Sports Medicine Institute, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A; Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison, Wisconsin, U.S.A.
Sports Medicine Institute, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A; Department of Sports Medicine, Desert Orthopaedic Center, Las Vegas, Nevada, U.S.A.
Arthroscopy. 2022 Nov;38(11):3023-3029. doi: 10.1016/j.arthro.2022.03.038. Epub 2022 Apr 22.
To evaluate the reliability, construct validity, and responsiveness of the lower extremity-specific Patient-Reported Outcomes Measurement Information System (PROMIS) Mobility (MO) bank in patients who underwent hip arthroscopic surgery for femoroacetabular impingement.
Patients who underwent primary hip arthroscopic surgery at a large academic musculoskeletal specialty center between November 2019 and November 2020 completed the following baseline and 6-month measures: PROMIS MO, PROMIS Pain Interference (PI), PROMIS Physical Function (PF), modified Harris Hip Score, International Hip Outcome Tool 33, visual analog scale, and Single Assessment Numeric Evaluation. Construct validity was evaluated using Spearman correlation coefficients. The number of questions until completion was recorded as a marker of test burden. The percentage of patients scoring at the extreme high (ceiling) or low (floor) for each measure was recorded to measure inclusivity. Responsiveness was tested by comparing differences between baseline and 6-month measures, controlling for age and sex, using generalized estimating equations. Magnitudes of responsiveness were assessed through the effect size (Cohen d).
In this study, 660 patients (50% female patients) aged 32 ± 14 years were evaluated. PROMIS MO showed a strong correlation with PROMIS PF (r = 0.84, P < .001), the International Hip Outcome Tool 33 (r = 0.73, P < .001), PROMIS PI (r = -0.76, P < .001), and the modified Harris Hip Score (r = 0.73, P < .001). Neither PROMIS MO, PROMIS PI, nor PROMIS PF met the conventional criteria for floor or ceiling effects (≥15%). The mean number of questions answered (± standard deviation) was 4.7 ± 2.1 for PROMIS MO, 4.1 ± 0.6 for PROMIS PI, and 4.1 ± 0.6 for PROMIS PF. From baseline to 6 months, the PROMIS and legacy measures exhibited significant responsiveness (P < .05), with similar effect sizes between the patient-reported outcome measures.
This longitudinal study reveals that in patients undergoing hip arthroscopy, PROMIS MO computerized adaptive testing maintains high correlation with legacy hip-specific instruments, significant responsiveness to change, and low test burden compared with legacy measures, with no ceiling or floor effects at 6-month postoperative follow-up.
Level IV, retrospective case series.
评估用于评估髋关节镜检查治疗股骨髋臼撞击症患者的下肢专用患者报告结局测量信息系统（PROMIS）活动能力（MO）银行的可靠性、结构有效性和反应能力。
2019 年 11 月至 2020 年 11 月期间，在一家大型学术肌肉骨骼专业中心接受初次髋关节镜手术的患者完成了以下基线和 6 个月的测量：PROMIS MO、PROMIS 疼痛干扰（PI）、PROMIS 身体功能（PF）、改良 Harris 髋关节评分、国际髋关节结局工具 33、视觉模拟量表和单项评估数字评估。使用 Spearman 相关系数评估结构有效性。记录完成的问题数量作为测试负担的指标。记录每个测量值的极高（上限）或极低（下限）得分的患者百分比，以衡量包容性。通过控制年龄和性别，使用广义估计方程比较基线和 6 个月测量值之间的差异来测试反应能力。通过效应量（Cohen d）评估反应能力的幅度。
在这项研究中，对 660 名（50%为女性）年龄为 32 ± 14 岁的患者进行了评估。PROMIS MO 与 PROMIS PF（r = 0.84，P < 0.001）、国际髋关节结局工具 33（r = 0.73，P < 0.001）、PROMIS PI（r = -0.76，P < 0.001）和改良 Harris 髋关节评分（r = 0.73，P < 0.001）具有很强的相关性。PROMIS MO、PROMIS PI 和 PROMIS PF 均未达到下限或上限效应（≥15%）的常规标准。PROMIS MO 的平均回答问题数（±标准差）为 4.7 ± 2.1，PROMIS PI 为 4.1 ± 0.6，PROMIS PF 为 4.1 ± 0.6。从基线到 6 个月，PROMIS 和传统测量方法均表现出显著的反应能力（P < 0.05），患者报告的测量结果之间具有相似的效应量。
这项纵向研究表明，在接受髋关节镜手术的患者中，与传统的髋关节特定仪器相比，PROMIS MO 计算机自适应测试保持了高度相关性，对变化具有显著的反应能力，并且与传统测量方法相比，测试负担较低，在 6 个月的术后随访中没有上限或下限效应。
IV 级，回顾性病例系列。
