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PROMIS may be valid, efficient measure for femoroacetabular impingement
BOSTON — The patient-reported outcomes measurement information system may be a valid and efficient patient-reported outcome in patients undergoing hip arthroscopy for femoroacetabular impingement, according to results presented at the American Orthopaedic Society for Sports Medicine Annual Meeting.
James T. Rosneck, MD, and colleagues collected modified Harris Hip Score (HHS), hip outcome score-activities of daily living (HOS-ADL), international hip outcome tool (iHOT-12) and patient-reported outcomes measurement information system (PROMIS) including physical function, pain interference and activity satisfaction for 38 patients undergoing elective hip arthroscopy for femoroacetabular impingement (FAI). Patients also completed questionnaires preoperatively and at 2 and 6 weeks postoperatively.
Results showed excellent correlation between PROMIS and the HOS-ADL, the modified HHS and the iHOT-12 tool. Researchers found a negative linear correlation among patients with higher PROMIS pain interference and pain intensity scores with modified HHS, HOS-ADL and the iHOT-12 tool, as well as an excellent-good correlation among patients with higher activity satisfaction with modified HHS and HOS-ADL.
Rosneck noted there was significant responsiveness between the PROMIS and patients undergoing hip arthroscopy. He added PROMIS also demonstrated test-retest reliability.
“There was no floor or ceiling effect exhibited by PROMIS as it related to physical function, pain interference, pain intensity, social participation and role satisfaction domain scores,” Rosneck, from the Cleveland Clinic, told Healio.com/Orthopedics.
Although these results may be a springboard in guiding which patient-reported outcomes are most beneficial for surgeons to use among patients undergoing hip arthroscopy, Rosneck noted there is more research that still needs to be done to confirm these results.
“This is the initial study that shows that [PROMIS] does correlate for this patient population, that it holds up against other proven outcome measures, but this is a relatively short study,” Rosneck said. “We do not have the 2- to 3-year outcomes that we will need to apply it to clinical care in the future.” – by Casey Tingle
Reference:
Minkara A, et al. Paper 20. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 11-14, 2019; Boston.
Disclosure: Rosneck reports no relevant financial disclosures.
Perspective
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Patient-reported outcome (PRO) measures are critically important tools used in the assessment of subjective physical, mental and social change following an intervention. Within orthopedic surgery, the patient-reported outcomes measurement information system (PROMIS) computerized adaptive tests (CAT) are being widely and increasingly integrated into both research and everyday clinical practice. By definition, the adaptive nature of CAT reduces patient burden via reduction in question fatigue. In turn, compliance increases. PROs are only worthwhile if they are collected and if their psychometric properties (validity, reliability, responsiveness) adequately address the condition being measured.
Anas Minkara and colleagues have added to the growing body of evidence implementing PROMIS in the field of hip preservation and femoroacetabular impingement (FAI) syndrome. The authors demonstrated excellent reliability and correlation with validated hip preservation legacy measures (hip outcome score, iHOT-12) in a small prospective non-arthritic hip sample. An especially important observation was the absence of ceiling/floor effects for physical function, pain interference, pain intensity, social participation and role satisfaction domains. A significant advantage of PROMIS is the ability to cross subspecialties (arthroscopy, sports medicine, pediatrics, arthroplasty). As hip preservation evidence grows, future studies like Minkara and colleagues hold PROMIS with analysis of the dozens of other hip-relevant subdomains.
Institute of Academic Medicine at Houston Methodist Research Institute
Department of orthopedics and sports medicine
Associate professor of orthopedic surgery
New York