Sprau Annelise C, Basil Gregory, Borowsky Peter, Yoon Jang W, Wang Michael Y
Neurological Surgery, University of Miami Miller School of Medicine, Miami, USA.
Neurological Surgery, University of Pennsylvania, Philadelphia, USA.
Cureus. 2020 Sep 9;12(9):e10326. doi: 10.7759/cureus.10326.
Background Evolution within spine surgery is driven by a surgeon's desire for expertise and significant improvement in their patients' quality of life. As surgeons move away from using subjective patient-reported outcome (PRO) surveys, there must be an alternative objective metric in its place. Modern iPhone (Apple Inc., Cupertino, CA) technology can be used to capture daily activity in a simple, non-user biased manner. These health data can be used to analyze objective functional status in conjunction with PRO surveys to measure surgical outcomes. Methods Patients who underwent an awake transforaminal lumbar interbody fusion (TLIF) between 2014 and 2018 at our institution were identified. Patients were consented and instructed to download the application "QS Access" (Quantified Self Labs, San Francisco, CA). Following data collection, we analyzed the demographic information of patients who were reached to gauge participation and feasibility of data exportation. Results A total of 177 patients who underwent an awake TLIF at our institution were contacted. Of those who answered, 41 (44.6%) agreed to participate and 51 (55.4%) declined to participate. When comparing those who either participated or declined, there were no significant differences in age (p=0.145), sex (p=0.589), or ethnicity (p=0.686). Conclusion Our pilot study examined the patient participation in the novel usage of Apple "Health" data, queried from "QS Access" (Quantified Self Labs), to objectively measure relative patient functional status surrounding spinal fusion. We demonstrated that a smartphone-based application was mostly well received by our patient cohort and has the potential to be used as an objective operative metric moving forward.
背景 脊柱外科的发展是由外科医生对专业技能的追求以及患者生活质量的显著改善所推动的。随着外科医生不再使用主观的患者报告结局（PRO）调查，必须有替代的客观指标取而代之。现代iPhone（苹果公司，加利福尼亚州库比蒂诺）技术可用于以简单、无用户偏差的方式记录日常活动。这些健康数据可与PRO调查结合使用，以分析客观功能状态，从而衡量手术效果。方法 确定2014年至2018年在我们机构接受清醒经椎间孔腰椎椎间融合术（TLIF）的患者。患者签署知情同意书并被指示下载“QS Access”应用程序（量化自我实验室，加利福尼亚州旧金山）。在收集数据后，我们分析了成功联系到的患者的人口统计学信息，以评估参与情况和数据导出的可行性。结果 我们机构共联系了177例接受清醒TLIF手术的患者。在回复的患者中，41例（44.6%）同意参与，51例（55.4%）拒绝参与。比较参与和拒绝参与的患者，在年龄（p=0.145）、性别（p=0.589）或种族（p=0.686）方面没有显著差异。结论 我们的初步研究调查了患者对苹果“健康”数据新用途的参与情况，这些数据是从“QS Access”（量化自我实验室）中查询的，以客观测量脊柱融合周围患者的相对功能状态。我们证明，基于智能手机的应用程序在我们的患者群体中大多受到好评，并且有可能在未来用作客观的手术指标。
