Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A.
Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A..
Arthroscopy. 2019 Oct;35(10):2817-2824. doi: 10.1016/j.arthro.2019.05.027.
To examine the preoperative performance of the Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE) Computer Adaptive Test (CAT) with respect to legacy scores in patients receiving rotator cuff repair (RCR). In addition, to define the impact of Workers' Compensation (WC) status on both performance and floor and ceiling effects.
The PROMIS UE CAT was administered preoperatively alongside legacy patient-reported outcome measures (PROMs) to patients undergoing isolated arthroscopic RCR from November 2017 to September 2018. Performance was assessed using Spearman correlation coefficients, and floor and ceiling effects were examined.
One hundred twenty-two patients (WC, n = 32; non-WC, n = 90; 62.3% male, 53.6 ± 11.5 years) were included. PROMs assessing physical function (r = 0.41-0.77) correlated more strongly to the PROMIS UE CAT than did multidomain or mental health PROMs (r = 0.25-0.61). In WC patients, the PROMIS UE CAT demonstrated diminished correlative strength relative to shoulder function PROMs. WC patients also demonstrated relative floor effects for Single Assessment Numerical Evaluation (SANE; 18.8%) and Constant-Murley (15.6%) and relative ceiling effects for the Brief Resilience Scale (53.1%), Short Form 12 Mental Component Score (50%), and Veterans Rand 12 Mental Component Score (53.1%) and were more likely to report the minimum SANE score (P < .01) and the maximum Brief Resilience Scale score (P < .01). No absolute or relative floor/ceiling effects for the PROMIS UE CAT were found.
Compared with a non-WC cohort, WC patients have significantly lower preoperative PROMIS UE CAT scores, are more likely to report the absolute minimum and maximum scores for various PROMs, and demonstrated relative floor and ceiling effects for PROMs assessing mental health. The absence of significant floor/ceiling effects for the PROMIS UE CAT may suggest improved outcome discrimination and may support the adoption of PROMIS UE for the assessment of functional status in WC patients with rotator cuff pathology.
Level III, retrospective comparative trial.
检查患者报告结局测量信息系统（PROMIS）上肢（UE）计算机自适应测试（CAT）在接受肩袖修复（RCR）患者中的术前表现，与传统评分相比。此外，还确定工人赔偿（WC）状况对表现和地板及天花板效应的影响。
2017 年 11 月至 2018 年 9 月，对接受关节镜下 RCR 的患者同时进行 PROMIS UE CAT 和传统患者报告结局测量（PROM）。使用 Spearman 相关系数评估表现，检查地板和天花板效应。
共纳入 122 例患者（WC 组，n=32；非 WC 组，n=90；62.3%为男性，53.6±11.5 岁）。评估躯体功能的 PROM 与 PROMIS UE CAT 的相关性更强（r=0.41-0.77），而多领域或心理健康 PROM 的相关性较弱（r=0.25-0.61）。在 WC 患者中，PROMIS UE CAT 与肩部功能 PROM 的相关性减弱。WC 患者的 SANE（18.8%）和 Constant-Murley（15.6%）也出现相对地板效应，而 Brief Resilience Scale（53.1%）、Short Form 12 Mental Component Score（50%）和 Veterans Rand 12 Mental Component Score（53.1%）则出现相对天花板效应，更有可能报告 SANE 的最低得分（P<.01）和 Brief Resilience Scale 的最高得分（P<.01）。未发现 PROMIS UE CAT 的绝对或相对地板/天花板效应。
与非 WC 队列相比，WC 患者的术前 PROMIS UE CAT 评分明显较低，更有可能报告各种 PROM 的绝对最低和最高得分，并且心理健康评估的 PROM 出现相对地板和天花板效应。PROMIS UE CAT 无显著地板/天花板效应可能提示其对功能状态的区分度更好，支持将 PROMIS UE 用于评估患有肩袖疾病的 WC 患者的功能状态。
III 级，回顾性比较试验。
