Role of Preoperative PROMIS Scores in Predicting Postoperative Outcomes and Likelihood of Achieving MCID Following Reverse Shoulder Arthroplasty

Franovic, Sreten; Kuhlmann, N; Schlosser, Collin; Pietroski, Alexander; Buchta, Asa G; Muh, Stephanie J.

doi:10.1016/j.jse.2021.03.033

Cited by 3 publications

(6 citation statements)

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“…In short, patients with worse preoperative depressive symptoms were more likely to experience improvement in depressive symptoms. 19 Our study alternatively used PROMIS to assess the relationship between mental health and physical function and found both PROMIS Depression and PROMIS Anxiety to be predictive of physical function. It is difficult to compare our study results to Franovic et al 19 because the MCID interprets outcome data in reference to a certain threshold of score change.…”

Section: Discussionmentioning

confidence: 78%

“…19 Our study alternatively used PROMIS to assess the relationship between mental health and physical function and found both PROMIS Depression and PROMIS Anxiety to be predictive of physical function. It is difficult to compare our study results to Franovic et al 19 because the MCID interprets outcome data in reference to a certain threshold of score change. Additionally, they exclusively studied shoulder arthroplasty patients at a mean follow-up of 9.6 months.…”

Section: Discussionmentioning

confidence: 78%

“…Additionally, we found that mean PROMIS Depression and PROMIS Anxiety decreased postoperatively, which corresponds with the previous literature. 4,7,19 However, the approximately normal distribution of change in PROMIS Depression and Anxiety (Figures 1 and 2) indicates that some patients had worse scores postoperatively. This may be partially explained by the difference between clinical depression and anxiety, and mental health symptoms related specifically to the shoulder.…”

Section: Discussionmentioning

confidence: 98%

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PROMIS Depression and Anxiety in shoulder surgery patients

Baker

Albelo

Zhang

et al. 2022

The Bone & Joint Journal

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Aims The purpose of this study was to assess the prevalence of depression and anxiety symptoms in patients undergoing shoulder surgery using the National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) Depression and Anxiety computer adaptive tests, and to determine the factors associated with more severe symptoms. Additionally, we sought to determine whether PROMIS Depression and Anxiety were associated with functional outcomes after shoulder surgery. Methods This was a retrospective analysis of 293 patients from an urban population who underwent elective shoulder surgery from 2015 to 2018. Survey questionnaires included preoperative and two-year postoperative data. Bivariate analysis was used to identify associations and multivariable analysis was used to control for confounding variables. Results Mean two-year PROMIS Depression and Anxiety scores significantly improved from preoperative scores, with a greater improvement observed in PROMIS Anxiety. Worse PROMIS Depression and Anxiety scores were also significantly correlated with worse PROMIS Physical Function (PF) and American Shoulder and Elbow Surgeons scores (ASES). After controlling for confounding variables, worse PROMIS Depression was an independent predictor of worse PROMIS PF, while worse PROMIS Anxiety was an independent predictor of worse PROMIS PF and ASES scores. Conclusion Mean two-year PROMIS Depression and Anxiety scores improved after elective shoulder surgery and several patient characteristics were associated with these scores. Worse functional outcomes were associated with worse PROMIS Depression and Anxiety; however, more severe two-year PROMIS Anxiety was the strongest predictor of worse functional outcomes. Cite this article: Bone Joint J 2022;104-B(4):479–485.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 98%

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PROMIS Depression and Anxiety in shoulder surgery patients

Baker

Albelo

Zhang

et al. 2022

The Bone & Joint Journal

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“…After removing duplicates, applying the eligibility criteria, screening the articles, and reviewing the full texts, we included 43 articles with a total of 16,408 patients (Fig. 1) [1, 3, 4, 5, 6, 7, 9, 14, 17, 18, 19, 22, 23, 25, 28, 31, 35, 36, 38, 39, 42-45, 48, 50, 52-55, 56-60, 63, 64, 65-68, 69, 70]. The median (range) maximum follow-up time for all studies was 20 months (0.75 to 68).…”

Section: Methodsmentioning

confidence: 99%

“…3), UCLA (10.5) Franovic et al[17] 2020 Distribution Rotator cuff arthropathy PROMIS-UE (3.1), PROMIS-PI (2.7), PROMIS-D (4.6) a An arbitrary method means that the MCID was not calculated using any known calculation technique; alternative methods use methods that are neither distributive nor anchor based. b For studies that used previously calculated MCID values, the specific MCID values are included to demonstrate the overlap in their application; in numerous incidences, the same MCID values are applied to several studies; the studies themselves that used these previously calculated MCID values are different; AVN = avascular necrosis; RA = rheumatoid arthritis.…”

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confidence: 99%

Substantial Inconsistency and Variability Exists Among Minimum Clinically Important Differences for Shoulder Arthroplasty Outcomes: A Systematic Review

Kolin

Moverman

Pagani

et al. 2022

Clin Orthop Relat Res

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Background As the value of patient-reported outcomes becomes increasingly recognized, minimum clinically important difference (MCID) thresholds have seen greater use in shoulder arthroplasty. However, MCIDs are unique to certain populations, and variation in the modes of calculation in this field may be of concern. With the growing utilization of MCIDs within the field and value-based care models, a detailed appraisal of the appropriateness of MCID use in the literature is necessary and has not been systematically reviewed. Questions/purposes We performed a systematic review of MCID quantification in existing studies on shoulder arthroplasty to answer the following questions: (1) What is the range of values reported for the MCID in commonly used shoulder arthroplasty patient-reported outcome measures (PROMs)? (2) What percentage of studies use previously existing MCIDs versus calculating a new MCID? (3) What techniques for calculating the MCID were used in studies where a new MCID was calculated? Methods The Embase, PubMed, and Ovid/MEDLINE databases were queried from December 2008 through December 2020 for total shoulder arthroplasty and reverse total shoulder arthroplasty articles reporting an MCID value for various PROMs. Two reviewers (DAK, MAM) independently screened articles for eligibility, specifically identifying articles that reported MCID values for PROMs after shoulder arthroplasty, and extracted data for analysis. Each study was classified into two categories: those referencing a previously defined MCID and those using a newly calculated MCID. Methods for determining the MCID for each study and the variability of reported MCIDs for each PROM were recorded. The number of patients, age, gender, BMI, length of follow-up, surgical indications, and surgical type were extracted for each article. Forty-three articles (16,408 patients) with a mean (range) follow-up of 20 months (0.75 to 68) met the inclusion criteria. The median (range) BMI of patients was 29.3 kg/m 2 (28.0 to 32.2 kg/m 2 ), and the median (range) age was 68 years (53 to 84). There were 17 unique PROMs with MCID values. Of the 112 MCIDs reported, the most common PROMs with MCIDs were the American One of the authors (AJ) certifies receipt of personal payments or benefits, during the study period, in an amount of less than USD 10,000 from DJO Global; in an amount of less than USD 10,000 from Ignite Orthopedics; in an amount of less than USD 10,000 from DePuy Synthes. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. Ethical approval for this study was not sought.

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What are the risk factors associated with limited musculoskeletal health literacy in shoulder arthroplasty patients?

Sabbagh

Shah

Newyear

et al. 2021

Musculoskeletal Care

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Objectives Low health literacy is both pervasive in the United States and a substantial barrier to satisfactory patient care and the appropriate utilization of healthcare resources. This prospective study aims to evaluate the factors that contribute to limited musculoskeletal literacy in patients who undergo shoulder arthroplasty. Methods Ninety patients undergoing shoulder replacement surgery completed demographics and Literacy in Musculoskeletal Problems (LiMP) surveys. Scores of less than six were considered indicative of limited musculoskeletal literacy. Results The overall percentage of participants with limited musculoskeletal literacy was 38.8%. Multivariable logistic regression analysis with multiple imputation modeling demonstrated a significant positive relationship between patient income and adequate LiMP scores (p = 0.009) with an odds ratio of 1.15 (CI: 1.04; 1.28) while level of education (p = 0.173) and patient ethnicity (p = 0.830) among other patient characteristics did not have a significant relationship with LiMP scores. Conclusion In patients undergoing shoulder replacement surgery, low income was the only variable found to be predictive of limited musculoskeletal health literacy scores. Therefore, when discussing the risks and benefits of shoulder arthroplasty, orthopaedic surgeons should be cognizant of the possibility that any given patient may not meet the threshold of adequate musculoskeletal literacy.

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Role of Preoperative PROMIS Scores in Predicting Postoperative Outcomes and Likelihood of Achieving MCID Following Reverse Shoulder Arthroplasty

Cited by 3 publications

References 0 publications

PROMIS Depression and Anxiety in shoulder surgery patients

PROMIS Depression and Anxiety in shoulder surgery patients

Substantial Inconsistency and Variability Exists Among Minimum Clinically Important Differences for Shoulder Arthroplasty Outcomes: A Systematic Review

What are the risk factors associated with limited musculoskeletal health literacy in shoulder arthroplasty patients?

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