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Clin Spine Surg. 2019 Feb 5. doi: 10.1097/BSD.0000000000000786. [Epub ahead of print]

Evaluating the Concurrent Validity of PROMIS Physical Function in Anterior Cervical Discectomy and Fusion.

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1
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.

Abstract

STUDY DESIGN:

This study was a retrospective cohort analysis.

OBJECTIVES:

This study aims to evaluate the concurrent validity of Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) domain as compared with legacy measures of patient-reported outcomes (PROs) among patients undergoing anterior cervical discectomy and fusion (ACDF).

SUMMARY OF BACKGROUND DATA:

As PROMIS becomes increasingly utilized, it is important to assess its validity among procedure-specific populations.

METHODS:

Patients undergoing a primary, 1-3 level ACDF were retrospectively identified from a prospectively maintained surgical registry. PROMIS PF and legacy PRO scores were obtained at preoperative, 6-week, 12-week, and 6-month postoperative visits. Legacy PROs included Neck Disability Index (NDI), Short Form-12 (SF-12) physical composite, Visual Analog Scale (VAS) neck pain, and VAS arm pain. Postoperative improvements in PROs were assessed using paired t tests. Correlations between PROMIS and legacy PROs were tested using Pearson correlation coefficient.

RESULTS:

A total of 57 ACDF patients were analyzed. The mean preoperative PROMIS PF was 40.0±6.4. PROMIS PF significantly improved at 12-week and 6-month follow-up. NDI, VAS neck pain, and VAS arm pain scores demonstrated significant improvement at all postoperative time points. SF-12 scores only exhibited significant improvement at the 6-month follow-up visit. Significant correlations between PROMIS PF, NDI, and SF-12 were identified at all preoperative and postoperative time points. PROMIS PF exhibited strong correlations with VAS neck pain at postoperative time points, and a moderate correlation preoperatively.

CONCLUSIONS:

Patients undergoing a primary 1-3 level ACDF experience significant improvements in PROMIS PF scores at 12-week and 6-month follow-up. Furthermore, PROMIS PF exhibits strong correlations to NDI and SF-12 at all preoperative and postoperative time points. These results suggest that PROMIS PF accurately measures PF and may be used in lieu of legacy PF instruments for patients undergoing ACDF.

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