St John Matthew J, Mitten David, Hammert Warren C
University of Rochester School of Medicine and Dentistry, Rochester, NY.
Department of Orthopaedics and Biomedical Engineering, University of Rochester School of Medicine and Dentistry, Rochester, NY.
J Hand Surg Am. 2017 Sep;42(9):705-710. doi: 10.1016/j.jhsa.2017.06.004. Epub 2017 Jul 12.
The Patient Reported Outcome Measurement Information System (PROMIS), developed by the National Institutes of Health, utilizes a health domain related to Pain Interference (PI). We evaluated this domain and its association with physical function (as determined by PROMIS Physical Function [PF]), administered as a computer adaptive test (CAT), and secondarily its association to a numerical 0 to 10 pain score. Our null hypothesis was that PI, as measured by CAT, has no correlation to PF and thus, there is no difference between comparisons of numerical pain scores and PROMIS PF.
Adult patients presenting to an upper extremity clinic from February to December 2015 completed PROMIS PF, PI, and numerical 0 to 10 pain score questionnaires. The PROMIS modules were completed electronically in their computer adaptive form. Mean population scoring on each module is defined at 50. Patients were also asked to rate their pain on a 0 to 10 scale. These data were collected as routine clinical care and were extracted from the electronic health record for cross-sectional evaluation. Bivariate Pearson correlation analysis defined the association between the PROMIS modules and the numerical pain scores. Correlations between PF and PI were compared with correlations between PF and pain scores.
We recorded data from patients' 10,574 first, 5,210 second, 2,633 third, 1,382 fourth, and 722 fifth visits. The PROMIS PI was negatively correlated to the PROMIS PF. Numerical pain scores were also negatively correlated to PROMIS PF. Numerical pain scores were less correlated than PROMIS PI through time relative to PF.
Both PROMIS PI and numerical pain scores had significant correlations with PF for each office visit. The PI had a larger correlation to PF than did numerical pain scores. The PI and numerical pain scale scores are also correlated.
Patient-reported pain using a 0 to 10 pain score can be a predictor of patients' level of function, and although pain score does not replace other patient-reported outcomes, it can provide useful information, particularly when other patient-reported outcomes are not available.
由美国国立卫生研究院开发的患者报告结局测量信息系统（PROMIS）采用了一个与疼痛干扰（PI）相关的健康领域。我们评估了该领域及其与身体功能（由PROMIS身体功能[PF]确定）的关联，以计算机自适应测试（CAT）的形式进行，其次评估其与0至10的数字疼痛评分的关联。我们的零假设是，通过CAT测量的PI与PF无相关性，因此，数字疼痛评分与PROMIS PF的比较之间没有差异。
2015年2月至12月到上肢诊所就诊的成年患者完成了PROMIS PF、PI以及0至10的数字疼痛评分问卷。PROMIS模块以计算机自适应形式电子方式完成。每个模块的平均总体得分定义为50。患者还被要求在0至10的量表上对其疼痛进行评分。这些数据作为常规临床护理收集，并从电子健康记录中提取以进行横断面评估。双变量Pearson相关性分析确定了PROMIS模块与数字疼痛评分之间的关联。将PF与PI之间的相关性与PF与疼痛评分之间的相关性进行比较。
我们记录了患者首次就诊10574例、第二次就诊5210例、第三次就诊2633例、第四次就诊1382例和第五次就诊722例的数据。PROMIS PI与PROMIS PF呈负相关。数字疼痛评分也与PROMIS PF呈负相关。相对于PF，随着时间推移，数字疼痛评分与PROMIS PI的相关性较小。
每次门诊就诊时，PROMIS PI和数字疼痛评分与PF均有显著相关性。PI与PF的相关性大于数字疼痛评分与PF的相关性。PI与数字疼痛量表评分也相关。
使用0至10疼痛评分的患者报告疼痛可以预测患者的功能水平，虽然疼痛评分不能替代其他患者报告的结局，但它可以提供有用信息，特别是在没有其他患者报告结局的情况下。
