Validation of Patient Reported Outcomes Measurement Information System (PROMIS) Computer Adaptive Tests (CATs) in the Surgical Treatment of Lumbar Spinal Stenosis

Patel, Alpesh A.; Dodwad, Shah Nawaz M.; Boody, Barrett; Bhatt, Surabhi; Savage, Jason W.; Hsu, Wellington K.; Rothrock, Nan

doi:10.1097/brs.0000000000002648

Cited by 69 publications

(66 citation statements)

References 28 publications

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“…14,[16][17][18][19] While the literature is still developing in assessing the concurrent validity of the PRO-MIS domains of Pain Intensity and Pain Interference in populations with thoracolumbar disorders, recent research by Papuga et al 4 similarly shows a strong correlation between PROMIS Physical Function and ODI score (R 2 ¼ 0.683) for patients presenting for spine surgical evaluation. In a population of patients undergoing surgical treatment for lumbar spinal stenosis, Patel et al 19 also showed multiple correlations between ODI and the PROMIS domains of Physical Function (r ¼ À0.58), Pain Intensity (r ¼ 0.73), and Pain Behavior (r ¼ 0.60), further demonstrating the convergent validity of PROMIS assessments. Our analysis adds to the growing body of literature describing the relationship between the "gold standard" legacy assessment of low back disability and the "new standard" of PROMIS.…”

Section: Discussionmentioning

confidence: 99%

ODI Cannot Account for All Variation in PROMIS Scores in Patients With Thoracolumbar Disorders

Passias

Horn

Segreto

et al. 2019

Global Spine Journal

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Study Design: Retrospective review of single institution. Objective: To assess the relationship between Patient-Reported Outcomes Measurement Information System (PROMIS) and Oswestry Disability Index (ODI) scores in thoracolumbar patients. Methods: Included: Patients ≥18 years with a thoracolumbar spine condition (spinal stenosis, disc herniation, low back pain, disc degeneration, spondylolysis). Bivariate correlations assessed the linear relationships between ODI and PROMIS (Physical Function, Pain Intensity, and Pain Interference). Correlation cutoffs assessed patients with high and low correlation between ODI and PROMIS. Linear regression predicted the relationship of ODI to PROMIS. Results: A total of 206 patients (age 53.7 ± 16.6 years, 49.5% female) were included. ODI correlated with PROMIS Physical Function ( r = −0.763, P < .001), Pain Interference ( r = 0.800, P < .001), and Pain Intensity ( r = 0.706, P < .001). ODI strongly predicted PROMIS for Physical Function ( R2 = 0.58, P < .001), Pain Intensity ( R2 = 0.50, P < .001), and Pain Interference ( R2 = 0.64, P < .001); however, there is variability in PROMIS that ODI cannot account for. ODI questions about sitting and sleeping were weakly correlated across the 3 PROMIS domains. Linear regression showed overall ODI score as accounting for 58.3% ( R2 = 0.583) of the variance in PROMIS Physical Function, 63.9% ( R2 = 0.639) of the variance in Pain Interference score, and 49.9% ( R2 = 0.499) of the variance in Pain Intensity score. Conclusions: There is a large amount of variability with PROMIS that cannot be accounted for with ODI. ODI questions regarding walking, social life, and lifting ability correlate strongly with PROMIS while sitting, standing, and sleeping do not. These results reinforce the utility of PROMIS as a valid assessment for low back disability, while indicating the need for further evaluation of the factors responsible for variation between PROMIS and ODI.

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Section: Discussionmentioning

confidence: 99%

ODI Cannot Account for All Variation in PROMIS Scores in Patients With Thoracolumbar Disorders

Passias

Horn

Segreto

et al. 2019

Global Spine Journal

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“…Numerous studies in the spine literature have demonstrated that both are valid and responsive questionnaires. [14][15][16] The ODI and the NDI are 2 other commonly used questionnaires that have been in use since the early 1980s and are validated as useful clinical tools representing pain and disability. 17,18 The preoperative PROMIS scores were recorded, as well as the preoperative ODI and NDI scores.…”

Section: Methodsmentioning

confidence: 99%

Patient-Reported Allergies, a Marker of Preoperative Pain and Disability in Elective Spine Surgery

Lyons

Borsinger

Lucas

et al. 2019

Global Spine Journal

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Study Design: Retrospective review. Objective: Previous literature demonstrates mixed results regarding the relationship between patient-reported allergies and pain, function, and satisfaction scores. The objective of this study was to investigate the correlation between patient-reported allergies and preoperative Oswestry Disability Index (ODI), Neck Disability Index (NDI), and Patient-Reported Outcomes Measurement System (PROMIS) scores. Methods: All patients undergoing elective cervical, lumbar procedures between May 2017 and October 2018 were included. Baseline demographic information was recorded, as well as all reported allergies or adverse reactions. Preoperative PROMIS, ODI, and NDI scores were recorded. Hierarchical multiple linear regressions were used to assess the relationship between total number of allergies and the preoperative pain and function scores. Results: A total of 570 patients were included (476 lumbar, 94 cervical). The mean number of allergies reported was 1.89 ± 2.32. The mean preoperative ODI and NDI scores were 46.39 ± 17.67 and 43.47 ± 16.51, respectively. The mean preoperative PROMIS Physical Health and PROMIS Mental Health scores were 37.21 ± 6.54 and 43.89 ± 9.26, respectively. Hierarchical multiple linear regression showed that total number of reported allergies shared a statistically significant negative relationship with all of the following scores: ODI ( B = 0.83, P = .02), NDI ( B = 1.45, P = .02), PROMIS Physical Health ( B = −0.29, P = .013), and PROMIS Mental Health ( B = −0.38, P = .024). Conclusions: Patient-reported allergies share a statistically significant negative relationship with preoperative pain and function scores; as patients have increasing total number of allergies, the ODI/NDI scores become worse (increase) and the PROMIS scores become worse (decrease).

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“…Completion time tended to be shorter, and thus PROMIS measures could be more efficient than legacy measures. 46 It should be noted that if a comprehensive assessment of QOL is desired, numerous domains would need to be captured (e.g., physical, social, and emotional functioning, pain interference and pain behavior, positive affect, and well-being, etc. ), and thus the completion time would likely be similar to existing multidimensional outcome measures or combinations of such.…”

Section: The Promise Of Irtmentioning

confidence: 99%

Patient-reported outcomes in spine surgery: past, current, and future directions

Finkelstein

Schwartz

2019

Journal of Neurosurgery: Spine

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The purpose of this article is to review the current state of outcome measurement in spine surgery, with an emphasis on patient-reported outcome measures (PROMs). The commonly used generic and disease-specific outcome measures used in spinal surgery and research will be discussed. The authors will introduce the concepts of response shift and appraisal processes, which may affect the face validity of PROMs, as well as their interpretation over time. It is not uncommon for there to be a discrepancy between the observed and expected outcome, which is not wholly explainable by objective measures. Current work on understanding how appraisal affects outcome measurement will be discussed, and future directions will be suggested to facilitate the continued evolution of PROMs.There has been an evolution in the way clinicians measure outcomes following spinal surgery. In moving from purely physical, objective measures to a growing emphasis on the patient’s perspective, spine surgery outcomes are better able to integrate the impact at multiple levels of relevant change. Appraisal concepts and methods are gaining traction as ways to understand the cognitive processes underlying PROMs over time. Measurement of appraisal is a valuable adjunct to the current spine outcome tools.

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Validation of Patient Reported Outcomes Measurement Information System (PROMIS) Computer Adaptive Tests (CATs) in the Surgical Treatment of Lumbar Spinal Stenosis

Abstract: 2.

Cited by 69 publications

References 28 publications

ODI Cannot Account for All Variation in PROMIS Scores in Patients With Thoracolumbar Disorders

ODI Cannot Account for All Variation in PROMIS Scores in Patients With Thoracolumbar Disorders

Patient-Reported Allergies, a Marker of Preoperative Pain and Disability in Elective Spine Surgery

Patient-reported outcomes in spine surgery: past, current, and future directions

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