PMID- 33878484 OWN - NLM STAT- MEDLINE DCOM- 20210921 LR - 20210921 IS - 1532-6500 (Electronic) IS - 1058-2746 (Linking) VI - 30 IP - 10 DP - 2021 Oct TI - Establishing clinically significant outcomes of the Patient-Reported Outcomes Measurement Information System Upper Extremity questionnaire after primary reverse total shoulder arthroplasty. PG - 2231-2239 LID - S1058-2746(21)00355-4 [pii] LID - 10.1016/j.jse.2021.03.147 [doi] AB - BACKGROUND AND HYPOTHESIS: Since its introduction, the Patient-Reported Outcomes Measurement Information System Upper Extremity (PROMIS UE) assessment has been increasingly used in shoulder arthroplasty outcome measurement. However, determination of clinically significant outcomes using the PROMIS UE has yet to be investigated following reverse total shoulder arthroplasty (RTSA). We hypothesized that we could establish clinically significant outcomes of the PROMIS UE outcome assessment in patients undergoing primary RTSA and identify significant baseline patient factors associated with achievement of these measures. METHODS: Consecutive patients undergoing primary RTSA between 2018 and 2019 who received preoperative baseline and follow-up PROMIS UE assessments at 12 months after surgery were retrospectively reviewed. Domain-specific anchor questions pertaining to pain and function assessed at 12 months after surgery were used to determine minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptomatic state (PASS) values for the PROMIS UE using receiver operating characteristic curve and area-under-the-curve (AUC) analysis. Univariate logistic regression analysis was then performed to identify significant patient factors associated with achieving the MCID, SCB, or PASS. RESULTS: A total of 95 patients met all inclusion criteria and were included in the analysis. By use of an anchor-based method, the PASS value was 36.68 (sensitivity, 0.795; specificity, 0.765; AUC, 0.793) and the SCB value was 11.62 (sensitivity, 0.597; specificity, 1.00; AUC, 0.806). By use of a distribution-based method, the MCID value was calculated to be 4.27. Higher preoperative PROMIS UE scores were a positive predictor in achievement of the PASS (odds ratio [OR], 1.107; P = .05), whereas lower preoperative PROMIS UE scores were associated with obtaining SCB (OR, 0.787; P < .001). Greater baseline forward flexion was negatively associated with achievement of the PASS (OR, 0.986; P = .033) and MCID (OR, 0.976, P = .013). Of the patients, 83.2%, 69.5%, and 47.4% achieved the MCID, PASS, and SCB, respectively. CONCLUSION: This study defines the MCID, SCB, and PASS for the PROMIS UE outcome assessment in patients undergoing primary RTSA, of whom the majority achieved meaningful outcome improvement at 12 months after surgery. These values may be used in assessing the outcomes and extent of functional improvement following RTSA. CI - Copyright (c) 2021 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved. FAU - Haunschild, Eric D AU - Haunschild ED AD - Midwest Orthopaedics at Rush, Chicago, IL, USA. FAU - Condron, Nolan B AU - Condron NB AD - Midwest Orthopaedics at Rush, Chicago, IL, USA. FAU - Gilat, Ron AU - Gilat R AD - Midwest Orthopaedics at Rush, Chicago, IL, USA. FAU - Fu, Michael C AU - Fu MC AD - Midwest Orthopaedics at Rush, Chicago, IL, USA. FAU - Wolfson, Theodore AU - Wolfson T AD - Midwest Orthopaedics at Rush, Chicago, IL, USA. FAU - Garrigues, Grant E AU - Garrigues GE AD - Midwest Orthopaedics at Rush, Chicago, IL, USA. FAU - Nicholson, Gregory AU - Nicholson G AD - Midwest Orthopaedics at Rush, Chicago, IL, USA. FAU - Forsythe, Brian AU - Forsythe B AD - Midwest Orthopaedics at Rush, Chicago, IL, USA. FAU - Verma, Nikhil AU - Verma N AD - Midwest Orthopaedics at Rush, Chicago, IL, USA. FAU - Cole, Brian J AU - Cole BJ AD - Midwest Orthopaedics at Rush, Chicago, IL, USA. Electronic address: bcole@rushortho.com. LA - eng PT - Journal Article DEP - 20210418 PL - United States TA - J Shoulder Elbow Surg JT - Journal of shoulder and elbow surgery JID - 9206499 SB - IM MH - *Arthroplasty, Replacement, Shoulder MH - Humans MH - Information Systems MH - Minimal Clinically Important Difference MH - Patient Reported Outcome Measures MH - Retrospective Studies MH - Treatment Outcome MH - Upper Extremity OTO - NOTNLM OT - MCID OT - PASS OT - PROMIS OT - SCB OT - Shoulder OT - reverse total shoulder arthroplasty EDAT- 2021/04/21 06:00 MHDA- 2021/09/22 06:00 CRDT- 2021/04/20 20:11 PHST- 2020/10/27 00:00 [received] PHST- 2021/03/23 00:00 [revised] PHST- 2021/03/28 00:00 [accepted] PHST- 2021/04/21 06:00 [pubmed] PHST- 2021/09/22 06:00 [medline] PHST- 2021/04/20 20:11 [entrez] AID - S1058-2746(21)00355-4 [pii] AID - 10.1016/j.jse.2021.03.147 [doi] PST - ppublish SO - J Shoulder Elbow Surg. 2021 Oct;30(10):2231-2239. doi: 10.1016/j.jse.2021.03.147. Epub 2021 Apr 18.