Yee Timothy J, Smith Brandon W, Joseph Jacob R, Saadeh Yamaan S, Nathan Jay K, Kahn Elyne N, Khalsa Siri S, Fearer Kelsey J, Kirsch Michael J, Nerenz David R, Chang Victor, Schwalb Jason M, Abdulhak Muwaffak M, Park Paul
1Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan.
2Neurological Institute, Cleveland Clinic, Cleveland, Ohio; and.
J Neurosurg Spine. 2019 Aug 9;31(5):691-696. doi: 10.3171/2019.5.SPINE19400. Print 2019 Nov 1.
The Oswestry Disability Index (ODI) is one of the most commonly used patient-reported outcome instruments, but completion of this 10-question survey can be cumbersome. Tools from the Patient-Reported Outcomes Measurement Information System (PROMIS) are an alternative, and potentially more efficient, means of assessing physical, mental, and social outcomes in spine surgery. Authors of this retrospective study assessed whether scores on the 4-item surveys of function and pain from the PROMIS initiative correlate with those on the ODI in lumbar spine surgery.
Patients evaluated in the adult neurosurgery spine clinic at a single institution completed the ODI, PROMIS Short Form v2.0 Physical Function 4a (PROMIS PF), and PROMIS Short Form v1.0 Pain Interference 4a (PROMIS PI) at various time points in their care. Score data were retrospectively analyzed using linear regressions with calculation of the Pearson correlation coefficient.
Three hundred forty-three sets of surveys (ODI, PROMIS PF, and PROMIS PI) were obtained from patients across initial visits (n = 147), 3-month follow-ups (n = 107), 12-month follow-ups (n = 52), and 24-month follow-ups (n = 37). ODI scores strongly correlated with PROMIS PF t-scores at baseline (r = -0.72, p < 0.0001), 3 months (r = -0.79, p < 0.0001), 12 months (r = -0.85, p < 0.0001), and 24 months (r = -0.89, p < 0.0001). ODI scores also correlated strongly with PROMIS PI t-scores at baseline (r = 0.71, p < 0.0001), at 3 months (r = 0.82, p < 0.0001), at 12 months (r = 0.86, p < 0.0001), and at 24 months (r = 0.88, p < 0.0001). Changes in ODI scores moderately correlated with changes in PROMIS PF t-scores (r = -0.68, p = 0.0003) and changes in PROMIS PI t-scores (r = 0.57, p = 0.0047) at 3 months postoperatively.
A strong correlation was found between the ODI and the 4-item PROMIS PF/PI at isolated time points for patients undergoing lumbar spine surgery. Large cohort studies are needed to determine longitudinal accuracy and precision and to assess possible benefits of time savings and improved rates of survey completion.
奥斯威斯利功能障碍指数（ODI）是最常用的患者报告结局工具之一，但完成这份包含10个问题的调查问卷可能会很繁琐。患者报告结局测量信息系统（PROMIS）的工具是评估脊柱手术中身体、心理和社会结局的另一种手段，且可能更高效。这项回顾性研究的作者评估了PROMIS计划中关于功能和疼痛的4项调查问卷得分与腰椎手术中ODI得分之间是否相关。
在单一机构的成人神经外科脊柱门诊接受评估的患者在其治疗的不同时间点完成了ODI、PROMIS简表v2.0身体功能4a（PROMIS PF）和PROMIS简表v1.0疼痛干扰4a（PROMIS PI）。使用线性回归并计算Pearson相关系数对得分数据进行回顾性分析。
从患者的初次就诊（n = 147）、3个月随访（n = 107）、12个月随访（n = 52）和24个月随访（n = 37）中获得了343套调查问卷（ODI、PROMIS PF和PROMIS PI）。ODI得分与基线时（r = -0.72，p < 0.0001）、3个月时（r = -0.79，p < 0.0001）、12个月时（r = -0.85，p < 0.0001）和24个月时（r = -0.89，p < 0.0001）的PROMIS PF t得分密切相关。ODI得分在基线时（r = 0.71，p < 0.0001）、3个月时（r = 0.82，p < 0.0001）、12个月时（r = 0.86，p < 0.0001）和24个月时（r = 0.88，p < 0.0001）也与PROMIS PI t得分密切相关。术后3个月时，ODI得分的变化与PROMIS PF t得分的变化中度相关（r = -0.68，p = 0.0003），与PROMIS PI t得分的变化中度相关（r = 0.57，p = 0.0047）。
对于接受腰椎手术的患者，在各个时间点发现ODI与4项PROMIS PF/PI之间存在强相关性。需要进行大型队列研究以确定纵向准确性和精确性，并评估节省时间和提高调查问卷完成率的可能益处。
