PMID- 28146018
OWN - NLM
STAT- MEDLINE
DCOM- 20190611
LR  - 20220409
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 42
IP  - 17
DP  - 2017 Sep 1
TI  - Need for Two-Year Patient-Reported Outcomes Score for Lumbar Spine Surgery Is 
      Procedure-Specific: Analysis From a Prospective Longitudinal Spine Registry.
PG  - 1331-1338
LID - 10.1097/BRS.0000000000002087 [doi]
AB  - STUDY DESIGN: Retrospective analysis of prospectively collected data. OBJECTIVE: 
      The aim of this study was to determine whether 1-year patient-reported outcomes 
      (PROs) can accurately assess effective care for patients undergoing surgery for 
      degenerative lumbar spine disease. SUMMARY OF BACKGROUND DATA: Prospective 
      longitudinal PROs registries provide a means to accurately assess outcomes and 
      determine the relative effectiveness of various spine treatments. Obtaining 
      long-term PROs can be costly and challenging. METHODS: Patients enrolled into a 
      prospective registry who underwent lumbar spine surgery for degenerative disease 
      were included. Baseline, 1-year, and 2-year Oswestry Disability Index (ODI) 
      scores were captured. Previously published minimum clinically important 
      difference (MCID) for ODI (14.9) was used. Multivariable linear regression model 
      was created to derive model-estimated 2-year ODI scores. Absolute differences 
      between 1-year and 2-year ODI were compared to absolute differences between 
      2-year and model-estimated 2-year ODI. Concordance rates in achieving MCID at 
      1-year and 2-year and predictive values were calculated. RESULTS: A total of 868 
      patients were analyzed. One-year ODI scores differed from 2-year scores by an 
      absolute difference of 9.7 +/- 8.9 points and predictive model-estimated 2-year 
      scores differed from actual 2-year scores by 8.8 +/- 7.3 points. The 
      model-estimated 2-year ODI was significantly different than actual 1-year ODI in 
      assessing actual 2-year ODI for all procedures (P = 0.001) except for primary 
      (P = 0.932) and revision microdiscectomy (P = 0.978) and primary laminectomy 
      (P = 0.267). The discordance rates of achieving or not achieving MCID for ODI 
      ranged from 8% to 27%. Concordance rate was about 90% for primary and revision 
      microdiscectomy. The positive and negative predictive value of 1-year ODI to 
      predict 2-year ODI was 83% and 67% for all procedures and 92% and 67% for primary 
      and 100% and 86% for revision microdiscectomy respectively. CONCLUSION: One-year 
      disability outcomes can potentially estimate 2-year outcomes for patient 
      populations, but cannot reliably predict 2-year outcomes for individual patients, 
      except for patients undergoing primary and revision microdiscectomy. LEVEL OF 
      EVIDENCE: 4.
FAU - Kim, Elliott J
AU  - Kim EJ
AD  - Department of Orthopaedic Surgery and Department of Neurological Surgery, 
      Vanderbilt University Medical Center, Nashville, TN.
FAU - Chotai, Silky
AU  - Chotai S
AD  - Department of Orthopaedic Surgery and Department of Neurological Surgery, 
      Vanderbilt University Medical Center, Nashville, TN.
FAU - Archer, Kristin R
AU  - Archer KR
AD  - Department of Orthopaedic Surgery, Vanderbilt University Medical Center, 
      Nashville, TN.
AD  - Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical 
      Center, Nashville, TN.
FAU - Bydon, Mohamad
AU  - Bydon M
AD  - Department of Neurosurgery, Mayo Clinic, Rochester, MN.
FAU - Asher, Anthony L
AU  - Asher AL
AD  - Department of Neurological Surgery, Carolina Neurosurgery and Spine Associates, 
      Charlotte, NC.
FAU - Devin, Clinton J
AU  - Devin CJ
AD  - Department of Orthopaedic Surgery and Department of Neurological Surgery, 
      Vanderbilt University Medical Center, Nashville, TN.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - Disability Evaluation
MH  - Health Care Surveys/*standards
MH  - Humans
MH  - Longitudinal Studies
MH  - Lumbar Vertebrae/*surgery
MH  - *Orthopedic Procedures/adverse effects/methods/statistics & numerical data
MH  - *Patient Reported Outcome Measures
MH  - Retrospective Studies
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2017/02/02 06:00
MHDA- 2019/06/14 06:00
CRDT- 2017/02/02 06:00
PHST- 2017/02/02 06:00 [pubmed]
PHST- 2019/06/14 06:00 [medline]
PHST- 2017/02/02 06:00 [entrez]
AID - 00007632-201709010-00016 [pii]
AID - 10.1097/BRS.0000000000002087 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2017 Sep 1;42(17):1331-1338. doi: 
      10.1097/BRS.0000000000002087.