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Spine (Phila Pa 1976). 2018 Nov 20. doi: 10.1097/BRS.0000000000002934. [Epub ahead of print]

An Evaluation of PROMIS in Patients with Primary or Metastatic Spine Tumors.

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Department of Orthopaedic Surgery, University of Rochester, 601 Elmwood Ave, Box 665, Rochester, NY 14642, USA.
Research Department, New York Chiropractic College, 2360 State Route 89, Seneca Falls, NY, 13148 USA.



Retrospective evaluation of prospectively collected data OBJECTIVE.: In spine tumor patients: 1) To assess the correlation of PROMIS Physical Function (PF), Pain Interference (PI) and Depression scores with Oswestry Disability Index (ODI) and Neck Disability Index (NDI) scores; 2) To assess ceiling and floor effects of PROMIS PF, PI and Depression domains and the ODI/NDI.


There remains no widely used PRO instrument for spine tumor patients. PROMIS, a universal PRO tool, may add notable value to patient care. A paucity of work exists comparing PROMIS to legacy PRO tools in primary and metastatic spine tumor patients.


Patients confirmed to have a primary or metastatic spine tumor were asked to complete PROMIS PF, PI and Depression domains and either an ODI or NDI questionnaire between May 2015 and December 2017. Pearson correlation coefficients (r) were calculated. Ceiling and floor effects were determined. p < 0.05 was significant.


Eighty unique visits from 51 patients with spine tumors (44 metastatic/67 visits; 7 primary/13 visits) met our inclusion criteria. A strong correlation existed between PROMIS PI and the ODI/NDI in both primary and metastatic tumor patient subgroups (range, r = 0.75 - 0.86, p < 0.05). PROMIS PF and the ODI/NDI demonstrated a strong correlation among all patients (r = -0.75, p < 0.05) and in the metastatic disease subgroup (r = -0.78, p < 0.05). A strong correlation existed between PROMIS Depression and the ODI/NDI in the primary tumor subgroup (r = 0.79, p < 0.05). PROMIS Depression demonstrated the largest floor effect (13.6%); there were similar ceiling effects.


PROMIS PF and PI domains correlate well with the ODI/NDI in spine tumor patients and have a similar ceiling effect but decreased floor effect. PROMIS Depression was not as well captured, except in the primary tumor subgroup.



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