Tariq Muhammad B, Jones Morgan H, Strnad Greg, Sosic Elizabeth, Spindler Kurt P
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
Cleveland Clinic Orthopaedic Sports Medicine, Cleveland, Ohio.
J Knee Surg. 2021 Jan;34(2):130-136. doi: 10.1055/s-0039-1694057. Epub 2019 Aug 7.
Patient-reported outcomes measures (PROMs) are important for the advancement of orthopaedic surgeries. The primary difficulty while collecting PROMs is obtaining adequate follow-up rates. Therefore, it is important to find methods to improve follow-up, especially in patients who have failed to respond to initial attempts. We hypothesized that PROMs follow-up could be effectively increased by sending a salvage-effort personalized surgeon letter to sports medicine patients who failed to respond to initial (centralized electronic, mail, and/or phone contacts) PROMs collection 1 year after surgery. Patients who failed to respond to 1-year follow-up of postoperative PROMs collection at our outpatient sports medicine surgery center were included. Patients were randomized into an intervention or control group. Patients in the intervention group were mailed PROMs form and an Institutional Review Board-approved letter that was personalized with surgical information, surgeon picture, and surgeon signature. Control group was mailed the same letter a month later. Chi-squared analysis was conducted at 5 weeks. Out of 843 surgeries, our initial 1-year PROMs follow-up rate was 65%, which allowed for 292 patients to be eligible for our study. After exclusions, 281 patients (randomized to 140 control group and 141 intervention group) were included in our study. We found a 20% response rate in the intervention group with 28 patients returning PROMs as compared with a 1.4% rate in the control group with two patients returning PROMs. The odds ratio was 17.1 (95% confidence interval: 4-73.3; < 0.0001). A salvage-effort personalized surgeon letter is an efficient and relatively cost-effective method to increase PROMs follow-up rate, which means that a personalized surgeon letter can reach and engage patients who would otherwise be considered lost to follow-up, allowing for better outcomes monitoring after surgery.
患者报告结局测量指标（PROMs）对骨科手术的进展很重要。收集PROMs时的主要困难在于获得足够的随访率。因此，找到改善随访的方法很重要，尤其是对于那些对初次尝试无反应的患者。我们假设，通过向术后1年对初次（集中电子、邮件和/或电话联系）PROMs收集无反应的运动医学患者发送一封挽救性的个性化外科医生信件，可以有效提高PROMs随访率。纳入了在我们门诊运动医学手术中心对术后PROMs收集1年随访无反应的患者。患者被随机分为干预组或对照组。干预组患者收到了PROMs表格以及一封经机构审查委员会批准的信件，该信件包含手术信息、外科医生照片和外科医生签名，进行了个性化处理。对照组在一个月后收到相同的信件。在5周时进行了卡方分析。在843例手术中，我们最初的1年PROMs随访率为65%，这使得292例患者有资格参与我们的研究。排除后，281例患者（随机分为140例对照组和141例干预组）纳入我们的研究。我们发现干预组的回复率为20%，有28例患者返回了PROMs，而对照组的回复率为1.4%，有2例患者返回了PROMs。优势比为17.1（95%置信区间：4 - 73.3；P < 0.0001）。一封挽救性的个性化外科医生信件是提高PROMs随访率的一种有效且相对经济高效的方法，这意味着个性化外科医生信件能够联系并促使那些原本会被视为失访的患者参与，从而在术后实现更好的结局监测。
