PMID- 37551708 OWN - NLM STAT- MEDLINE DCOM- 20230908 LR - 20231012 IS - 1552-3365 (Electronic) IS - 0363-5465 (Linking) VI - 51 IP - 11 DP - 2023 Sep TI - Use of Area Deprivation Index to Predict Minimal Clinically Important Difference for Patient Reported Outcomes Measurement Information System After Arthroscopic Rotator Cuff Repair. PG - 2815-2823 LID - 10.1177/03635465231187904 [doi] AB - BACKGROUND: Socioeconomic disparities correlate with worse outcomes after arthroscopic rotator cuff repair. However, use of a surrogate to describe socioeconomic disadvantage has been a challenge. The Area Deprivation Index (ADI) is a tool that encompasses 17 socioeconomic variables into a single metric based on census location. HYPOTHESIS: Higher ADI would result in a worse minimal clinically important difference (MCID) for the Patient Reported Outcomes Measurement Information System (PROMIS) and have less improvement in range of motion (ROM) following arthroscopic rotator cuff repair (ARCR). STUDY DESIGN: Cohort study; Level of evidence, 3. METHOD: A retrospective review was performed for patients who underwent arthroscopic rotator cuff repair. Patients in the most socioeconomically disadvantaged quartile (ADI(High)) were compared with the least disadvantaged quartile (ADI(Low)) in the ability to reach MCID. Demographic and surgical features were assessed for attainment of MCID. RESULTS: In total 1382 patients were identified who underwent ARCR, of which a total of 306 patients met final inclusion criteria. A higher percentage of patients within the ADI(High) cohort identified as "Black" or "other" race and had government-issued insurance compared with the ADI(Low) cohort (P < .05). The ADI(High) cohort had significantly worse postoperative forward flexion compared with the ADI(Low) cohort (145.0 degrees +/- 32.5 degrees vs 156.3 degrees +/- 23.4 degrees ; P = .001) despite starting with comparable preoperative ROM (P = .17). Logistic regression showed that ADI was the only variable significant for predicting achievement of MCID for all 3 PROMIS domains, with the ADI(High) cohort having significantly worse odds of achieving MCID Physical Function (odds ratio [OR], 0.31; P = .001), Pain Interference (OR, 0.21; P = .001), and Depression (OR, 0.28; P = .001). Meanwhile, age, sex, body mass index, and smoking history were nonsignificant. Moreover, "other" for race and Medicare insurance were significant for achievement of MCID Depression but not Physical Function or Pain Interference. Finally, ADI was the main feature for predictive logistic regression modeling. CONCLUSION: ADI served as the only significant predictor for achieving MCID for all 3 PROMIS domains after arthroscopic rotator cuff repair. Patients who face high levels of socioeconomic disadvantage have lower rates of achieving MCID. In addition, patients with greater neighborhood disadvantage demonstrated significantly worse improvement in active forward flexion. Further investigation is required to understand the role of ADI on physical therapy compliance and to identify the barriers that prevent equitable postoperative care. FAU - Shaikh, Hashim J F AU - Shaikh HJF AD - Department of Orthopaedic Surgery & Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Anderson, Devon E AU - Anderson DE AD - Department of Orthopaedic Surgery & Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Chait, Alexander R AU - Chait AR AD - Department of Orthopaedic Surgery & Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Ramirez, Gabriel AU - Ramirez G AD - Department of Orthopaedic Surgery & Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Bronstein, Robert D AU - Bronstein RD AD - Department of Orthopaedic Surgery & Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Goldblatt, John P AU - Goldblatt JP AD - Department of Orthopaedic Surgery & Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Giordano, Brian D AU - Giordano BD AD - Department of Orthopaedic Surgery & Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Maloney, Michael D AU - Maloney MD AD - Department of Orthopaedic Surgery & Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Nicandri, Gregg T AU - Nicandri GT AD - Department of Orthopaedic Surgery & Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Voloshin, Ilya AU - Voloshin I AUID- ORCID: 0000-0003-0161-4314 AD - Department of Orthopaedic Surgery & Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. FAU - Mannava, Sandeep AU - Mannava S AD - Department of Orthopaedic Surgery & Physical Performance, University of Rochester Medical Center, Rochester, New York, USA. LA - eng PT - Journal Article DEP - 20230808 PL - United States TA - Am J Sports Med JT - The American journal of sports medicine JID - 7609541 SB - IM MH - Humans MH - Aged MH - United States MH - *Rotator Cuff Injuries/surgery MH - Rotator Cuff/surgery MH - Cohort Studies MH - Minimal Clinically Important Difference MH - Treatment Outcome MH - Medicare MH - Arthroscopy MH - Retrospective Studies MH - Pain MH - Range of Motion, Articular MH - Patient Reported Outcome Measures MH - Information Systems OTO - NOTNLM OT - MCID OT - arthroscopy OT - rotator cuff tear OT - socioeconomic disparities EDAT- 2023/08/08 12:42 MHDA- 2023/09/08 06:42 CRDT- 2023/08/08 06:42 PHST- 2023/09/08 06:42 [medline] PHST- 2023/08/08 12:42 [pubmed] PHST- 2023/08/08 06:42 [entrez] AID - 10.1177/03635465231187904 [doi] PST - ppublish SO - Am J Sports Med. 2023 Sep;51(11):2815-2823. doi: 10.1177/03635465231187904. Epub 2023 Aug 8.