Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts.
J Arthroplasty. 2024 Jun;39(6):1496-1499. doi: 10.1016/j.arth.2023.12.007. Epub 2023 Dec 9.
Arthroplasty surgeons use a variety of patient-reported outcome measures (PROMs) to assess functional well-being, including the Knee Injury and Osteoarthritis Outcome Score (KOOS) Physical Function short form (KOOS-PS), Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Short Form 10a (PROMIS PF SF 10a), and PROMIS Global-10 Physical Health subscale. However, there is a paucity of literature assessing their concurrent validity and performance.
Between June 2016 and December 2020, patient visits at an arthroplasty clinic for knee concerns were identified. Patients who completed KOOS-PS, PROMIS PF SF 10a, and PROMIS Global-10, including its physical and mental health subscales, at the same visit were identified. Spearman rho (ρ) correlations were calculated and ceiling and floor effects identified. Overall, 5,303 patient encounters were included.
Among physical function domains, strong correlation existed between the KOOS-PS and PROMIS PF SF 10a (ρ = 0.76, P < .001), KOOS-PS and PROMIS Global Physical Health (ρ = 0.71, P < .001), and PROMIS PF SF 10a and PROMIS Global Physical Health (ρ = 0.78, P < .001). No physical function-focused PROM had an appreciable floor effect (ie, at or more than 1%). The KOOS-PS had a small but measurable ceiling effect (n = 105 [2.0%]).
All of the examined PROMs are acceptable to measure the functional status of patients with knee pathology, with the PROMIS Global-10 also being able to capture elements of mental health too. The PROMIS Global-10 may be of most value of the PROMs assessed, as the United States Centers for Medicare and Medicaid Services already incorporate the mental health component into new alternative payment models.
关节置换外科医生使用各种患者报告的结果测量(PROM)来评估功能健康状况,包括膝关节损伤和骨关节炎结果评分(KOOS)物理功能简表(KOOS-PS)、患者报告的结果测量信息系统(PROMIS)物理功能短表 10a(PROMIS PF SF 10a)和 PROMIS 全球 10 身体健康子量表。然而,评估它们的同时有效性和性能的文献很少。
2016 年 6 月至 2020 年 12 月,确定在关节置换诊所就诊的膝关节问题患者。在同一次就诊时完成 KOOS-PS、PROMIS PF SF 10a 和 PROMIS 全球 10(包括其身体和心理健康子量表)的患者被确定。计算了 Spearman rho(ρ)相关系数,并确定了天花板和地板效应。共纳入 5303 例患者就诊。
在物理功能领域,KOOS-PS 与 PROMIS PF SF 10a(ρ=0.76,P<.001)、KOOS-PS 与 PROMIS 全球身体健康(ρ=0.71,P<.001)以及 PROMIS PF SF 10a 与 PROMIS 全球身体健康(ρ=0.78,P<.001)之间存在较强相关性。没有任何以物理功能为重点的 PROM 具有明显的天花板效应(即,为 1%或更多)。KOOS-PS 有一个较小但可测量的天花板效应(n=105[2.0%])。
所有检查的 PROM 都可用于测量膝关节病理患者的功能状态,PROMIS 全球-10 还能够捕捉心理健康的元素。PROMIS 全球-10 在评估的 PROM 中可能最有价值,因为美国医疗保险和医疗补助服务中心已经将心理健康部分纳入新的替代支付模式。