Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, MD, United States; Department of Surgery, The Uniformed Services University of the Health Sciences, Bethesda, MD, United States.
Department of Orthopaedic Surgery, The Mayo Clinic, Rochester, MN, United States.
J Clin Neurosci. 2021 Jun;88:95-101. doi: 10.1016/j.jocn.2021.03.037. Epub 2021 Apr 2.
Retrospective cohort.
To evaluate the single assessment numerical evaluation (SANE) as a patient reported outcomes measure (PROM) after anterior cervical discectomy and fusion (ACDF), by comparing to legacy measures.
We included all patients undergoing ACDF with at least one year of follow up with complete PROM data. Patients completed the Neck Disability Index (NDI), the RAND-36 and the EuroQual Five Dimension (EQ-5D) scale, as well as the one-question SANE, pre- and post-operatively. Validity of SANE compared with other PROMs was determined utilizing Pearson's correlation (ρ), proportional bias (B), responsiveness, minimal clinically important difference (MCID) and agreement.
Sixty-nine patients were included. There were moderate-to-strong correlations at a minimum of one-year follow-up between the SANE and NDI (ρ = -0.73, P < 0.0001), RAND (ρ = 0.80, P < 0.0001), and EQ-5D (ρ = -0.66, P < 0.0001). No significant proportional bias was found for the SANE when compared to the RAND (B = 0.03, p = 0.99), NDI (B = -0.003, p = 0.99), or EQ-5D (B = -0.0007, p = 0.99). Responsiveness for SANE was statistically similar to all other PROMs. The MCID for SANE was determined to be 10.5, with 42% of patients achieving the MCID. Bland-Altman plots demonstrated high agreement between all PROMs.
We found the SANE score provides clinically important patient outcomes data after ACDF, despite only requiring answering one question. The SANE performs comparably to more burdensome health questionnaires. The SANE score may offer spine surgeons the option to easily and quickly collect clinically relevant data on their surgical patients.
回顾性队列研究。
通过与传统测量方法比较，评估单一评估数字评估（SANE）作为一种患者报告结局测量（PROM）在颈椎前路椎间盘切除融合术（ACDF）后的应用效果。
我们纳入了所有接受 ACDF 治疗且至少有一年随访期并具有完整 PROM 数据的患者。患者在术前和术后完成了颈椎残疾指数（NDI）、RAND-36 和欧洲五维健康量表（EQ-5D）评分，以及单问题 SANE 评分。通过 Pearson 相关系数（ρ）、比例偏差（B）、反应性、最小临床重要差异（MCID）和一致性，来确定 SANE 与其他 PROM 之间的有效性。
共纳入 69 例患者。在至少一年的随访中，SANE 与 NDI（ρ=-0.73，P<0.0001）、RAND（ρ=0.80，P<0.0001）和 EQ-5D（ρ=-0.66，P<0.0001）之间存在中度至强相关性。当与 RAND（B=0.03，p=0.99）、NDI（B=-0.003，p=0.99）或 EQ-5D（B=-0.0007，p=0.99）比较时，SANE 未发现显著的比例偏差。SANE 的反应性在统计学上与所有其他 PROM 相似。SANE 的 MCID 为 10.5，42%的患者达到了 MCID。Bland-Altman 图显示所有 PROM 之间具有高度一致性。
尽管 SANE 仅需回答一个问题，但它为 ACDF 后患者提供了有临床意义的结局数据。SANE 的表现与更繁琐的健康问卷相当。SANE 评分可能为脊柱外科医生提供了一种简便、快速收集手术患者临床相关数据的选择。
