PMID- 35172206
OWN - NLM
STAT- MEDLINE
DCOM- 20220622
LR  - 20220622
IS  - 1532-6500 (Electronic)
IS  - 1058-2746 (Linking)
VI  - 31
IP  - 7
DP  - 2022 Jul
TI  - Risk factors for failure to achieve minimal clinically important difference and 
      significant clinical benefit in PROMIS computer adaptive test domains in patients 
      undergoing rotator cuff repair.
PG  - 1416-1425
LID - S1058-2746(22)00221-X [pii]
LID - 10.1016/j.jse.2022.01.125 [doi]
AB  - BACKGROUND: The Patient-Reported Outcomes Measurement Information System (PROMIS) 
      has emerged as a valid and efficient means of collecting outcomes in patients 
      with rotator cuff tears. The purpose of this study was to establish threshold 
      score changes to determine minimal clinically important difference (MCID) and 
      substantial clinical benefit (SCB) in PROMIS computer adaptive test (CAT) scores 
      following rotator cuff repair (RCR). Additionally, we sought to identify 
      potential risk factors for failing to achieve MCID and SCB. METHODS: Patients 
      undergoing arthroscopic RCR were identified over a 24-month period. Only patients 
      who completed both preoperative and postoperative PROMIS CAT assessments were 
      included in this cohort. PROMIS CAT forms for upper extremity physical function 
      (PROMIS-UE), pain interference (PROMIS-PI), and depression (PROMIS-D) were used 
      with a minimum of 1.5-year follow-up. Statistical analysis was performed to 
      determine threshold score changes to determine anchor-based MCID and SCB, as well 
      as risk factors for failure to achieve significant clinical improvement following 
      surgery. RESULTS: Of 198 eligible patients, 168 (84.8%) were included in 
      analysis. DeltaPROMIS-UE values of 5.8 and 9.7 (area under the curve [AUC] = 0.906 
      and 0.949, respectively) and DeltaPROMIS-PI values of -11.4 and -12.9 (AUC = 0.875 
      and 0.938, respectively) were identified as threshold predictors of MCID and SCB 
      achievement. On average, 81%, 65%, and 55% of patients achieved MCID for 
      PROMIS-UE, PROMIS-PI, and PROMIS-D whereas 71%, 61%, and 38% of patients in the 
      cohort, respectively, achieved SCB. MCID achievement in PROMIS-UE significantly 
      differed according to risk factors, including smoking status (likelihood ratio 
      [LR]: 9.8, P = .037), tear size (LR: 10.4, P < .001), distal clavicle excision 
      (LR: 6.1, P = .005), and prior shoulder surgery (LR: 19.2, P < .001). Factors 
      influencing SCB achievement for PROMIS-UE were smoking status (LR: 9.3, 
      P = .022), tear size (LR: 8.0, P = .039), and prior shoulder surgery (11.9, 
      P < .001). Significantly different rates of MCID and SCB achievement in PROMIS-PI 
      for smoking status (LR: 7.0, P = .030, and LR: 5.2, P = .045) and prior shoulder 
      surgery (LR: 9.1, P = .002, and LR: 7.4, P = .006) were also identified. 
      DISCUSSION AND CONCLUSION: The majority of patients showed clinically significant 
      improvements that exceeded the established MCID for PROMIS-UE and PROMIS-PI 
      following RCR. Patients with larger tear sizes, a history of prior shoulder 
      surgery, tobacco users, and those who received concomitant distal clavicle 
      excision were at risk for failing to achieve MCID in PROMIS-UE. Additionally, 
      smokers and patients who underwent prior shoulder surgery demonstrated 
      significantly lower improvements in pain scores following surgery.
CI  - Copyright (c) 2022 Journal of Shoulder and Elbow Surgery Board of Trustees. 
      Published by Elsevier Inc. All rights reserved.
FAU - Tramer, Joseph S
AU  - Tramer JS
AD  - Department of Orthopedic Surgery, Henry Ford Health System, Detroit, MI, USA.
FAU - Yedulla, Nikhil R
AU  - Yedulla NR
AD  - Department of Orthopedic Surgery, Henry Ford Health System, Detroit, MI, USA.
FAU - Ziedas, Alexander C
AU  - Ziedas AC
AD  - Department of Orthopedic Surgery, Henry Ford Health System, Detroit, MI, USA.
FAU - Patel, Mit
AU  - Patel M
AD  - Department of Orthopedic Surgery, Henry Ford Health System, Detroit, MI, USA.
FAU - Franovic, Sreten
AU  - Franovic S
AD  - Department of Orthopedic Surgery, Henry Ford Health System, Detroit, MI, USA.
FAU - Muh, Stephanie J
AU  - Muh SJ
AD  - Department of Orthopedic Surgery, Henry Ford Health System, Detroit, MI, USA.
FAU - Makhni, Eric C
AU  - Makhni EC
AD  - Department of Orthopedic Surgery, Henry Ford Health System, Detroit, MI, USA. 
      Electronic address: ericmakhnimd@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20220213
PL  - United States
TA  - J Shoulder Elbow Surg
JT  - Journal of shoulder and elbow surgery
JID - 9206499
SB  - IM
MH  - Computers
MH  - Humans
MH  - *Minimal Clinically Important Difference
MH  - Pain
MH  - Patient Reported Outcome Measures
MH  - Risk Factors
MH  - *Rotator Cuff
MH  - Rupture
MH  - Treatment Outcome
OTO - NOTNLM
OT  - MCID
OT  - PROMIS
OT  - RCR
OT  - arthroscopic
OT  - patient-reported outcomes
OT  - physical function
OT  - rotator cuff repair
EDAT- 2022/02/17 06:00
MHDA- 2022/06/23 06:00
CRDT- 2022/02/16 20:07
PHST- 2021/10/01 00:00 [received]
PHST- 2021/12/29 00:00 [revised]
PHST- 2022/01/09 00:00 [accepted]
PHST- 2022/02/17 06:00 [pubmed]
PHST- 2022/06/23 06:00 [medline]
PHST- 2022/02/16 20:07 [entrez]
AID - S1058-2746(22)00221-X [pii]
AID - 10.1016/j.jse.2022.01.125 [doi]
PST - ppublish
SO  - J Shoulder Elbow Surg. 2022 Jul;31(7):1416-1425. doi: 10.1016/j.jse.2022.01.125. 
      Epub 2022 Feb 13.