术前患者报告结局测量信息系统在肩袖病变患者中的表现。
Preoperative Performance of the Patient-Reported Outcomes Measurement Information System in Patients With Rotator Cuff Pathology.
机构信息
The Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A..
The Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A.
出版信息
Arthroscopy. 2017 Oct;33(10):1770-1774.e1. doi: 10.1016/j.arthro.2017.04.018. Epub 2017 Jun 24.
PURPOSE
To evaluate the Patient-Reported Outcomes Measurement Information System upper extremity item bank (PROMIS UE) and physical function computerized adaptive test (PROMIS PF CAT) in patients with rotator cuff (RC) pathology at their preoperative clinic visit.
METHODS
Patient data were collected from January 2015 to September 2015. Patients with a preoperative diagnosis of RC pathology were prospectively enrolled at the time of their surgical indication for RC repair. Each patient was asked to fill out the Western Ontario Rotator Cuff Index (WORC), American Shoulder and Elbow Surgeons Shoulder Assessment Form, Marx Shoulder Activity Scale, Short Form 36 Health Survey Physical Function and General Health (SF-36 PF and GH), EuroQol-5 Dimension (EQ-5D), PROMIS PF CAT, and PROMIS UE. Correlation was defined as excellent (>0.7), excellent-good (0.61-0.7), good (0.4-0.6), and poor (0.2-0.3).
RESULTS
Patient data were collected from January 2015 to September 2015. No patients were excluded from participation in the study. In 82 patients with preoperative RC pathology, the PROMIS UE showed excellent correlation with American Shoulder and Elbow Surgeons Shoulder Assessment Form (r = 0.77, P < .01), WORC (r = 0.73, P < .01), and the EQ-5D (r = 0.73, P < .01); there was excellent-good correlation with the SF-36 PF (r = .66, P < .01) and PROMIS PF CAT (r = .70, P < .01). The PROMIS PF CAT showed excellent correlation with the SF-36 PF (r = 0.77, P < .01); there was excellent-good correlation with EQ-5D (r = 0.65, P < .01) and WORC (r = 0.61, P < .01). There were no significant floor or ceiling effects using the PROMIS UE item bank or PROMIS PF CAT.
CONCLUSIONS
We report that in a patient population with preoperative RC pathology, the PROMIS UE and PROMIS CAT are valid patient-reported outcome alternatives that have high correlation with traditional shoulder and upper extremity patient-reported outcomes. We find a decreased question burden using the PROMIS PF CAT. We find no significant floor or ceiling effects present in the PROMIS UE or PROMIS PF CAT.
LEVEL OF EVIDENCE
Level II, prospective diagnostic study.
目的
评估患者报告结局测量信息系统上肢项目库（PROMIS UE）和物理功能计算机自适应测试（PROMIS PF CAT）在术前就诊的肩袖（RC）病变患者中的表现。
方法
患者数据于 2015 年 1 月至 2015 年 9 月收集。前瞻性招募术前诊断为 RC 病变的患者，作为 RC 修复的手术指征。每位患者均被要求填写 Western Ontario Rotator Cuff Index（WORC）、美国肩肘外科医生肩关节评估表、Marx 肩部活动量表、SF-36 健康调查简表生理功能和总体健康（SF-36 PF 和 GH）、EuroQol-5 维度（EQ-5D）、PROMIS PF CAT 和 PROMIS UE。相关性定义为极好（>0.7）、优秀-良好（0.61-0.7）、良好（0.4-0.6）和差（0.2-0.3）。
结果
患者数据于 2015 年 1 月至 2015 年 9 月收集。没有患者被排除在研究之外。在 82 例术前 RC 病变患者中，PROMIS UE 与美国肩肘外科医生肩关节评估表（r=0.77，P<.01）、WORC（r=0.73，P<.01）和 EQ-5D（r=0.73，P<.01）具有极好的相关性；与 SF-36 PF（r=0.66，P<.01）和 PROMIS PF CAT（r=0.70，P<.01）具有优秀-良好的相关性。PROMIS PF CAT 与 SF-36 PF（r=0.77，P<.01）具有极好的相关性；与 EQ-5D（r=0.65，P<.01）和 WORC（r=0.61，P<.01）具有优秀-良好的相关性。PROMIS UE 项目库或 PROMIS PF CAT 均未出现明显的地板效应或天花板效应。
结论
我们报告称，在术前 RC 病变患者人群中，PROMIS UE 和 PROMIS CAT 是有效的患者报告结局替代方法，与传统的肩部和上肢患者报告结局具有高度相关性。我们发现使用 PROMIS PF CAT 可减少问题负担。我们发现 PROMIS UE 或 PROMIS PF CAT 均不存在明显的地板效应或天花板效应。
证据水平
Ⅱ级，前瞻性诊断研究。
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