原发性或转移性脊柱肿瘤患者的 PROMIS 评估。
An Evaluation of PROMIS in Patients With Primary or Metastatic Spine Tumors.
机构信息
Department of Orthopedic Surgery, University of Rochester, Rochester, NY.
Research Department, New York Chiropractic College, Seneca Falls, NY.
出版信息
Spine (Phila Pa 1976). 2019 May 15;44(10):747-752. doi: 10.1097/BRS.0000000000002934.
STUDY DESIGN
Retrospective evaluation of prospectively collected data.
OBJECTIVE
In spine tumor patients: i) to assess the correlation of Patient-reported Outcomes Measurement Information System (PROMIS) physical function (PF), pain interference (PI), and Depression scores with Oswestry Disability Index (ODI) and Neck Disability Index (NDI) scores; and ii) to assess ceiling and floor effects of PROMIS PF, PI, and Depression domains and the ODI/NDI.
SUMMARY OF BACKGROUND DATA
There remains no widely used patient-reported outcome (PRO) instrument for spine tumor patients. PROMIS, a universal PRO tool, may add notable value to patient care. A paucity of work exists comparing PROMIS to legacy PRO tools in primary and metastatic spine tumor patients.
METHODS
Patients confirmed to have a primary or metastatic spine tumor were asked to complete PROMIS PF, PI, and Depression domains and either an ODI or NDI questionnaire between May 2015 and December 2017. Pearson correlation coefficients (r) were calculated. Ceiling and floor effects were determined. P < 0.05 was significant.
RESULTS
Eighty unique visits from 51 patients with spine tumors (44 metastatic/67 visits; 7 primary/13 visits) met our inclusion criteria. A strong correlation existed between PROMIS PI and the ODI/NDI in both primary and metastatic tumor patient subgroups (range, r = 0.75-0.86, P < 0.05). PROMIS PF and the ODI/NDI demonstrated a strong correlation among all patients (r = -0.75, P < 0.05) and in the metastatic disease subgroup (r = -0.78, P < 0.05). A strong correlation existed between PROMIS Depression and the ODI/NDI in the primary tumor subgroup (r = 0.79, P < 0.05). PROMIS Depression demonstrated the largest floor effect (13.6%); there were similar ceiling effects.
CONCLUSION
PROMIS PF and PI domains correlate well with the ODI/NDI in spine tumor patients and have a similar ceiling effect but decreased floor effect. PROMIS Depression was not as well captured, except in the primary tumor subgroup.
LEVEL OF EVIDENCE
研究设计
前瞻性收集数据的回顾性评估。
目的
在脊柱肿瘤患者中：i）评估患者报告的结局测量信息系统（PROMIS）躯体功能（PF）、疼痛干扰（PI）和抑郁评分与 Oswestry 功能障碍指数（ODI）和颈部残疾指数（NDI）评分的相关性；ii）评估 PROMIS PF、PI 和抑郁领域以及 ODI/NDI 的天花板和地板效应。
背景资料总结
目前尚无广泛用于脊柱肿瘤患者的患者报告结局（PRO）工具。PROMIS 作为一种通用的 PRO 工具，可能会为患者护理带来显著价值。在原发性和转移性脊柱肿瘤患者中，比较 PROMIS 与传统 PRO 工具的研究很少。
方法
2015 年 5 月至 2017 年 12 月，我们要求确诊为原发性或转移性脊柱肿瘤的患者完成 PROMIS PF、PI 和抑郁领域以及 ODI 或 NDI 问卷。计算 Pearson 相关系数（r）。确定天花板和地板效应。P＜0.05 为差异有统计学意义。
结果
51 例脊柱肿瘤患者的 80 个独特就诊（44 例转移性/67 个就诊；7 例原发性/13 个就诊）符合我们的纳入标准。PI 与 ODI/NDI 之间存在很强的相关性，无论是在原发性还是转移性肿瘤患者亚组中（范围，r=0.75-0.86，P＜0.05）。在所有患者（r=-0.75，P＜0.05）和转移性疾病亚组（r=-0.78，P＜0.05）中，PF 与 ODI/NDI 之间也存在很强的相关性。在原发性肿瘤亚组中，抑郁与 ODI/NDI 之间存在很强的相关性（r=0.79，P＜0.05）。PROMIS 抑郁的地板效应最大（13.6%）；天花板效应相似。
结论
在脊柱肿瘤患者中，PROMIS PF 和 PI 领域与 ODI/NDI 相关性良好，具有相似的天花板效应，但地板效应降低。除了在原发性肿瘤亚组外，PROMIS 抑郁的相关性较差。
证据水平
2 级。
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