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PROMIS Global-10 may be a valid outcomes assessment for patients with rotator cuff pathology
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Recently published results suggest the patient-reported outcomes measurement information system global-10 may be valid in assessing patients with rotator cuff disease, with high correlation in physical function scores when compared with legacy patient-reported outcome instruments.
David Kovacevic, MD, and colleagues prospectively collected patient-reported outcomes measurement information system (PROMIS) Global-10, EuroQol-5D, American Shoulder and Elbow Surgeons shoulder assessment form and single assessment numeric evaluation from 323 patients with rotator cuff disease, as well as the Western Ontario Rotator Cuff Index from patients with known rotator cuff tears.
Results showed excellent correlation between the PROMIS Global-10 and EQ-5D, while PROMIS physical scores had excellent-good correlation with ASES scores and good correlation with the Western Ontario Rotator Cuff Index and the single assessment numeric evaluation. Researchers also found poor correlation between the PROMIS mental scores with ASES, Western Ontario Rotator Cuff Index and single assessment numeric evaluation. No floor or ceiling effects were found, according to results. Despite the overall similarity in mean scores between the estimated and actual EQ-5D scores, agreement analysis showed substantial variance in individual scores. Researchers noted a range in Bland-Altman 95% limits of agreement for estimated EQ-5D scores from 34% below to 31% above actual EQ-5D scores.
“The NIH PROMIS Global-10, while validated for general health in our U.S. population, has yet to be validated in specific musculoskeletal and orthopedic patient populations,” Kovacevic told Healio.com/Orthopedics. “This study, funded in part by NIH [National Institute of Arthritis and Musculoskeletal and Skin Diseases] NIAMS, evaluated the performance of the PROMIS Global-10 compared with legacy instruments in patients with rotator cuff disease and found that it is an appropriate instrument for outcome measurement in such populations. Given the broad applicability, the PROMIS Global-10 can potentially be utilized by physicians in multispecialty groups.” – by Casey Tingle
Disclosures: Kovacevic reports he received education and hospitality payments from Arthrex, DePuy Synthes and Tornier and has received honoraria from Fidia Pharma. Please see the full study for a list of all other authors’ relevant financial disclosures.
Perspective
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John D. Kelly IV, MD
The age of outcomes is upon us and rightfully so, as insurers increasingly scrutinize the value of what orthopedic surgeons do. Lengthy traditional patient-recorded outcome instruments (PROs) can present a significant burden to office workflow. In response, the NIH has proposed PROMIS as a means of attaining precise yet convenient patient outcome data.
In this paper, Nicholson and colleagues compared the PROMIS Global-10, a 10-question instrument which assesses overall physical function, fatigue, pain, emotional distress and social health, to traditional “legacy” PROs, including the Western Ontario Rotator Cuff Index, ASES shoulder assessment form, single assessment numeric evaluation and EQ-5D, for 323 patients presenting with rotator cuff disease.
PROMIS Global-10 not only showed excellent correlation with traditional shoulder PROs, but also demonstrated no ceiling or floor effects. PROMIS Global-10 required on average 1.72 minutes to complete and also correlates well with general health PROs. With the exception of EQ-5D, this user-friendly instrument may supplant other “legacy PROs” in assessing outcomes of rotator cuff disease treatments.
University of Pennsylvania
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