添加患者报告结局测量信息系统（PROMIS）疼痛工具是否能提高关节镜下肩袖修复术后PROMIS上肢评分的敏感性？
Does the addition of Patient-Reported Outcome Measure Information System (PROMIS) pain instruments improve the sensitivity of PROMIS upper extremity scores after arthroscopic rotator cuff repair?
作者信息
Alben Matthew G, Romeo Paul V, Papalia Aidan G, Cecora Andrew J, Kwon Young W, Rokito Andrew S, Zuckerman Joseph D, Virk Mandeep S
机构信息
Division of Shoulder and Elbow Surgery, Department of Orthopedic Surgery, NYU Grossman School of Medicine, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY, USA; Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
Division of Shoulder and Elbow Surgery, Department of Orthopedic Surgery, NYU Grossman School of Medicine, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY, USA; Department of Orthopedic Surgery, Rutgers Robert Wood Johnson University Hospital, New Brunswick, NJ, USA.
出版信息
J Shoulder Elbow Surg. 2025 Feb;34(2):595-605. doi: 10.1016/j.jse.2024.06.002. Epub 2024 Aug 6.
BACKGROUND
Although Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (P-UE) has been validated in upper extremity orthopedics, its ability to capture a patient's functional recovery after arthroscopic rotator cuff repair (aRCR), as measured by its responsiveness, is minimal in the early postoperative period. The primary purpose of this study is to determine if the addition of PROMIS Pain Intensity (P-Intensity) or Pain Interference (P-Interference) scores to PROMIS UE improves the responsiveness throughout the 1-year postoperative period after aRCR.
METHODS
This prospective, longitudinal study included 100 patients who underwent aRCR. Patients completed P-UE, P-Interference, P-Intensity, American Shoulder and Elbow Surgeons, and Western Ontario Rotator Cuff Index scores preoperatively and at 2 weeks, 6 weeks, 3 months, 6 months, and 12 months after surgery. Responsiveness at each time point relative to preoperative baseline and 1-way analysis of variance with post hoc analysis was conducted for each PROM. The responsiveness of the outcome score was determined using the effect size, graded as small (0.2), medium (0.5), or large (0.8). The Pearson correlation coefficient (r) was determined between these instruments at each time point.
RESULTS
In isolation, P-UE, P-Interference, and P-Intensity showed a medium-large ability to detect change (positive and negative) throughout the 1-year postoperative period. The addition of PROMIS pain scores to P-UE improved the responsiveness of the instrument (from medium to a large effect size) starting at 3 months and continued throughout the 12-month follow-up period. Although the addition of pain scores increases the response burden for PROMIS, this was still lower than the response burden for the legacy outcome scores (P < .05).
CONCLUSION
The addition of PROMIS pain instruments improves the responsiveness of the P-UE function score in patients undergoing aRCR.
背景
尽管患者报告结局测量信息系统（PROMIS）上肢（P-UE）已在上肢骨科中得到验证，但其在关节镜下肩袖修复术（aRCR）后捕捉患者功能恢复的能力，通过其反应度来衡量，在术后早期是极小的。本研究的主要目的是确定在PROMIS UE中加入PROMIS疼痛强度（P-强度）或疼痛干扰（P-干扰）评分是否能在aRCR术后1年期间提高反应度。
方法
这项前瞻性纵向研究纳入了100例行aRCR的患者。患者在术前以及术后2周、6周、3个月、6个月和12个月完成P-UE、P-干扰、P-强度、美国肩肘外科医师协会和西安大略肩袖指数评分。对每个PROM进行相对于术前基线的各时间点反应度分析以及事后分析的单因素方差分析。使用效应量确定结局评分的反应度，效应量分为小（0.2）、中（0.5）或大（0.8）。在每个时间点确定这些工具之间的Pearson相关系数（r）。
结果
单独来看，P-UE、P-干扰和P-强度在术后1年期间显示出中等至较大的检测变化（正向和负向）的能力。从术后3个月开始，在P-UE中加入PROMIS疼痛评分提高了该工具的反应度（从中等效应量提高到较大效应量），并在12个月的随访期内持续。尽管加入疼痛评分增加了PROMIS的反应负担，但这仍低于传统结局评分的反应负担（P < 0.05）。
结论
加入PROMIS疼痛工具可提高接受aRCR患者的P-UE功能评分的反应度。
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