Correlation of PROMIS CAT with Validated Hip Outcome Scores in Patients Undergoing Hip Arthroscopy

Childs, Sean; Canham, Colin D.; Kenney, Raymond; Silas, Diana Rebecca; Adler, Kelly L.; Giordano, Brian D.

doi:10.1177/2325967117s00451

Cited by 8 publications

(9 citation statements)

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“…We selected the PRO instruments used in this study (HOOS Pain and PS, PROMIS PF and PI, mHHS, VAS) based on current literature regarding the psychometric properties of PRO instruments for patients undergoing PAO 1 and hip arthroscopy. 4 , 14 , 20 , 37 We elected to omit other well-validated PRO instruments in order to limit participant fatigue with testing. Inclusion of other hip metrics, including the Western Ontario and McMaster Universities Osteoarthritis Index and the Hip Outcome Score, 23 could be considered in future study.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Disability Related to Hip Dysplasia Using Objective Measures of Physical Performance

Scott

Willey

Mercado

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Lower extremity physical performance measures (PPMs), which can objectively quantify functional ability, are an attractive adjuvant to patient-reported outcome (PRO) instruments. However, few tests have been validated for use in hip instability. Purpose: To evaluate 4 different PPMs for their ability to differentiate between young adults with hip dysplasia indicated for treatment with periacetabular osteotomy (PAO) and asymptomatic controls and to test inter- and intratest reliability and relationship with popular hip PRO instruments. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A total of 24 symptomatic patients aged 15 to 39 years (100% female) with hip dysplasia (lateral center-edge angle <25°) indicated for treatment with PAO completed the visual analog scale (VAS) for pain, Hip disability and Osteoarthritis Outcome (HOOS) Pain subscale, HOOS Short Version (HOOS PS), International Hip Outcome Tool Short Version (iHOT-12), modified Harris Hip Score (mHHS), Patient Reported Outcome Measurement Information System (PROMIS) physical function (PF) and pain interference (PI), and 4 physical function tests: (1) self-selected walking speed (SSWS), sit-to-stand 5 times (STS5), (3) 4-square step test (FSST), and (4) timed stair ascent (TSA). A further 21 young, asymptomatic adults aged 18 to 39 years (91% female) also underwent testing. Between-group comparisons were made with unpaired t test with Bonferroni-Holm correction. Inter- and intrarater reliability was assessed in 38 participants by repeating PPMs at a second visit and using 2 raters. Spearman rank correlation coefficients were used to determine associations between PPMs and PRO instruments. Results: Significant differences between patients with hip dysplasia and controls were observed for all PRO instruments (HOOS Pain, 47.8 vs 99.2; HOOS PS, 61.9 vs 99.2; iHOT-12, 32.2 vs 99.2; mHHS, 54.5 vs 90.6; PROMIS PF, 41.4 vs 65.6; and PROMIS PI, 62.0 vs 39.1 [all P < .001]), and all PPMs (SSWS, 1.21 vs 1.53 m/s; STS5, 10.85 vs 5.95 s; FSST, 6.59 vs 4.03 s [all P < .001]; and TSA, 4.58 vs 3.29 s [ P = .002]). All 4 PPMs demonstrated excellent intra- and intertest reliability (intraclass correlation coefficient, 0.83-0.99). STS5, FSST, and TSA were correlated highly ( r > 0.5) with physical function PRO instruments, including PROMIS PF, mHHS, and iHOT-12. Conclusion: Patients with symptomatic hip dysplasia demonstrated significant impairment on functional testing compared with asymptomatic controls, and performance measure testing demonstrated excellent test-retest reliability. Timed stair ascent and sit-to-stand testing in particular were correlated strongly with physical function PRO instruments. PPMs may be a viable and well-received adjuvant to PRO instrument administration for patients with nonarthritic hip conditions, and investigation of the ability of PPMs to assess surgical outcomes for hip dysplasia is warranted.

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Section: Discussionmentioning

confidence: 99%

Assessment of Disability Related to Hip Dysplasia Using Objective Measures of Physical Performance

Scott

Willey

Mercado

et al. 2020

Orthopaedic Journal of Sports Medicine

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“…Comparative studies of small sample size have been performed utilizing PROMIS measures with the mHHS, iHOT-33, and Hip dysfunction and Osteoarthritis Outcome Score (HOOS) among patients with FAI syndrome. 7,20,40 However, the complete spectrum of the PROMIS multiple domains has not been compared with legacy scores or studied in a hip pain population of all diagnoses. 21 These domains include anxiety (ANX), depression (DEP), fatigue (FT), sleep (SL), ability to participate in social roles and activities (SOC), pain interference (PIF), pain intensity (PIN), pain behavior (PB), and physical function (PF) scores.…”

mentioning

confidence: 99%

Relationship Between PROMIS Computer Adaptive Tests and Legacy Hip Measures Among Patients Presenting to a Tertiary Care Hip Preservation Center

Kollmorgen¹,

Hutyra

Green

et al. 2019

Am J Sports Med

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Background: Legacy hip outcome measures may be burdensome to patients and sometimes yield floor or ceiling effects. Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive tests (CATs) allow for low-burden data capture and limited ceiling and floor effects. Purpose/Hypothesis: The purpose of this study was to determine whether the PROMIS CAT domains demonstrate correlation against commonly used legacy patient-reported outcome measures in a population of patients presenting to a tertiary care hip preservation center. The authors hypothesized the following: (1) PROMIS CAT scores based on physical function (PF), pain interference (PIF), pain behavior, and pain intensity would show strong correlation with the following legacy scores: modified Harris Hip Score (mHHS), International Hip Outcome Tool–12 (iHOT-12), Hip Outcome Score (HOS) Sports and Activities of Daily Living subscales, and Veterans RAND–6D (VR-6D) utility measure. (2) The mental and physical health portions of the VR-6D legacy measure would show weak correlation with mental- and psychosocial-specific PROMIS elements—depression, anxiety, fatigue, sleep, and ability to participate in social roles and activities. (3) All PROMIS measures would exhibit fewer floor and ceiling effects than legacy scores. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Prospective data were collected on 125 patients in the hip preservation clinics. Enrollees completed legacy scores (visual analog scale for pain, mHHS, iHOT-12, HOS, and VR-6D) and PROMIS CAT questionnaires (PF, PIF, pain behavior, anxiety, depression, sleep, social roles and activities, pain intensity, fatigue). Spearman rank correlations were calculated, with rs values of 0 to 0.3 indicating negligible correlation; 0.3 to 0.5, weak correlation; 0.5 to 0.7, moderately strong correlation; and >0.7, strong correlation. Floor and ceiling effects were evaluated. Results: As anticipated, the PF-CAT yielded strong correlations with the iHOT-12, mHHS, HOS–Sports, HOS–Activities of Daily Living, and VR-6D, with rs values of 0.76, 0.71, 0.81, 0.87, and 0.71, respectively. The PIF-CAT was the only pain score to show moderately strong to strong correlation with all 14 patient-reported outcome measures. A strong correlation was observed between the VR-6D and the social roles and activities CAT (rs = 0.73). The depression CAT had a significant floor effect at 19%. No additional floor or ceiling effect was present for any other legacy or PROMIS measure. Conclusion: The PF-CAT shows strong correlation with legacy patient-reported outcome scores among patients presenting to a tertiary care hip preservation center. The PIF-CAT also correlates strongly with legacy and PROMIS measures evaluating physical and mental well-being. PROMIS measures are less burdensome and demonstrate no floor or ceiling effects, making them a potential alternative to legacy patient-reported outcome measures for the hip.

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“…The PROMIS-PF CAT also had improved reliability over the ASES score and a lower rate of floor effect compared with the SST. 6 Brodke et al 8 reported that the PROMIS-PF CAT outperformed the With regard to patients undergoing hip arthroscopy, Childs et al 13 recently demonstrated that the PROMIS-PF CAT and PROMIS-PI correlated well with legacy PROMs such as VAS, HOS-ADL, HOS-SS, and mHHS up to 3 months postoperatively. The authors found that the PROMIS-PF performed better, having high correlation with legacy PROMs, whereas the PROMIS-PI had only a moderate correlation.…”

Section: Discussionmentioning

confidence: 99%

“…With regard to patients undergoing hip arthroscopy, Childs et al 13 recently demonstrated that the PROMIS-PF CAT and PROMIS-PI correlated well with legacy PROMs such as VAS, HOS-ADL, HOS-SS, and mHHS up to 3 months postoperatively. The authors found that the PROMIS-PF performed better, having high correlation with legacy PROMs, whereas the PROMIS-PI had only a moderate correlation.…”

Section: Discussionmentioning

confidence: 99%

Defining Clinically Significant Improvement on the Patient-Reported Outcomes Measurement Information System Test at 1-Year Follow-up for Patients Undergoing Hip Arthroscopy for the Treatment of Femoroacetabular Impingement Syndrome

et al. 2021

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Background: Although minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), and substantial clinical benefit (SCB) have been defined for hip-specific legacy patient-reported outcome measures, these metrics have not been defined for the Patient-Reported Outcomes Measurement Information System (PROMIS) instruments for patients undergoing hip arthroscopy. Purpose: To define the MCID, PASS, and SCB thresholds for the PROMIS Physical Function (PF) computerized adaptive test (CAT) and PROMIS Pain Interference (PI) instruments in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS). Study Design: Cohort study (Diagnosis); Level of evidence, 2. Methods: Patients undergoing primary hip arthroscopy between August 2018 and January 2019 for the treatment of FAIS were retrospectively analyzed. Patients were administered the PROMIS-PF, PROMIS-PI, Hip Outcome Score (HOS)–Activities of Daily Living, HOS–Sports Subscale, modified Harris Hip Score, and International Hip Outcome Tool–12 preoperatively and at 1 year postoperatively. MCID was calculated using the distribution method, whereas PASS and SCB were calculated using an anchor-based method. Patients achieving clinically significant outcomes (CSOs) were compared with those who did not achieve CSOs via chi-square and independent-samples t tests, and a multivariate logistic regression was conducted to determine predictors of CSO achievement. Results: 124 patients with a mean age of 32.7 ± 12.3 years were included in the analysis. The threshold scores required to achieve MCID, PASS, and SCB, respectively, were as follows: PROMIS-PI (–3.1, 53.7, 51.9) and PROMIS-PF (3.3, 47.0, 49.9). Patients achieved any MCID, PASS, and SCB for PROMIS scores at a rate of 89.0%, 71.8%, and 62.1%, respectively, compared with 87.1%, 76.6%, and 71.8% for legacy patient-reported outcome measurements. For PROMIS-PF, higher preoperative PROMIS-PF score was a positive predictor of CSO achievement, and patients achieving SCB were significantly younger (30.3 ± 12 vs 35.6 ± 12 years; P = .017) with significantly lower body mass index (BMI) (24.7 ± 6.4 vs 27.9 ± 7; P = .009). Preoperative chronic pain and history of orthopaedic surgery were negative predictors of PROMIS-PI CSO achievement, whereas higher (worse) preoperative PROMIS-PI scores were a positive predictor. Conclusion: Our study defined the MCID, PASS, and SCB for the PROMIS-PF CAT and PROMIS-PI CAT at 1 year postoperatively. Patients with higher preoperative PROMIS scores, younger age, and lower BMI were more likely to achieve CSO, whereas preoperative chronic pain and history of orthopaedic surgery were negative predictors of CSO achievement.

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Correlation of PROMIS CAT with Validated Hip Outcome Scores in Patients Undergoing Hip Arthroscopy

Cited by 8 publications

References 0 publications

Assessment of Disability Related to Hip Dysplasia Using Objective Measures of Physical Performance

Assessment of Disability Related to Hip Dysplasia Using Objective Measures of Physical Performance

Relationship Between PROMIS Computer Adaptive Tests and Legacy Hip Measures Among Patients Presenting to a Tertiary Care Hip Preservation Center

Defining Clinically Significant Improvement on the Patient-Reported Outcomes Measurement Information System Test at 1-Year Follow-up for Patients Undergoing Hip Arthroscopy for the Treatment of Femoroacetabular Impingement Syndrome

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