What Are the Floor and Ceiling Effects of Patient-Reported Outcomes Measurement Information System Computer Adaptive Test Domains in Orthopaedic Patients? A Systematic Review

Gulledge, Caleb M.; Lizzio, Vincent A.; Smith, D. Grace; Guo, Eric W.; Makhni, Eric C.

doi:10.1016/j.arthro.2019.09.022

Cited by 38 publications

(37 citation statements)

References 67 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a systematic review of floor and ceiling effects across 12 studies including 18 113 patients, Gulledge et al reported floor effects ranging from 0% to 1.6% and ceiling effects ranging from 0% to 28% (290).…”

Section: Promis Physical Function Upper Extremity Catmentioning

confidence: 99%

Measures of Adult Shoulder Function

Buchbinder

Smolen

Huang

et al. 2020

Arthritis Care & Research

View full text Add to dashboard Cite

Section: Promis Physical Function Upper Extremity Catmentioning

confidence: 99%

Measures of Adult Shoulder Function

Buchbinder

Smolen

Huang

et al. 2020

Arthritis Care & Research

View full text Add to dashboard Cite

“…This is consistent with numerous reports in the orthopaedic literature. 4,[10][11][12] These high floor effects are likely multifactorial in nature, and patients may be hesitant or unwilling to disclose true mental health concerns in such a manner. This could result in a high proportion of responses indicating an absence of depressive symptoms (ie, high floor effect).…”

Section: Discussionmentioning

confidence: 99%

Pediatric PROMIS Computer Adaptive Tests Are Highly Correlated With Adult PROMIS Computer Adaptive Tests in Pediatric Sports Medicine Patients

Bernstein¹,

Franovic

Smith

et al. 2020

Am J Sports Med

Self Cite

View full text Add to dashboard Cite

Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) is a powerful set of patient-reported outcome measures (PROMs) that are gaining popularity throughout orthopaedic surgery. The use of both adult and pediatric PROMIS questionnaires in orthopaedic sports medicine limits the value of the PROMIS in routine sports medicine clinical care, research, and quality improvement. Because orthopaedic sports medicine surgeons see patients across a wide age range, simplifying the collection of PROMIS computer adaptive tests (CATs) to a single set of questionnaires, regardless of age, is of notable value. Purpose/Hypothesis: The purpose was to determine the strength of the correlation between the pediatric and adult PROMIS questionnaires. We hypothesized that there would be a high correlation between the adult and pediatric versions for each PROMIS domain, thereby justifying the use of only the adult version for most sports medicine providers, regardless of patient age. Study Design: Cohort study (Diagnosis); Level of evidence, 2. Methods: Between December 2018 and December 2019, all pediatric sports medicine patients presenting to a single, academic, orthopaedic sports medicine clinic were asked to participate in the present study with their parents’ consent. Patients were asked to complete a set of adult PROMIS domains (Physical Function and/or Upper Extremity, Pain Interference, and Depression) as well as a set of pediatric PROMIS domains (Mobility and/or Upper Extremity, Pain Interference, and Depressive Symptoms). Concurrent validity was assessed using Pearson correlation coefficients ( r). Ceiling and floor effects were determined. Results: A total of 188 patients met our inclusion criteria. The correlation between the adult and pediatric PROMIS Upper Extremity, Physical Function and Mobility, Pain Interference, and Depression and Depressive Symptoms forms were high-moderate ( r = 0.68; P < .01), high-moderate ( r = 0.69; P < .01), high ( r = 0.78; P < .01), and high ( r = 0.85; P < .01), respectively. Both adult and pediatric depression-related PROMIS domains demonstrated notable floor effects (adult: 38%; pediatric: 24%). The pediatric PROMIS Upper Extremity domain demonstrated a ceiling effect (20%). Conclusion: Adult PROMIS CATs may be used in an orthopaedic sports medicine clinic for both adult and pediatric patients. Our findings will help decrease the amount of resources needed for the implementation and use of PROMs for patient care, research, and quality improvement in orthopaedic sports medicine clinics.

show abstract

“…The PROMIS PF CAT demonstrated a dose‐response relationship with disease activity in patients with RA, with a lower function associated with higher disease activity . Ceiling or floor effects are uncommon (0%‐9%) . The PROMIS instruments were designed to cover a large range of function, particularly at the lower end of PF .…”

Section: Promis Physical Function Computer Adaptive Testmentioning

confidence: 99%

“…Adaptive by design, the PROMIS PF CAT evaluates function efficiently and precisely. Notably, it performs well across a broad spectrum of function, with negligible floor or ceiling effects . Generalizability is strong because the scores are standardized to the general population, and it has been used in a wide variety of rheumatic and other conditions.…”

Section: Promis Physical Function Computer Adaptive Testmentioning

confidence: 99%