Concurrent Validity and Comparative Responsiveness of PROMIS-SF Versus Legacy Measures in the Cervical and Lumbar Spine Population: Longitudinal Analysis from Baseline to Postsurgery

World Neurosurg. 2018 Jul:115:e664-e675. doi: 10.1016/j.wneu.2018.04.131. Epub 2018 Apr 27.

Abstract

Background: The aim of our study was to evaluate the change in Patient-Reported Outcome Measurement Information System (PROMIS) scores at baseline, 3 months, and 12 months postprocedure and correlate with legacy measures.

Methods: We analyzed patients in 3 cohorts: lumbar, cervical, and the pooled cohort from our database, 2014-2017. Outcome variables were PROMIS items of pain interference, emotional distress and physical function, EuroQol 5 dimensions, visual analog scale, Oswestry Disability Index/Neck Disability Index, back, leg/neck and arm pain scales, and Patient Satisfaction Index.

Results: Patients with lumbar and cervical diseases constituted 55.3% (n = 52) and 44.7% (n = 42) of patients, respectively. There was a significant change in median PROMIS pain interference (65.5 to 57.6), anxiety (56.3 to 48.4), depression (51.2 to 37.1), and physical function (37.2 to 42.6) at baseline and 3 months, respectively. Similarly, change in these scores from baseline to 12 months was significant (n = 48). Compared with change in median Neck Disability Index and Oswestry Disability Index from baseline to 12 months (24.0 to 10.0; P = 0.0004 and 19.0 to 10.0; P < 0.0001), change in median PROMIS physical function score in the same cohort was 38.7 to 45.4 (P = 0.0025) and 37.2 to 41.8 (P < 0.0001), respectively. There was significant correlation between PROMIS pain interference/physical function and the legacy measures at 3 months.

Conclusions: PROMIS items correlated with legacy measures at baseline and postsurgery. Patients undergoing spine surgery improved in their patient-reported outcomes from baseline to 3 months after surgery and the gain were maintained at 12 months.

Keywords: Neck Disability Index; Oswestry Disability Index; PROMIS; Spine surgery.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Cervical Vertebrae / surgery*
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Pain Measurement / standards
  • Patient Reported Outcome Measures*
  • Postoperative Care / methods
  • Postoperative Care / standards*
  • Reproducibility of Results
  • Spinal Diseases / diagnosis
  • Spinal Diseases / surgery*
  • Surveys and Questionnaires / standards*
  • Treatment Outcome