Nwachukwu Benedict U, Rasio Jonathan, Beck Edward C, Okoroha Kelechi R, Sullivan Spencer W, Makhni Eric C, Nho Shane J
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A..
Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A.
Arthroscopy. 2020 Dec;36(12):2992-2997. doi: 10.1016/j.arthro.2020.07.008. Epub 2020 Jul 14.
To compare the use and responsiveness of Patient Reported Outcomes Measurement Information System (PROMIS) to legacy patient-reported outcome measures (PROMs) in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS) at 6-month follow-up.
Data from patients who underwent primary hip arthroscopy with routine capsular closure between August 2018 and January 2019 for the treatment of FAIS were analyzed. Preoperative outcomes, 6-month postoperative outcomes, and demographics were recorded. Primary outcome measures included PROMIS Physical Function (PROMIS-PF), PROMIS Pain Interference (PROMIS-PI), and PROMIS Depression. The legacy PROMs included Hip Outcome Score Activities of Daily Living (HOS-ADL), Hip Outcome Score Sport Subscale (HOS-SS), and the international hip outcome tool 12 questions (iHOT-12). Floor and ceiling effects along with the responsiveness and Cohen's d effect size of each PROM tool were calculated.
Ninety-six patients with an average age and body mass index of 32.4 ± 11.9 years and 25.9 ± 6.1 kg/m, respectively, were included in the final analysis. All outcomes were significantly higher at 6 months compared with the preoperative level (P < .001) except for PROMIS Depression (P = .873). PROMIS-PF demonstrated excellent correlation with HOS-SS (r = 0.81; P < .001), very good correlation with HOS-ADL (r = 0.73; P < .001), and good correlation with iHOT-12 (r = 0.68; P < .001). No floor was observed for any measure. The effect size was large for all outcomes, except PROMIS Depression (d = 0.04), but largest for iHOT12 (d = 1.87) followed by HOS-ADL (d = 1.29). The iHOT-12 was more responsive than PROMIS-PI (relative efficiency [RE] = 3.95), PROMIS-PF (RE = 4.13), HOS-ADL (RE = 2.26), and HOS-SS (RE = 3.84). HOS-SS was similarly responsive to PROMIS-PI (RE=1.03) and PROMIS-PF (RE=1.08). However, PROMIS-PF was overall the least responsive.
In patients at 6 months postoperatively from hip arthroscopy for FAIS, iHOT-12 was the most responsive and had the largest effect size. In contrast, PROMIS-PF had a lower effect size compared with legacy hip-specific PROMs. Additionally, PROMIS-PF did not correlate as well with iHOT-12 compared with HOS-SS.
Level IV, case series.
比较患者报告结局测量信息系统（PROMIS）与传统患者报告结局指标（PROMs）在股骨髋臼撞击综合征（FAIS）行髋关节镜检查患者6个月随访时的使用情况及反应性。
分析2018年8月至2019年1月因FAIS接受初次髋关节镜检查并常规缝合关节囊患者的数据。记录术前结局、术后6个月结局及人口统计学数据。主要结局指标包括PROMIS身体功能（PROMIS-PF）、PROMIS疼痛干扰（PROMIS-PI）和PROMIS抑郁。传统PROMs包括髋关节结局评分日常生活活动（HOS-ADL）、髋关节结局评分运动亚量表（HOS-SS）和国际髋关节结局工具12个问题（iHOT-12）。计算每个PROM工具的地板效应和天花板效应以及反应性和科恩d效应量。
最终分析纳入96例患者，平均年龄和体重指数分别为32.4±11.9岁和25.9±6.1kg/m²。除PROMIS抑郁（P = 0.873）外，所有结局在6个月时均显著高于术前水平（P < 0.001）。PROMIS-PF与HOS-SS显示出极好的相关性（r = 0.81；P < 0.001），与HOS-ADL显示出很好的相关性（r = 0.73；P < 0.001），与iHOT-12显示出良好的相关性（r = 0.68；P < 0.001）。任何测量指标均未观察到地板效应。除PROMIS抑郁（d = 0.04）外，所有结局的效应量均较大，但iHOT-12最大（d = 1.87），其次是HOS-ADL（d = 1.29）。iHOT-12比PROMIS-PI（相对效率[RE] = 3.95）、PROMIS-PF（RE = 4.13）、HOS-ADL（RE = 2.26）和HOS-SS（RE = 3.84）更具反应性。HOS-SS与PROMIS-PI（RE = 1.03）和PROMIS-PF（RE = 1.08）的反应性相似。然而，总体而言PROMIS-PF反应性最低。
在FAIS行髋关节镜检查术后6个月的患者中，iHOT-12反应性最强且效应量最大。相比之下，与传统的髋关节特异性PROMs相比，PROMIS-PF的效应量较低。此外，与HOS-SS相比，PROMIS-PF与iHOT-12的相关性也较差。
IV级，病例系列。
