Variability of PROMIS Scores Across Hand Conditions

Beleckas, Casey M.; Gerull, William D.; Wright, Melissa A.; Guattery, Jason; Calfee, Ryan P.

doi:10.1016/j.jhsa.2018.10.029

Cited by 24 publications

(24 citation statements)

References 32 publications

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“…To place into context, patients with common hand conditions such as carpal tunnel syndrome (mean: 43), thumb carpometacarpal osteoarthritis (mean: 46), or trigger digit (mean: 47), have lower average PROMIS Physical Function scores at presentation. 17 Furthermore, the patients in our study had low average Pain Interference scores (median: 39), meaning that they had little effect of pain on activities of daily life compared with patients who presented with carpal tunnel syndrome (mean: 61), trigger digit (mean: 58), thumb carpometacarpal osteoarthritis (mean: 60), or even Dupuytren disease (mean: 52). 17 These findings suggest that patients with Kienböck's disease in our study adapted well after surgery.…”

Section: Discussionmentioning

confidence: 63%

Radial Shortening Osteotomy for Symptomatic Kienböck's Disease: Complications and Long-Term Patient-Reported Outcome

et al. 2020

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Objective To determine the rate of salvage procedures and any other unplanned reoperations in patients with symptomatic Kienböck's disease who were treated with radial shortening osteotomy. In addition, we studied patient-reported outcome in the long term using Patient-Reported Outcome Measure Information System (PROMIS) instruments. Methods We performed a retrospective review of all patients who underwent radial shortening osteotomy for stage 2 and 3A Kienböck's disease. Patients who had concomitant revascularization were grouped separately. We collected demographic data, data regarding type of surgery and reoperations, and radiographic data. Patient-reported outcome measures were the PROMIS Upper Extremity Computer Adaptive Testing (CAT) and Pain Interference instruments, the abbreviated Disabilities of Arm, Shoulder, and Hand (QuickDASH), and the 0 to 10 numeric rating scale for pain and satisfaction. Results We included 48 patients who had radial shortening osteotomy alone, and 17 patients who had a combined procedure of radial shortening and direct revascularization. The rate of unplanned reoperations was 33% (16 of 48) in those who had radial shortening osteotomy and 24% (4 of 17) in those who had a combined procedure. Six (13%) of 48 patients underwent proximal row carpectomy due to failed radial shortening osteotomy. No salvage procedures were performed after combined radial shortening/revascularization. Median PROMIS Physical Function CAT scores were 56 (interquartile range [IQR]: 44–56) and 56 (IQR: 41–56), respectively. Median PROMIS Pain Interference scores were 39 (IQR: 39–52) and 39 (IQR: 39–49), respectively. Median QuickDASH scores were 2.3 (IQR: 0–23) and 4.5 (IQR: 2.3–14), respectively. Conclusion Radial shortening osteotomy for symptomatic Kienböck's disease yields reasonable long-term function. We observed that approximately one in eight patients underwent salvage surgery after radial shortening, and this should be taken into account when making the initial decision to treat Kienböck's disease surgically. There appeared to be no benefit of direct revascularization in addition to radial shortening in terms of patient-reported outcome in the long term. Level of Evidence This is a Level IV, therapeutic study.

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Section: Discussionmentioning

confidence: 63%

Radial Shortening Osteotomy for Symptomatic Kienböck's Disease: Complications and Long-Term Patient-Reported Outcome

et al. 2020

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“…Further, the present study uses PROMIS-a set of general PROMs that are growing in popularity within hand and UE surgery. 10,19,20 As the call to increase the use of PROMs in daily clinical practice grows, 21 we believe our work helps provide important detail on this unique patient population. However, future work is warranted with a larger sample size to confirm these findings and determine continued patterns of recovery.…”

Section: Discussionmentioning

confidence: 94%

Evaluating Immediate and Short-Term Postoperative Clinical Outcomes of Patients Undergoing Ulnar Shortening for Ulnar Impaction Syndrome Using PROMIS

2021

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Background The early recovery trajectory of patients undergoing ulnar shortening for ulnar impaction syndrome using the Patient-Reported Outcomes Measurement Information System (PROMIS) is unknown. Questions/Purposes Using PROMIS Upper Extremity (UE), Physical Function (PF), Pain Interference (PI), and Depression, we asked (1) do patients undergoing operative management for ulnar impaction syndrome present at their preoperative visit with notable impairment?; (2) At immediate follow-up, do patients present with a clinically appreciable change in symptom severity?; and (3) At short-term follow-up, do patients present with a clinically appreciable change in symptom severity? Patients and Methods We identified patients from 01/2017 to 12/2019 at our institution undergoing ulnar shortening for ulnar impaction syndrome who completed all PROMIS domains at a preoperative visit and at least one postoperative time point (i.e., less than 4 weeks and/or greater than 12 weeks). Distribution- and anchor-based minimal clinically important difference estimates were used to evaluate clinically appreciable changes in symptoms over time. Results A total of 38 patients met our inclusion criteria. The average change in PROMIS UE, PF, PI, and Depression scores from preoperative to immediate postoperative follow-up were –3.8, –4.3, 3.2, and 0.5, respectively. However, by short-term follow-up, the average change in PROMIS UE, PF, PI, and Depression scores were 3.7, 3.2, –4.7, and –3.9, respectively. Conclusions Patients have worsening function at the immediate postoperative follow-up. By short-term postoperative follow-up, functional status and PI levels improve. Our findings can help hand surgeons provide evidence-based guidance on expected initial recovery following operative management for ulnar impaction syndrome. Level of Evidence This is a level II, prognostic study.

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“…For example, patients were labeled as “depressed” for a score ≥55 and “not depressed” for a score <55. For social satisfaction, a score ≤45 was deemed “impaired social satisfaction.” These definitions incorporate a clinically significant change and have been used previously in studies of IBD and other chronic disease states (10–14).…”

Section: Methodsmentioning

confidence: 99%

“…For social satisfaction, a score #45 was deemed "impaired social satisfaction." These definitions incorporate a clinically significant change and have been used previously in studies of IBD and other chronic disease states (10)(11)(12)(13)(14).…”

Section: Methodsmentioning

confidence: 99%

Urgency and Its Association With Quality of Life and Clinical Outcomes in Patients With Ulcerative Colitis

et al. 2022

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INTRODUCTION:Urgency, the immediate need to defecate, is common in active ulcerative colitis (UC). We investigated the association of urgency in patients with UC with (i) quality of life (QoL) domains and (ii) future hospitalizations, corticosteroid use, and colectomy for UC.METHODS:We conducted a cross-sectional and subsequent longitudinal study within Inflammatory Bowel Disease Partners, a patient-powered research network. We described associations of levels of urgency in patients with UC with Patient-Reported Outcomes Measurement Information System QoL domains. We conducted a longitudinal cohort to determine associations between baseline urgency and subsequent hospitalization, corticosteroid use, or colectomy for UC within 12 months. We used bivariate statistics and logistic regression models to describe independent associations.RESULTS:A total of 632 patients with UC were included in the cross-sectional study. After adjusting for clinical variables, rectal bleeding, and stool frequency, urgency defined as “hurry,” “immediately,” and “incontinence” increased the odds of social impairment (odds ratio [OR] 2.05 95% confidence interval [CI] 1.24–3.4, OR 2.76 95% CI 1.1–6.74, and OR 7.7 95% CI 1.66–38.3, respectively) compared with “no hurry.” Urgency also significantly increased the odds of depression, anxiety, and fatigue. Urgency was associated with a significant increase in risk of hospitalizations and corticosteroids, whereas “hurry,” “immediately,” and “incontinence” increased the odds of colectomy within 12 months by 1.42 (1.15–1.75), 1.90 (1.45–2.50), and 3.69 (2.35–5.80).DISCUSSION:We demonstrated that urgency is a patient-reported outcome independently associated with compromised QoL and future risk of hospitalizations, corticosteroids, and colectomy. Our findings support the consideration of urgency as a UC-specific patient-reported outcome and its use as an outcome in clinical trials to capture QoL and risk of clinical decompensation.

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Variability of PROMIS Scores Across Hand Conditions

Cited by 24 publications

References 32 publications

Radial Shortening Osteotomy for Symptomatic Kienböck's Disease: Complications and Long-Term Patient-Reported Outcome

Radial Shortening Osteotomy for Symptomatic Kienböck's Disease: Complications and Long-Term Patient-Reported Outcome

Evaluating Immediate and Short-Term Postoperative Clinical Outcomes of Patients Undergoing Ulnar Shortening for Ulnar Impaction Syndrome Using PROMIS

Urgency and Its Association With Quality of Life and Clinical Outcomes in Patients With Ulcerative Colitis

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