Department of Orthopedics and Rehabilitation, University of Iowa Hospitals & Clinics, Iowa City, IA, USA.
Iowa Orthop J. 2021 Dec;41(2):58-71.
The Patient-Reported Outcomes Measurement Information System (PROMIS®) was designed to monitor the global wellbeing of patients, with the Physical Function Computer-Adaptive Test (PF-CAT) component focused specifically on functional outcome. PROMIS aims for increased item-bank accuracy, lower administrative burden, and decreased floor and ceiling effects compared to legacy patient-reported outcome measures (PROMs). Our primary research outcomes focused on sports medicine surgical populations, which may skew younger or have wide-ranging functional statuses. Specifically, for this population, we questioned if PROMIS PF-CAT was equal to legacy PROMs in (1) construct validity and (2) convergent/divergent validities; and superior to legacy PROMs with respect to (3) survey burden and (4) floor and ceiling effects.
Searches were performed in April 2019 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, utilizing PubMed, Cochrane Central, and Embase databases for Level I-III evidence. This resulted in 541 records, yielding 12 studies for inclusion. PROM data was available for patients undergoing arthroscopic orthopaedic procedures of the knee, shoulder, and hip. Measures of construct validity, convergent/divergent validity, survey burden, and floor/ceiling effects were evaluated for PROMIS PF-CAT versus legacy PROMs.
PROMIS PF-CAT demonstrated excellent or excellent-good correlation with legacy PROMS for physical function and quality of life for patients undergoing arthroscopic interventions of the knee, shoulder, and hip. Compared to legacy PROM instruments, PROMIS PF-CAT demonstrated the lowest overall survey burden and had the lowest overall number of floor or ceiling effects across participants.
PROMIS PF-CAT is an accurate, efficient evaluation tool for sports medicine surgical patients. PROMIS PF-CAT strongly correlates with legacy physical function PROMs while having a lower test burden and less incidence of floor and ceiling effects. PROMIS PF-CAT may be an optimal alternative for traditional physical function PROMs in sports medicine patients undergoing arthroscopic procedures. Further studies are required to extend the generalizability of these findings to patients during postoperative timepoints after shoulder and hip interventions III.
患者报告结局测量信息系统（PROMIS®）旨在监测患者的整体健康状况，其身体机能计算机适应测试（PF-CAT）部分专门关注功能结果。与传统的患者报告结局测量工具（PROMs）相比，PROMIS 旨在提高项目库的准确性、降低管理负担、减少地板效应和天花板效应。我们的主要研究结果集中在运动医学手术人群，这些人群可能更年轻或功能状态广泛。具体来说，对于这一人群，我们质疑 PROMIS PF-CAT 在以下方面是否与传统的 PROMs 相当：（1）结构有效性；（2）收敛/发散有效性；以及在以下方面优于传统的 PROMs：（3）调查负担；（4）地板和天花板效应。
根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，于 2019 年 4 月进行了搜索，利用 PubMed、Cochrane 中央和 Embase 数据库检索了 I-III 级证据。这产生了 541 条记录，纳入了 12 项研究。PROM 数据可用于接受膝关节、肩关节和髋关节关节镜矫形手术的患者。评估了 PROMIS PF-CAT 与传统 PROM 相比在结构有效性、收敛/发散有效性、调查负担和地板/天花板效应方面的测量值。
对于接受膝关节、肩关节和髋关节关节镜干预的患者，PROMIS PF-CAT 与传统 PROMS 相比，在身体功能和生活质量方面表现出极好或极好的相关性。与传统的 PROM 工具相比，PROMIS PF-CAT 的整体调查负担最低，在所有参与者中整体地板或天花板效应的数量最低。
PROMIS PF-CAT 是运动医学手术患者的一种准确、高效的评估工具。与传统的身体功能 PROM 相比，PROMIS PF-CAT 具有更低的测试负担和更少的地板和天花板效应。在接受关节镜手术的运动医学患者中，PROMIS PF-CAT 可能是传统身体功能 PROM 的理想替代品。需要进一步的研究来将这些发现推广到接受肩关节和髋关节干预后的术后时间点的患者。
