Vogel Michael J, Wright-Chisem Joshua, Alvero Alexander B, Chan Jimmy J, Chapman Reagan S, Nho Shane J
Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.
Am J Sports Med. 2024 Mar;52(4):998-1004. doi: 10.1177/03635465241227181. Epub 2024 Feb 14.
Minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) thresholds have been previously defined for the Patient-Reported Outcomes Measurement Information System (PROMIS) at 1-year follow-up in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome; however, the MCID and PASS thresholds are yet to be defined for the PROMIS at 2-year follow-up.
(1) To establish MCID and PASS thresholds for the PROMIS Pain Interference (PROMIS-PI) and PROMIS Physical Function (PROMIS-PF) at 2-year follow-up and (2) to correlate PROMIS scores with hip-specific patient-reported outcome measure (PROM) scores.
Cohort study (diagnosis); Level of evidence, 3.
Patients undergoing primary hip arthroscopy for femoroacetabular impingement syndrome between August and November 2020 with preoperative and minimum 2-year postoperative data were identified. Collected scores included those for the PROMIS-PI, PROMIS-PF, Hip Outcome Score-Activities of Daily Living (HOS-ADL), Hip Outcome Score-Sports Subscale (HOS-SS), International Hip Outcome Tool-12 (iHOT-12), and visual analog scale (VAS) for pain. MCID thresholds were calculated using the distribution-based method and PASS thresholds using the anchor-based method. Pearson correlation coefficients were used to compare scores between PROMs.
A total of 65 patients met the criteria for inclusion (72.3% female; mean age, 36.9 ± 13.5 years; mean body mass index, 26.2 ± 6.0). The mean follow-up was 25.3 ± 3.3 months. Significant preoperative to postoperative improvements were observed for all PROMs ( < .001). MCID thresholds and achievement rates were as follows: HOS-ADL, 10.1 and 75%, respectively; HOS-SS, 13.8 and 79%, respectively; iHOT-12, 14.0 and 67%, respectively; VAS pain, -13.8 and 78%, respectively; PROMIS-PI, -4.7 and 65%, respectively; and PROMIS-PF, 5.8 and 60%, respectively. PASS thresholds and achievement rates were as follows: HOS-ADL, 78.7 and 67%, respectively; HOS-SS, 76.4 and 62%, respectively; iHOT-12, 67.4 and 60%, respectively; VAS pain, 25.5 and 61%, respectively; PROMIS-PI, 57.0 and 65%, respectively; and PROMIS-PF, 45.6 and 58%, respectively. PROMIS-PI scores correlated most strongly with HOS-ADL ( = -0.836), HOS-SS ( = -0.767), and iHOT-12 ( = -0.719) scores and exhibited at least moderate correlations (≥-0.595) with the other PROM scores. PROMIS-PF demonstrated moderate correlations with all the other PROM scores (≥-0.586). Strong correlations were seen between the hip-specific PROM scores (≥-0.745).
This study defined 2-year MCID and PASS thresholds for the PROMIS-PI and PROMIS-PF and demonstrated moderate to strong correlations between PROMIS scores and hip-specific PROM scores.
对于因股骨髋臼撞击综合征接受髋关节镜手术的患者，先前已定义了患者报告结局测量信息系统（PROMIS）在1年随访时的最小临床重要差异（MCID）和患者可接受症状状态（PASS）阈值；然而，PROMIS在2年随访时的MCID和PASS阈值尚未确定。
（1）确定PROMIS疼痛干扰（PROMIS-PI）和PROMIS身体功能（PROMIS-PF）在2年随访时的MCID和PASS阈值，（2）将PROMIS评分与髋关节特异性患者报告结局测量（PROM）评分进行相关性分析。
队列研究（诊断）；证据等级，3级。
确定2020年8月至11月间因股骨髋臼撞击综合征接受初次髋关节镜手术且有术前和至少2年术后数据的患者。收集的评分包括PROMIS-PI、PROMIS-PF、髋关节结局评分-日常生活活动（HOS-ADL）、髋关节结局评分-运动子量表（HOS-SS）、国际髋关节结局工具-12（iHOT-12）以及疼痛视觉模拟量表（VAS）。使用基于分布的方法计算MCID阈值，使用基于锚定的方法计算PASS阈值。采用Pearson相关系数比较各PROM之间的评分。
共有65例患者符合纳入标准（女性占72.3%；平均年龄36.9±13.5岁；平均体重指数26.2±6.0）。平均随访时间为25.3±3.3个月。所有PROM从术前到术后均有显著改善（P<0.001）。MCID阈值及达成率如下：HOS-ADL分别为10.1和75%；HOS-SS分别为13.8和79%；iHOT-12分别为14.0和67%；VAS疼痛分别为-13.8和78%；PROMIS-PI分别为-4.7和65%；PROMIS-PF分别为5.8和60%。PASS阈值及达成率如下：HOS-ADL分别为78.7和67%；HOS-SS分别为76.4和62%；iHOT-12分别为67.4和60%；VAS疼痛分别为25.5和61%；PROMIS-PI分别为57.0和65%；PROMIS-PF分别为45.6和58%。PROMIS-PI评分与HOS-ADL（r=-0.836）、HOS-SS（r=-0.767）和iHOT-12（r=-0.719）评分相关性最强，与其他PROM评分至少呈中度相关（≥-0.595）。PROMIS-PF与所有其他PROM评分呈中度相关（≥-0.586）。髋关节特异性PROM评分之间呈强相关（≥-0.745）。
本研究确定了PROMIS-PI和PROMIS-PF在2年时的MCID和PASS阈值，并证明了PROMIS评分与髋关节特异性PROM评分之间存在中度至强相关性。
