From the Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, OH.
J Am Acad Orthop Surg. 2022 Jan 15;30(2):71-78. doi: 10.5435/JAAOS-D-20-01324.
The objective of this study was to compare instruments from the Patient-Reported Outcomes Information System (PROMIS) with previously validated acetabulum fracture outcome instruments.
This study included adult patients presenting for routine follow-up at least 3 months after surgical treatment of an acetabulum fracture. Participants completed four different patient-reported outcomes in a randomized order: PROMIS Mobility, PROMIS Physical Function, Short Form 36 (SF-36), and Short Musculoskeletal Functional Assessment (SMFA). Primary outcomes were the correlations between instruments, floor/ceiling effects, and survey completion time. The effects of age, education, and race on survey completion time were also evaluated.
Overall strong correlations were observed between PROMIS instruments and the SMFA/SF-36 (r = 0.73 to 0.86, P < 0.05) with weaker, more moderate correlations in those with >18 months of follow-up (r = 0.41 to 0.76, P < 0.05). No instruments demonstrated notable floor or ceiling effects. The PROMIS outcomes required less time to complete (PROMIS [56 to 59 seconds] than SF-36 [5 minutes 22 seconds] and SMFA [6 minutes 35 seconds]; P < 0.001). Older individuals required more time to complete the PROMIS PF (0.5 s/yr, P = 0.03), SF-36 (2.35 s/yr, P = 0.01), and SMFA (3.85 s/yr, P < 0.01). Level of education did not affect completion time; however, African Americans took significantly longer than Caucasians to complete the SMFA and SF-36 by 151 and 164 seconds (P < 0.01).
This study supports that the PROMIS Mobility and Physical Function surveys are much more efficient instruments for evaluating patients with acetabulum fractures when compared with the SMFA and SF-36. Convergent validity of the PROMIS instruments was overall strong but weaker and more moderate in those with a long-term follow-up, and additional study is suggested for longer-term outcomes. Level of education did not influence survey completion time; however, it took markedly longer time for older individuals and African Americans to complete the SMFA and SF-36.
本研究旨在比较来自患者报告结局信息系统（PROMIS）的工具与先前经过验证的髋臼骨折结局工具。
本研究纳入了在接受髋臼骨折手术治疗后至少 3 个月接受常规随访的成年患者。参与者以随机顺序完成四项不同的患者报告结局：PROMIS 移动性、PROMIS 身体机能、SF-36（Short Form 36）和 SMFA（Short Musculoskeletal Functional Assessment）。主要结局为工具之间的相关性、地板/天花板效应以及调查完成时间。还评估了年龄、教育程度和种族对调查完成时间的影响。
在 PROMIS 工具与 SMFA/SF-36 之间观察到总体上较强的相关性（r = 0.73 至 0.86，P < 0.05），在随访时间超过 18 个月的患者中相关性较弱，更适中（r = 0.41 至 0.76，P < 0.05）。没有工具表现出明显的地板或天花板效应。PROMIS 结局所需的完成时间更短（PROMIS [56 至 59 秒] 短于 SF-36 [5 分钟 22 秒] 和 SMFA [6 分钟 35 秒]；P < 0.001）。年龄较大的个体完成 PROMIS PF（0.5 秒/年，P = 0.03）、SF-36（2.35 秒/年，P = 0.01）和 SMFA（3.85 秒/年，P < 0.01）所需的时间更长。教育程度并不影响完成时间；然而，非裔美国人完成 SMFA 和 SF-36 所需的时间比白种人分别长 151 秒和 164 秒（P < 0.01）。
与 SMFA 和 SF-36 相比，本研究支持 PROMIS 移动性和身体机能调查是评估髋臼骨折患者的更有效工具。PROMIS 工具的收敛效度总体较强，但在长期随访的患者中较弱且更适中，建议对长期结局进行进一步研究。教育程度并不影响调查完成时间；然而，年龄较大的个体和非裔美国人完成 SMFA 和 SF-36 的时间明显更长。
