcomes In Enhanmentioning

confidence: 99%

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Patient-Reported Outcomes in an Enhanced Recovery Pathway

Abola

Bennett‐Guerrero

Kent

et al. 2018

Anesthesia &Amp; Analgesia

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Patient-reported outcomes (PROs) are measures of health status that come directly from the patient. PROs are an underutilized tool in the perioperative setting. Enhanced recovery pathways (ERPs) have primarily focused on traditional measures of health care quality such as complications and hospital length of stay. These measures do not capture postdischarge outcomes that are meaningful to patients such as function or freedom from disability. PROs can be used to facilitate shared decisions between patients and providers before surgery and establish benchmark recovery goals after surgery. PROs can also be utilized in quality improvement initiatives and clinical research studies. An expert panel, the Perioperative Quality Initiative (POQI) workgroup, conducted an extensive literature review to determine best practices for the incorporation of PROs in an ERP. This international group of experienced clinicians from North America and Europe met at Stony Brook, NY, on December 2-3, 2016, to review the evidence supporting the use of PROs in the context of surgical recovery. A modified Delphi method was used to capture the collective expertise of a diverse group to answer clinical questions. During 3 plenary sessions, the POQI PRO subgroup presented clinical questions based on a literature review, presented evidenced-based answers to those questions, and developed recommendations which represented a consensus opinion regarding the use of PROs in the context of an ERP. The POQI workgroup identified key criteria to evaluate patient-reported outcome measures (PROMs) for their incorporation in an ERP. The POQI workgroup agreed on the following recommendations: (1) PROMs in the perioperative setting should be collected in the framework of physical, mental, and social domains. (2) These data should be collected preoperatively at baseline, during the immediate postoperative time period, and after hospital discharge. (3) In the immediate postoperative setting, we recommend using the Quality of Recovery-15 score. After discharge at 30 and 90 days, we recommend the use of the World Health Organization Disability Assessment Scale 2.0, or a tailored use of the Patient-Reported Outcomes Measurement Information System. (4) Future study that consistently applies PROMs in an ERP will define the role these measures will have evaluating quality and guiding clinical care. Consensus guidelines regarding the incorporation of PRO measures in an ERP were created by the POQI workgroup. The inclusion of PROMs with traditional measures of health care quality after surgery provides an opportunity to improve clinical care.

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“…For example, preoperative instrument scores have also been used to determine which patients are best suited for surgery. 37,38 More specifically, data suggest SNOT-22 scores of at least 20 in those who have failed maximal medical therapy indicate sufficient symptom impact to warrant endoscopic sinus surgery; accordingly, an international expert panel endorsed this threshold value as one of three operative indications on which their group could achieve consensus. 38 In patients with sensorineural hearing loss, randomized clinical trial data suggest that those with Inner EAR scores of 27 (95% CI: 25-28) improve, on average, to a score of 65 when amplification devices are utilized.…”

Section: Implications For Practicementioning

confidence: 99%

The Utility and Feasibility of Extending Beyond Traditional Patient Descriptions in Daily Practice

et al. 2019

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Objectives/Hypothesis Institutional and national programs have endorsed the use of validated instruments in daily practice, but their utility for frontline clinicians is unknown. Our first objective was thus to determine if routinely obtained patient descriptions accurately predict disease‐specific validated instrument results. Our second objective was to assess the feasibility of deploying an electronic system to obtain and document patient‐reported descriptions of health status. Study Design Prospective assessment of consecutive eligible ambulatory care patients. Methods For the first objective, patients presenting with the same chief complaint at consecutive visits provided concurrent routine symptom descriptions and validated instrument responses. To determine whether patients’ routine descriptions predicted scores from disease‐specific instruments, receiver operator characteristic (ROC) curves, sensitivity/specificity, Spearman ρ correlation, and regression models were utilized. For the second objective, feasibility assessment focused on percent with successful response capture, time to questionnaire completion, and impact on physician time needed to obtain and document patient histories. Results For the first objective, among patients with hearing loss, eustachian tube dysfunction, nasal obstruction, and chronic rhinosinusitis, the areas under the ROC curves were 0.38 to 0.83. Spearman ρ coefficients were 0.25 to 0.46. Sensitivity and specificity ranged from 15.9% to 87.8%, with correct classification in 42.3% to 55.2% of cases. For the second objective, there was a 91% completion rate. Completion times were 7:18 to 12:37 for new patients and 3:23 to 6:41 for established patients. Physician time savings were estimated at 11 minutes per patient. Conclusions Using validated instruments and electronic data collection systems in daily practice has practical and clinical implications. These topics warrant further study. Level of Evidence 2c Laryngoscope, 130:S1–S13, 2020

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Preoperative PROMIS Scores Predict Postoperative Success in Foot and Ankle Patients

Abstract: Level II, prognostic study.

Cited by 199 publications

References 18 publications

Patient-Reported Outcomes — Are They Living Up to Their Potential?

Patient-Reported Outcomes — Are They Living Up to Their Potential?

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Patient-Reported Outcomes in an Enhanced Recovery Pathway

The Utility and Feasibility of Extending Beyond Traditional Patient Descriptions in Daily Practice

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