Responsiveness of the PROMIS and FAAM Instruments in Foot and Ankle Orthopedic Population

Abstract

Background: Investigating the responsiveness of an instrument is important in order to provide meaningful interpretation of clinical outcomes. This study examined the responsiveness of the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF), the PROMIS Pain Interference (PI), and the Foot and Ankle Ability Measure (FAAM) Sports subscale in an orthopedic sample with foot and ankle ailments. Methods: Patients presenting to an orthopedic foot and ankle clinic during the years 2014–2017 responded to the PROMIS and FAAM instruments prior to their clinical appointments. The responsiveness of the PROMIS PF v1.2, PROMIS PI v1.1, and FAAM Sports were assessed using paired samples t test, effect size (ES), and standardized response mean (SRM) at 4 different follow-up points. A total of 785 patients with an average age of 52 years (SD = 17) were included. Results: The PROMIS PF had ESs of 0.95 to 1.22 across the 4 time points (3, >3, 6, and <6 months) and SRMs of 1.04 to 1.43. The PROMIS PI had ESs of 1.04 to 1.63 and SRMs of 1.17 to 1.23. For the FAAM Sports, the ESs were 1.25 to 1.31 and SRMs were 1.07 to 1.20. The ability to detect changes via paired samples t test provided mixed results. But in general, the patients with improvement had statistically significant improved scores, and the worsening patients had statistically significant worse scores. Conclusion: The PROMIS PF, PROMIS PI, and FAAM Sports were sensitive and responsive to changes in patient-reported health. Level of Evidence: Level II, prospective comparative study.

A Patient-Reported Outcomes Measurement Information System Short Form for Measuring Physical Function During Geriatric Rehabilitation: Test-Retest Reliability, Construct Validity, Responsiveness, and Interpretability

“…30 A limitation is that most of these studies used distribution-based methods instead of the preferred method of hypotheses testing to determine responsiveness. 22,38,39 We found a minimal important change value of 8 points. Two studies determined the minimal important change of the PROMIS-PF-10a in patients with osteoarthritis and rheumatoid arthritis using multiple anchor-based methods and found a range of 1.9e2.2.…”

Responsiveness of the PROMIS and its Concurrent Validity with Other Region- and Condition-specific PROMs in Patients Undergoing Carpal Tunnel Release

“…PROMs, especially generic instruments such as the PROMIS, are becoming common in orthopaedic clinics with an increasing interest in value-based health care. In many orthopaedic settings, the PROMIS, which may add more value than other PROMs because of its ability to provide insight into a patient's overall health in the setting of illness, has been shown to capture constructs that are similar to those of more focused PROMs (such as region-specific PROMs) [2,9,10,25,28] with comparable responsiveness [13,16,17,19]. However, it is unclear if this is consistent within a patient population that has a single, common hand condition (that is, CTS) treated with the same procedure (CTR).…”

“…One benefit of the PROMIS is that it captures constructs that are similar to those of specialty-specific PROMs [2,9,10,25,28]. It is also responsive; that is, the PROMIS's domains can be used detect change over time [13,14,16,17,19]. Although studies in certain areas of orthopaedic surgery (such as ACL reconstruction and spine disorders) show that the PROMIS domains and region-specific scales have comparable responsiveness [19,32], there is still concern that the PROMIS Physical Function (PF), Upper Extremity (UE), and Pain Interference (PI) domains are not sufficiently specific to the hand or certain hand procedures such as carpal tunnel release (CTR).…”

Radiographic and Magnetic Resonance Imaging of the Symptomatic Synthetic Cartilage Implant

“…Postoperative clini-cal data included Patient-Reported Outcome Measures Informational System (PROMIS) physical function and pain interference scores obtained at clinical follow-up visits. 9,10 Patient satisfaction postoperatively and revision surgical procedures, including conversions to fusion, were collected via phone interviews by a study member not involved with the SCI surgery.…”