验证PROMIS身体功能量表在评估急性跟腱断裂术后疗效中的应用
Validation of PROMIS Physical Function for Evaluating Outcome After Acute Achilles Tendon Rupture.
作者信息
Ochen Yassine, Guss Daniel, Houwert R Marijn, Smith Jeremy T, DiGiovanni Christopher W, Groenwold Rolf H H, Heng Marilyn
机构信息
Department of Orthopedic Surgery, Harvard Medical School Orthopedic Trauma Initiative, Massachusetts General Hospital, Boston, Massachusetts, USA.
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.
出版信息
Orthop J Sports Med. 2021 Oct 18;9(10):23259671211022686. doi: 10.1177/23259671211022686. eCollection 2021 Oct.
BACKGROUND
There is increased demand for valid, reliable, and responsive patient-reported outcome measures (PROMs) to evaluate treatment for Achilles tendon rupture, but not all PROMs currently in use are reliable and responsive for this condition.
PURPOSE
To evaluate the measurement properties of the Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS PF) compared with other PROMs used after treatment for acute Achilles tendon rupture.
STUDY DESIGN
Cohort study (diagnosis); Level of evidence, 2.
METHODS
A retrospective cohort study with a follow-up questionnaire was performed. All adult patients with an acute Achilles tendon rupture between June 2016 and June 2018 with a minimum 12-month follow-up were eligible for inclusion. Functional outcome was assessed using the PROMIS PF computerized adaptive test (CAT), Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL), FAAM-Sports, and Achilles Tendon Total Rupture Score (ATRS). Pearson correlation () was used to assess the correlations between PROMs. Absolute and relative floor and ceiling effects were calculated.
RESULTS
In total, 103 patients were included (mean age, 44.7 years; 74% male); 82 patients (79.6%) underwent operative repair, while 21 patients (20.4%) underwent nonoperative management. The mean time between treatment and collection of PROMs was 25.3 months (range, 15-36 months). The mean scores were 55.4 ± 9.2 (PROMIS PF), 92.9 ± 12.2 (FAAM-ADL), 77.7 ± 22.9 (FAAM-Sports), and 83.0 ± 19.4 (ATRS). The ATRS was correlated with FAAM-ADL ( = 0.80; 95% CI, 0.72-0.86; < .001) and FAAM-Sports ( = 0.86; 95% CI, 0.80-0.90; < .001). The PROMIS PF was correlated with the FAAM-ADL ( = 0.66; 95% CI, 0.53-0.75; < .001), FAAM-Sports ( = 0.65; 95% CI, 0.53-0.75; < .001), and ATRS ( = 0.69; 95% CI, 0.58-0.78; < .001). The PROMIS PF did not show absolute floor or ceiling effects (0%). The FAAM-ADL (35.9%), FAAM-Sports (15.8%), and ATRS (20.4%) had substantial absolute ceiling effects.
CONCLUSION
The PROMIS PF, FAAM-ADL, and FAAM-Sports all showed a moderate to high mutual correlation with the ATRS. Only the PROMIS PF avoided substantial floor and ceiling effects. The results suggest that the PROMIS PF CAT is a valid, reliable, and perhaps the most responsive tool to evaluate patient outcomes after treatment for an Achilles tendon rupture.
背景
评估跟腱断裂治疗效果的有效、可靠且具有反应性的患者报告结局测量指标（PROMs）的需求日益增加，但目前使用的并非所有PROMs对此病症都可靠且具有反应性。
目的
与治疗急性跟腱断裂后使用的其他PROMs相比，评估患者报告结局测量信息系统身体功能（PROMIS PF）的测量特性。
研究设计
队列研究（诊断）；证据等级，2级。
方法
进行了一项带有随访问卷的回顾性队列研究。纳入2016年6月至2018年6月间所有急性跟腱断裂且至少随访12个月的成年患者。使用PROMIS PF计算机自适应测试（CAT）、足踝能力测量（FAAM）日常生活活动（ADL）、FAAM-运动以及跟腱完全断裂评分（ATRS）评估功能结局。采用Pearson相关性（）评估PROMs之间的相关性。计算绝对和相对地板效应及天花板效应。
结果
共纳入103例患者（平均年龄44.7岁；74%为男性）；82例患者（79.6%）接受了手术修复，21例患者（20.4%）接受了非手术治疗。治疗与收集PROMs之间的平均时间为25.3个月（范围15 - 36个月）。平均得分分别为55.4±9.2（PROMIS PF）、92.9±12.2（FAAM-ADL）、77.7±22.9（FAAM-运动）和83.0±19.4（ATRS）。ATRS与FAAM-ADL（=0.80；95%CI，0.72 - 0.86；<0.001）和FAAM-运动（=0.86；95%CI，0.80 - 0.90；<0.001）相关。PROMIS PF与FAAM-ADL（=0.66；95%CI，0.53 - 0.75；<0.001）、FAAM-运动（=0.65；95%CI，0.53 - 0.75；<0.001）以及ATRS（=0.69；95%CI，0.58 - 0.78；<0.001）相关。PROMIS PF未显示绝对地板效应或天花板效应（0%）。FAAM-ADL（35.9%）、FAAM-运动（15.8%）和ATRS（20.4%）有显著的绝对天花板效应。
结论
PROMIS PF、FAAM-ADL和FAAM-运动均与ATRS显示出中度至高的相互相关性。只有PROMIS PF避免了显著的地板效应和天花板效应。结果表明，PROMIS PF CAT是评估跟腱断裂治疗后患者结局的有效、可靠且可能最具反应性的工具。
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