Abstract
Purpose
The current study compares the Patient Reported Outcomes Information System Physical Function Computer Adaptive Test (PROMIS PF CAT) to traditional knee PRO instruments in a healthy population undergoing surgery for ACL injuries with the following objectives: (1) identify and determine the strength of any correlations between the scores of PROMIS PF CAT and current knee PROs or their subscales that measure physical function; (2) evaluate PROMIS PF CAT’s test burden; and (3) determine if PROMIS PF CAT has any floor or ceiling effects in this population.
Methods
Patients indicated for ACL surgery completed the Short Form-36 Physical Function (SF-36 PF), Knee Injury and Osteoarthritis Outcome Score (KOOS), Marx Knee Activity Rating Scale (Marx), the EuroQol 5-dimensions Questionnaire (EQ-5D), and PROMIS PF CAT. Correlations between PROs were defined as follows: High (≥ 0.7); high–moderate (0.61–0.69); moderate (0.4–0.6); moderate–weak (0.31–0.39); and weak (≤ 0.3). Floor or ceiling effects were considered significant if 15% or more patients reported the lowest or highest possible total score, respectively.
Results
100 patients participated with a mean age of 26 years (range 11–57). The PROMIS PF CAT demonstrated high correlations with SF-36 PF (r = 0.82, p < 0.01), EQ-5D (r = − 0.70, p < 0.01) KOOS ADL (r = 0.74, p < 0.01), and KOOS Sport (r = 0.70, p < 0.01). There were no ceiling or floor effects for PROMIS PF CAT (0%). The mean number of items completed for the PROMIS PF CAT was 4.2 (median 4; range 4–11).
Conclusions
The PROMIS PF CAT shows a high correlation with commonly employed PROs that also measure physical function with low test burden and without ceiling effects in this relatively young and healthy population.
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References
Amstutz HC, Sew Hoy AL, Clarke IC (1981) UCLA anatomic total shoulder arthroplasty. Clin Orthop Relat Res 155:7–20
Beaton DE, Katz JN, Fossel AH, Wright JG, Tarasuk V, Bombardier C (2001) Measuring the whole or the parts? Validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity. J Hand Ther 14:128–146
Cella D, Gershon R, Lai JS, Choi S (2007) The future of outcomes measurement: item banking, tailored short-forms, and computerized adaptive assessment. Qual Life Res 16(Suppl 1):133–141
Chakravarty EF, Bjorner JB, Fries JF (2007) Improving patient reported outcomes using item response theory and computerized adaptive testing. J Rheumatol 34:1426–1431
Doring AC, Nota SP, Hageman MG, Ring DC (2014) Measurement of upper extremity disability using the patient-reported outcomes measurement information system. J Hand Surg Am 39:1160–1165
Fries J, Rose M, Krishnan E (2011) The PROMIS of better outcome assessment: responsiveness, floor and ceiling effects, and Internet administration. J Rheumatol 38:1759–1764
Fries JF, Bruce B, Cella D (2005) The promise of PROMIS: using item response theory to improve assessment of patient-reported outcomes. Clin Exp Rheumatol 23:S53–S57
Garrard L, Price LR, Bott MJ, Gajewski BJ (2015) A novel method for expediting the development of patient-reported outcome measures and an evaluation of its performance via simulation. BMC Med Res Methodol 15:77
Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51:737–755
Hoppe DJ, Bhandari M (2008) Evidence-based orthopaedics: a brief history. Indian J Orthop 42:104–110
Huber EO, Meichtry A, de Bie RA, Bastiaenen CH (2016) Construct validity of change scores of the Chair Stand Test versus Timed Up and Go test, KOOS questionnaire and the isometric muscle strength test in patients with severe knee osteoarthritis undergoing total knee replacement. Man Ther 21:262–267
Hung M, Baumhauer JF, Brodsky JW, Cheng C, Ellis SJ, Franklin JD et al (2014) Psychometric comparison of the PROMIS physical function CAT with the FAAM and FFI for measuring patient-reported outcomes. Foot Ankle Int 35:592–599
Hung M, Baumhauer JF, Latt LD, Saltzman CL, SooHoo NF, Hunt KJ (2013) Validation of PROMIS (R) physical function computerized adaptive tests for orthopaedic foot and ankle outcome research. Clin Orthop Relat Res 471:3466–3474
Hung M, Stuart AR, Higgins TF, Saltzman CL, Kubiak EN (2014) Computerized adaptive testing using the PROMIS physical function item bank reduces test burden with less ceiling effects compared to the short musculoskeletal function assessment in orthopaedic trauma patients. J Orthop Trauma 28:439–443
Hurwitz S (2003) Evidence-based medicine in orthopaedic surgery—a way to the future. Iowa Orthop J 23:61–65
Marchetti P, Binazzi R, Vaccari V, Girolami M, Morici F, Impallomeni C et al (2005) Long-term results with cementless Fitek (or Fitmore) cups. J Arthroplasty 20:730–737
Marx RG (2003) Knee rating scales. Arthroscopy 19:1103–1108
Marx RG, Stump TJ, Jones EC, Wickiewicz TL, Warren RF (2001) Development and evaluation of an activity rating scale for disorders of the knee. Am J Sports Med 29:213–218
McHorney CA, Ware JE Jr, Raczek AE (1993) The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31:247–263
Mohtadi NG, Chan DS, Hollinshead RM, Boorman RS, Hiemstra LA, Lo IK et al (2014) A randomized clinical trial comparing open and arthroscopic stabilization for recurrent traumatic anterior shoulder instability: two-year follow-up with disease-specific quality-of-life outcomes. J Bone Jt Surg Am 96:353–360
Nguyen J, Marx R, Hidaka C, Wilson S, Lyman S (2016) Validation of electronic administration of knee surveys among ACL-injured patients. Knee Surg Sports Traumatol Arthrosc 25:3116–3122
Noyes FR, Barber SD, Mooar LA (1989) A rationale for assessing sports activity levels and limitations in knee disorders. Clin Orthop Relat Res 246:238–249
Nutton RW, McBirnie JM, Phillips C (1997) Treatment of chronic rotator-cuff impingement by arthroscopic subacromial decompression. J Bone Joint Surg Br 79:73–76
Rabin R, de Charro F (2001) EQ-5D: a measure of health status from the EuroQol Group. Ann Med 33:337–343
Roos EM, Lohmander LS (2003) The Knee injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes 1:64–64
Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD (1998) Knee Injury and Osteoarthritis Outcome Score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther 28:88–96
Shoukri M (1998) Statistical methods for health sciences, 2nd edn. CRC Press, Pause
Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res Sep:43–49
Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J et al (2007) Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 60:34–42
Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483
Wyer PC, Silva SA (2009) Where is the wisdom? I—a conceptual history of evidence-based medicine. J Eval Clin Pract 15:891–898
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Hancock, K.J., Glass, N., Anthony, C.A. et al. PROMIS: a valid and efficient outcomes instrument for patients with ACL tears. Knee Surg Sports Traumatol Arthrosc 27, 100–104 (2019). https://doi.org/10.1007/s00167-018-5034-z
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DOI: https://doi.org/10.1007/s00167-018-5034-z