Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO.
J Pediatr Orthop. 2022 Oct 1;42(9):521-531. doi: 10.1097/BPO.0000000000002226. Epub 2022 Aug 10.
The lack of a common patient-reported outcome metric used among the orthopaedic population is a problem that has been previously identified by the American Academy of Orthopaedic Surgeons. The Patient-Reported Outcomes Measurement Information System (PROMIS) was developed by the National Institute of Health with the goal of creating a precise and efficient measurement tool for patient-reported symptoms, functioning, and health-related quality of life to be used in clinical research. A study summarizing its use in the pediatric orthopaedic population has not been previously performed.
We performed a literature search of Ovid Medline, Embase, Scopus, and the Cochrane Central Register of Controlled Trials from 2010 to August 2021. There were 1961 unique citations included after the removal of 1756 duplicates. After initial screening, 183 studies were screened under full-text review leaving a final number of 51 studies included in this scoping review.
Pediatric PROMIS studies were grouped by body part or sub-speciality: "Hand and Upper Extremity" (25.5%, n=13), "Sports" (23.5%, n=12), "Spine" (13.7%, n=7), "Trauma" (13.7%, n=7), "General Pediatric Orthopaedics" (11.8%, n=6), "Lower Extremity" (9.8%, n=5), and "Orthopaedic Oncology" (2%, n=1). An increase in studies utilizing PROMIS was seen throughout the study period with only 3 studies published from 2013 to 2016 to 39 in 2020 and 2021 alone. The 3 most frequently used pediatric PROMIS domains were Pain Interference (76.5%, n=39/51), Mobility (60.8%, n=31/51), and Upper Extremity (54.9%, n=28/51). 64.3% (n=9/14) of the included studies which reported on the floor effects of Pain Interference exhibited a significant floor effect. In all, 77.8% (n=7/9) of the included studies which reported on ceiling effects of Upper Extremity exhibited a significant ceiling effect.
The use of PROMIS increased significantly since the first publication in 2013 suggesting orthopaedic providers have increasingly utilized PROMIS in their day-to-day practice as an outcome measure. Ceiling and floor effects were prominent in several of the included domains (Pain Interference and Upper Extremity). Overall, PROMIS measures are efficient, reliable, and effective to use.
IV.
美国骨科医师学会之前已经发现，骨科患者中缺乏通用的患者报告结局指标是一个问题。患者报告结局测量信息系统（PROMIS）是由美国国立卫生研究院开发的，其目标是创建一种精确和高效的测量工具，用于测量患者报告的症状、功能和与健康相关的生活质量，以便在临床研究中使用。之前尚未对其在儿科骨科人群中的应用进行总结。
我们对 Ovid Medline、Embase、Scopus 和 Cochrane 对照试验中心注册数据库进行了文献检索，检索时间为 2010 年至 2021 年 8 月。在去除 1756 份重复文献后，共纳入 1961 篇独特的参考文献。经过初步筛选，有 183 篇研究进行了全文审查，最终有 51 篇研究纳入本范围综述。
儿科 PROMIS 研究按身体部位或亚专科分组：“手和上肢”（25.5%，n=13）、“运动”（23.5%，n=12）、“脊柱”（13.7%，n=7）、“创伤”（13.7%，n=7）、“普通儿科骨科”（11.8%，n=6）、“下肢”（9.8%，n=5）和“骨科肿瘤学”（2%，n=1）。研究期间，使用 PROMIS 的研究数量有所增加，2013 年至 2016 年仅发表了 3 篇研究，而 2020 年和 2021 年就发表了 39 篇。最常使用的儿科 PROMIS 领域有疼痛干扰（76.5%，n=39/51）、移动性（60.8%，n=31/51）和上肢（54.9%，n=28/51）。报告疼痛干扰地板效应的 14 项研究中，有 64.3%（n=9/14）显示出显著的地板效应。报告上肢天花板效应的 77.8%（n=7/9）研究中，有 77.8%（n=7/9）显示出显著的天花板效应。
自 2013 年首次发表以来，PROMIS 的使用显著增加，这表明骨科医生在日常实践中越来越多地将 PROMIS 用作一种结果衡量标准。几个纳入的领域（疼痛干扰和上肢）存在明显的天花板和地板效应。总的来说，PROMIS 测量方法高效、可靠、有效。
IV。
