PMID- 29620940
OWN - NLM
STAT- MEDLINE
DCOM- 20190412
LR  - 20191210
IS  - 1944-7876 (Electronic)
IS  - 1071-1007 (Linking)
VI  - 39
IP  - 7
DP  - 2018 Jul
TI  - Validation and Generalizability of Preoperative PROMIS Scores to Predict 
      Postoperative Success in Foot and Ankle Patients.
PG  - 763-770
LID - 10.1177/1071100718765225 [doi]
AB  - BACKGROUND: A recent publication reported preoperative Patient-Reported Outcomes 
      Measurement Instrumentation System (PROMIS) scores to be highly predictive in 
      identifying patients who would and would not benefit from foot and ankle surgery. 
      Their applicability to other patient populations is unknown. The aim of this 
      study was to assess the validation and generalizability of previously published 
      preoperative PROMIS physical function (PF) and pain interference (PI) threshold t 
      scores as predictors of postoperative clinically meaningful improvement in foot 
      and ankle patients from a geographically unique patient population. METHODS: 
      Prospective PROMIS PF and PI scores of consecutive patient visits to a tertiary 
      foot and ankle clinic were obtained between January 2014 and November 2016. 
      Patients undergoing elective foot and ankle surgery were identified and PROMIS 
      values obtained at initial and follow-up visits (average, 7.9 months). Analysis 
      of variance was used to assess differences in PROMIS scores before and after 
      surgery. The distributive method was used to estimate a minimal clinically 
      important difference (MCID). Receiver operating characteristic curve analysis was 
      used to determine thresholds for achieving and failing to achieve MCID. To assess 
      the validity and generalizability of these threshold values, they were compared 
      with previously published threshold values for accuracy using likelihood ratios 
      and pre- and posttest probabilities, and the percentages of patients identified 
      as achieving and failing to achieve MCID were evaluated using chi(2) analysis. 
      RESULTS: There were significant improvements in PF ( P < .001) and PI ( P < .001) 
      after surgery. The area under the curve for PF (0.77) was significant ( P < .01), 
      and the thresholds for achieving MCID and not achieving MCID were similar to 
      those in the prior study. A significant proportion of patients (88.9%) identified 
      as not likely to achieve MCID failed to achieve MCID ( P = .03). A significant 
      proportion of patients (84.2%) identified as likely to achieve MCID did achieve 
      MCID ( P < .01). The area under the curve for PROMIS PI was not significant. 
      CONCLUSIONS: PROMIS PF threshold scores from published data were successful in 
      classifying patients from a different patient and geographic population who would 
      improve with surgery. If functional improvement is the goal, these thresholds 
      could be used to help identify patients who will benefit from surgery and, most 
      important, those who will not, adding value to foot and ankle health care. LEVEL 
      OF EVIDENCE: Level II, Prospective Comparative Study.
FAU - Anderson, Michael R
AU  - Anderson MR
AD  - 1 University of Rochester, Rochester NY, USA.
FAU - Houck, Jeff R
AU  - Houck JR
AD  - 2 George Fox University, Newberg, OR, USA.
FAU - Saltzman, Charles L
AU  - Saltzman CL
AD  - 3 University of Utah, Salt Lake City, UT, USA.
FAU - Hung, Man
AU  - Hung M
AD  - 3 University of Utah, Salt Lake City, UT, USA.
FAU - Nickisch, Florian
AU  - Nickisch F
AD  - 3 University of Utah, Salt Lake City, UT, USA.
FAU - Barg, Alexej
AU  - Barg A
AD  - 3 University of Utah, Salt Lake City, UT, USA.
FAU - Beals, Timothy
AU  - Beals T
AD  - 3 University of Utah, Salt Lake City, UT, USA.
FAU - Baumhauer, Judith F
AU  - Baumhauer JF
AD  - 1 University of Rochester, Rochester NY, USA.
LA  - eng
GR  - U01 AR067138/AR/NIAMS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Validation Study
DEP - 20180405
PL  - United States
TA  - Foot Ankle Int
JT  - Foot & ankle international
JID - 9433869
SB  - IM
MH  - Adult
MH  - Aged
MH  - Ankle Joint/*surgery
MH  - Elective Surgical Procedures
MH  - Female
MH  - Foot/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Minimal Clinically Important Difference
MH  - Pain Threshold
MH  - *Patient Reported Outcome Measures
MH  - Prospective Studies
MH  - ROC Curve
MH  - Treatment Outcome
OTO - NOTNLM
OT  - PROMIS
OT  - foot and ankle
OT  - pain
OT  - patient-reported outcomes
OT  - physical function
EDAT- 2018/04/06 06:00
MHDA- 2019/04/13 06:00
CRDT- 2018/04/06 06:00
PHST- 2018/04/06 06:00 [pubmed]
PHST- 2019/04/13 06:00 [medline]
PHST- 2018/04/06 06:00 [entrez]
AID - 10.1177/1071100718765225 [doi]
PST - ppublish
SO  - Foot Ankle Int. 2018 Jul;39(7):763-770. doi: 10.1177/1071100718765225. Epub 2018 
      Apr 5.