Papuga Mark O, Mesfin Addisu, Molinari Robert, Rubery Paul T
The Center for Musculoskeletal Research, University of Rochester, Rochester, NY.
New York Chiropractic College, Seneca Falls, NY.
Spine (Phila Pa 1976). 2016 Jul 15;41(14):1153-1159. doi: 10.1097/BRS.0000000000001518.
A prospective and retrospective cross-sectional cohort analysis.
The aim of this study was to show that Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive testing (CAT) assessments for physical function and pain interference can be efficiently collected in a standard office visit and to evaluate these scores with scores from previously validated Oswestry Disability Index (ODI) and Neck Disability Index (NDI) providing evidence of convergent validity for use in patients with spine pathology.
Spinal surgery outcomes are highly variable, and substantial debate continues regarding the role and value of spine surgery. The routine collection of patient-based outcomes instruments in spine surgery patients may inform this debate. Traditionally, the inefficiency associated with collecting standard validated instruments has been a barrier to routine use in outpatient clinics. We utilized several CAT instruments available through PROMIS and correlated these with the results obtained using "gold standard" legacy outcomes measurement instruments.
All measurements were collected at a routine clinical visit. The ODI and the NDI assessments were used as "gold standard" comparisons for patient-reported outcomes.
PROMIS CAT instruments required 4.5 ± 1.8 questions and took 35 ± 16 seconds to complete, compared with ODI/NDI requiring 10 questions and taking 188 ± 85 seconds when administered electronically. Linear regression analysis of retrospective scores involving a primary back complaint revealed moderate to strong correlations between ODI and PROMIS physical function with r values ranging from 0.5846 to 0.8907 depending on the specific assessment and patient subsets examined.
Routine collection of physical function outcome measures in clinical practice offers the ability to inform and improve patient care. We have shown that several PROMIS CAT instruments can be efficiently administered during routine clinical visits. The moderate to strong correlations found validate the utility of computer adaptive testing when compared with the gold standard "static" legacy assessments.
前瞻性与回顾性横断面队列分析。
本研究旨在表明，患者报告结局测量信息系统（PROMIS）针对身体功能和疼痛干扰的计算机自适应测试（CAT）评估能够在标准门诊就诊时有效收集，并将这些分数与先前验证的奥斯维斯特里残疾指数（ODI）和颈部残疾指数（NDI）的分数进行评估，为脊柱病变患者提供收敛效度的证据以供使用。
脊柱手术的结果差异很大，关于脊柱手术的作用和价值仍存在大量争论。在脊柱手术患者中常规收集基于患者的结局工具可能为这场争论提供信息。传统上，与收集标准验证工具相关的低效率一直是门诊常规使用的障碍。我们使用了通过PROMIS获得的几种CAT工具，并将这些工具与使用“金标准”传统结局测量工具获得的结果进行关联。
所有测量均在常规临床就诊时收集。ODI和NDI评估用作患者报告结局的“金标准”比较。
PROMIS CAT工具需要4.5±1.8个问题，完成时间为35±16秒，而ODI/NDI以电子方式 administered时需要10个问题，耗时188±85秒。对涉及主要背部主诉的回顾性分数进行线性回归分析显示，ODI与PROMIS身体功能之间存在中度至强相关性，r值范围为0.5846至0.8907，具体取决于所检查的特定评估和患者亚组。
在临床实践中常规收集身体功能结局测量数据能够为改善患者护理提供信息。我们已经表明，几种PROMIS CAT工具可以在常规临床就诊期间有效 administered。与金标准“静态”传统评估相比，发现的中度至强相关性验证了计算机自适应测试的效用。
4级。
