Huddleston Hailey P, Mehta Nabil, Lavoie-Gagne Ophelie Z, Maheshwer Bhargavi, Fu Michael C, Cole Brian J, Verma Nikhil N, Forsythe Brian, Yanke Adam B
Hospital for Special Surgery, New York, NY, USA.
Department of Orthopedics, Rush University Medical Center, Chicago, IL, USA.
Shoulder Elbow. 2023 Dec;15(6):626-633. doi: 10.1177/17585732221137555. Epub 2022 Nov 10.
The purpose of this study was to investigate the associations between each mental health patient-reported outcome measure with postoperative functional outcomes following shoulder arthroplasty, and to compare psychometric properties of patient-reported outcomes measurement information system depression to the legacy (VR-12 Mental) patient-reported outcome measure.
Patients who underwent primary shoulder arthroplasty from July 2018 to February 2019 were retrospectively reviewed. Patient-reported outcomes measurement information system depression and VR-12 Mental were administered preoperatively; American Shoulder and Elbow Surgeons and Single Assessment Numeric Evaluation were administered at 6-month and 1-year postoperatively. Rasch partial credit modeling analysis was used to compare psychometric properties of legacy versus patient-reported outcomes measurement information system instruments in assessing mental health.
Ninety-three patients who underwent total shoulder arthroplasty ( = 52), reverse total shoulder arthroplasty ( = 39), or hemiarthroplasty ( = 2) were included. Preoperative VR-12 Mental scores were moderately associated with American Shoulder and Elbow Surgeons at 6-months (coefficient: 0.52, = 0.026) and 1-year (coefficient: 0.65, = 0.002), while preoperative patient-reported outcomes measurement information system depression scores were not. Patient-reported outcomes measurement information system depression demonstrated significant floor effects (16%); VR-12 Mental demonstrated minimal floor and ceiling effects (1.1% for both). VR-12 Mental demonstrated broader coverage of mental outlook on Rasch modeling than patient-reported outcomes measurement information system depression and had adequate model fit after one round of reiterative item elimination.
Patient-reported outcomes measurement information system depression was poorly associated with postoperative American Shoulder and Elbow Surgeons scores, demonstrated significant floor effects, and had limited coverage of mental health on Rasch modeling with reiterative elimination.
IV.
本研究旨在调查每种心理健康患者报告结局指标与肩关节置换术后功能结局之间的关联，并比较患者报告结局测量信息系统抑郁量表与传统（VR - 12心理健康）患者报告结局指标的心理测量特性。
回顾性分析2018年7月至2019年2月接受初次肩关节置换术的患者。术前使用患者报告结局测量信息系统抑郁量表和VR - 12心理健康量表；术后6个月和1年使用美国肩肘外科医师协会评分和单维度评估数值评定法。采用拉施克部分计分模型分析比较传统量表与患者报告结局测量信息系统工具在评估心理健康方面的心理测量特性。
纳入93例行全肩关节置换术（n = 52）、反式全肩关节置换术（n = 39）或半关节置换术（n = 2）的患者。术前VR - 12心理健康量表得分与术后6个月（系数：0.52，P = 0.026）和1年（系数：0.65，P = 0.002）的美国肩肘外科医师协会评分中度相关，而术前患者报告结局测量信息系统抑郁量表得分则无此相关性。患者报告结局测量信息系统抑郁量表显示出显著的地板效应（16%）；VR - 12心理健康量表显示出最小的地板效应和天花板效应（两者均为1.1%）。在拉施克模型中，VR - 心理健康量表比患者报告结局测量信息系统抑郁量表对心理状态的覆盖范围更广，并且在一轮迭代项目剔除后具有良好的模型拟合度。
患者报告结局测量信息系统抑郁量表与术后美国肩肘外科医师协会评分相关性较差，显示出显著的地板效应，并且在迭代剔除的拉施克模型中对心理健康的覆盖范围有限。
IV级。
