Validity and Responsiveness of PROMIS in Adult Spinal Deformity: The Need for a Self-Image Domain

Publication date: Available online 25 July 2018

Source: The Spine Journal

Author(s): Micheal Raad, Amit Jain, Mitchell Huang, Richard L. Skolasky, Daniel M. Sciubba, Khaled M. Kebaish, Brian J. Neuman

Abstract

Background Context

. Validity and responsiveness of the Patient Reported Outcomes Measurement Information System (PROMIS) have been investigated in several orthopaedic subspecialties. PROMIS has shorter completion time and greater research flexibility for the heterogeneous adult spinal deformity (ASD) population versus the Oswestry Disability Index (ODI) and Scoliosis Research Society 22-item questionnaire (SRS-22r).

Purpose

. Evaluate the validity and responsiveness of PROMIS in ASD surgery during the early postoperative period.

Design

. Prospective, longitudinal study.

Patient Sample

. One hundred twenty-three patients with complete SRS-22r and PROMIS data.

Measures

. Validity and responsiveness of PROMIS versus the ODI and SRS-22r.

Methods

. We identified patients who completed SRS-22r, ODI, and PROMIS questionnaires. Spearman's correlation was used to assess validity, paired-samples t tests to assess responsiveness, and Cohen's d to assess measure of effect. The authors report no conflicts of interests. No funding was received in support of this study.

Results

. One hundred twenty-three patients with SRS-22r and PROMIS data from the preoperative visit were included in the validity analysis. Seventy-six patients with preoperative and early postoperative (6-week to 3-month) data were included in the responsiveness analysis. SRS-22r function, self-image, pain, and mental health scores were moderately to strongly correlated with the following PROMIS domains: physical function (r = .53), satisfaction with participation in social roles (r = .51), pain (r = −.60), and anxiety (r = −.73). All SRS-22r domains, PROMIS domains, and ODI scores changed significantly from preoperatively to postoperatively (p < .05). Compared with the SRS-22r, PROMIS showed superior responsiveness across all domains except self-image.

Conclusion

. Our results indicate that PROMIS is a valid measure with comparable responsiveness to that of the SRS-22r and ODI during the early period after ASD surgery. However, a domain that reflects how ASD patients perceive their self-image should be developed and validated.

Level of Evidence

. 2

https://ift.tt/2LoEshd