Shahgholi L, Yost K J, Carter R E, Geske J R, Hagen C E, Amrami K K, Diehn F E, Kaufmann T J, Morris J M, Murthy N S, Wald J T, Thielen K R, Kallmes D F, Maus T P
From the Departments of Physical Medicine and Rehabilitation (L.S.)
Division of Epidemiology (K.J.Y.).
AJNR Am J Neuroradiol. 2015 Mar;36(3):594-9. doi: 10.3174/ajnr.A4150. Epub 2015 Jan 22.
The Patient Reported Outcomes Measurement Information System is a newly developed outcomes measure promulgated by the National Institutes of Health. This study compares changes in pain and physical function-related measures of this system with changes on the Numeric Rating Pain Scale, Roland Morris Disability Index, and the European Quality of Life scale 5D questionnaire in patients undergoing transformational epidural steroid injections for radicular pain.
One hundred ninety-nine patients undergoing transforaminal epidural steroid injections for radicular pain were enrolled in the study. Before the procedure, they rated the intensity of their pain by using the 0-10 Numeric Rating Pain Scale, Roland Morris Disability Index, and European Quality of Life scale 5D questionnaire. Patients completed the Patient Reported Outcomes Measurement Information System Physical Function, Pain Behavior, and Pain Interference short forms before transforaminal epidural steroid injections and at 3 and 6 months. Seventy and 43 subjects replied at 3- and 6-month follow-up. Spearman rank correlations were used to assess the correlation between the instruments. The minimally important differences were calculated for each measurement tool as an indicator of meaningful change.
All instruments were responsive in detecting changes at 3- and 6-month follow-up (P < .0001). There was significant correlation between changes in Patient Reported Outcomes Measurement Information System scores and legacy questionnaires from baseline to 3 months (P < .05). There were, however, no significant correlations in changes from 3 to 6 months with any of the instruments.
The studied Patient Reported Outcomes Measurement Information System domains offered responsive and correlative psychometric properties compared with legacy instruments in a population of patients undergoing transforaminal epidural steroid injections for radicular pain.
患者报告结局测量信息系统是美国国立卫生研究院新发布的一种结局测量工具。本研究比较了该系统中疼痛及身体功能相关测量指标的变化与接受经椎间孔硬膜外类固醇注射治疗根性疼痛患者的数字疼痛评分量表、罗兰·莫里斯残疾指数及欧洲五维健康量表问卷变化情况。
199例接受经椎间孔硬膜外类固醇注射治疗根性疼痛的患者纳入本研究。在治疗前,患者使用0至10分数字疼痛评分量表、罗兰·莫里斯残疾指数及欧洲五维健康量表问卷对疼痛强度进行评分。患者在经椎间孔硬膜外类固醇注射治疗前、治疗后3个月和6个月完成患者报告结局测量信息系统的身体功能、疼痛行为及疼痛干扰简表。70例和43例受试者分别在3个月和6个月随访时回复。采用Spearman等级相关分析评估各工具之间的相关性。计算每个测量工具的最小有意义差异作为有意义变化的指标。
所有工具在3个月和6个月随访时均能有效检测到变化(P <.0001)。从基线到3个月,患者报告结局测量信息系统评分变化与传统问卷变化之间存在显著相关性(P <.05)。然而,在3至6个月的变化中,与任何工具均无显著相关性。
在接受经椎间孔硬膜外类固醇注射治疗根性疼痛的患者群体中,与传统工具相比,所研究的患者报告结局测量信息系统领域具有有效的和相关的心理测量学特性。