Browsing by Subject "Patient Reported Outcome Measures"
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Item Comparing PROMIS-29 to SF-12 in Evaluating Quality of Life in Patients with Diabetes-Related Foot Disease(2020-05-01T05:00:00.000Z) Ahn, Junho; Wukich, Dane K.; Raspovic, Katherine M.; Liu, George T.BACKGROUND: With the increasing prevalence of diabetes mellitus (DM), DM-related foot disease (DFD) is an underappreciated problem with far-reaching consequences. Understanding the impact of DFD on clinical outcomes and patient-reported quality of life (QOL) is an important step for improving patient care. Historically, the 12-item Short Form (SF-12) has been commonly used to evaluate QOL in this population. However, with recent innovations in survey methods such as in the Patient-Reported Outcomes Measurement Information System (PROMIS) and computer adaptive testing (CAT), these emerging surveys should be evaluated and compared to the legacy surveys for effectiveness in measuring patient QOL. OBJECTIVE: The aim of this research was to describe patient-reported quality of life in those with and without DFD using the SF-12 and the PROMIS-29. METHODS: All patients included in the study were treated in a foot and ankle clinic in a tertiary care hospital and completed both the SF-12 and the PROMIS surveys. Patients who did not complete both surveys during the same clinic visit were not included. Patient-reported QOL was compared statistically between those with and without DFD. RESULTS: One-hundred fifty patients were included in the study. Seventy-two (48%) had DFD. Between groups, those with DFD were younger, more often male, and had poorer DM-related parameters. Patient responses on the SF-12 and PROMIS surveys correlated significantly on most parameters including SF-12 mental component summary (MCS-12) and PROMIS Depression and Anxiety subscales as well as SF-12 physical component summary (PCS-12) and PROMIS physical function. However, when evaluating ceiling and floor effects, the PROMIS survey was found to have a longer ceiling effect in patients with DFD than the SF-12. CONCLUSION: The PROMIS survey correlates well with the legacy standard, SF-12, for patient-reported QOL in those with and without DFD. In addition, the PROMIS survey may be less sensitive to ceiling effects correlated with the effects of DFD on physical and mental health, potentially being a more effective tool than SF-12 for long-term monitoring of patient QOL. In addition, the technologic advance of CAT in surveys, the patient burden of repeated survey evaluation may be diminished.Item Embracing electronic tools to improve patient outcomes(2017-08-18) Beg, MuhammadItem Patient reported outcomes: the patient's perspective(2020-01-10) Bajaj, PuneetItem The Relationship between Pre-Operative Pain Characteristics and Periacetabular Osteotomy Outcomes in Patients with Acetabular Dysplasia(2022-02-01) Everett, Brandon; Nakonezny, Paul A.; Mulligan, Edward P.; Chhabra, Avneesh; Wells, JoelINTRODUCTION: Bernese Periacetabular Osteotomy (PAO) is widely performed for patients with acetabular dysplasia, however the relationship between preoperative pain characteristics and patient-reported outcome measures (PROM) is not well-studied. AIMS: (1) Does maximum severity of pain in a location other than the groin that is greater or equal to that of the groin affect PROM? (2) Does the presence of nongroin pain affect PROM? (3) Does the severity of pain affect PROM? (4) Does the number of pain locations affect PROM? METHODS: We reviewed 52 hips (48 patients) treated with PAO for acetabular dysplasia from February 2017 to July 2020, using modified Harris Hip Score (mHHS), Hip Outcome Score (HOS), and international Hip Outcome Tool (iHOT-12) score, radiographic analysis, and pain location/severity questionnaires. Descriptive statistics, Analysis of Covariance (ANCOVA), and Spearman partial correlation coefficients were implemented. RESULTS: Twenty-six hips experienced the most severe pre-operative pain in the groin, and 26 hips experienced equal or greater pain in a non-groin location. Outcome scores between these groups were not significantly different (mHHS P = .59, HOS P = .48, iHOT-12 P = .99). Additionally, the presence of pre-operative pain in any non-groin location had no significant relationship with PROM (all Pvalues ≥ .14). Furthermore, the maximum severity of pre-operative pain and number of pain locations showed no significant relationship with PROM (maximum severity: mHHS P = .82, HOS P = .99, iHOT-12 P = .36; number of pain locations: mHHS P = .56, HOS P = 0.10, iHOT-12 P = 0.62). DISCUSSION: Location of most severe pre-operative pain and the presence of nongroin pain in a patient with acetabular dysplasia does not adversely affect PROM. Additionally, increased pain severity and pain locations does not appear to have any significant impact on outcomes. Therefore, a wide array of patients with acetabular dysplasia might expect similar, favorable outcomes from PAO regardless of pre-operative pain characteristics. CLINICAL RELEVANCE: This study attempts to fill a current gap in knowledge that could help orthopaedic surgeons better understand the relationship between pain location and hip outcomes for patients following PAO.Item Rodeo Thumb: To Replant or Not(2020-05-01T05:00:00.000Z) Davis, Justin Joe; Zhang, Andrew; Sammer, Douglas; Koehler, DanielOBJECTIVE: To investigate patient reported outcomes after surgical treatment of Rodeo Thumb to help guide clinical decision making at the time of injury. METHODS: A retrospective review was performed for all rodeo thumb amputations from 2009-2019. Outcomes measured included daily functionality determined by QuickDASH scores, roping ability, and overall satisfaction. These were then compared between different levels of injury and definitive treatment. Outcomes between older and younger patients were also compared. Two-sided t-tests were used for QuickDASH scores and Pearson's Chi square test for categorical data. RESULTS: Thirty-seven patients underwent replantation or amputation as definitive treatment. IP level injury patients treated with replantation had a lower average QuickDASH than those treated with amputation (1.36 vs. 8.11; p=0.07), but fewer were roping at the same level or better (40% vs 78.6%; p=0.262). Patients with MCP level injury treated with replantation also had an average QuickDASH less than those treated with amputation (7.32 vs 10.4; p=0.52) and were roping at same level or better (66.6% vs 55.6%; p=1.00). Younger patients had lower QuickDASH scores than older patients (5.53 vs. 8.19; p=0.42), more who were roping at the same level or better (100% vs. 53%; p=0.02), and more who were satisfied with their treatment decision (88.9% vs. 60.7%; p=0.22.). CONCLUSIONS: For IP level injury, amputation seems to result in the same or better roping abilities as replantation. Replantation is the preferred treatment for MCP level injury. Younger patients tend to have better outcomes, possibly due to increased adaptation to injury. LEVEL OF EVIDENCE: IVItem Weightbearing and Activity Restriction Treatments and Quality of Life in Patients with Perthes Disease(2021-05-01T05:00:00.000Z) Do, Dang-Huy; Kim, Harry K. W.; Huo, Michael; Wells, JoelBACKGROUND: Weightbearing and activity restrictions are commonly prescribed during the active stages of Perthes disease. These restrictions, ranging from cast or brace treatment with nonweightbearing to full weightbearing with activity restrictions, may have a substantial influence on the physical, mental, and social health of a child. However, their impact on the patient's quality of life is not well-described. OBJECTIVES: After controlling for confounding variables, are restrictions on weightbearing and activity associated with physical health measures (as expressed by the Patient-Reported Outcome Measurement Information System [PROMIS] mobility, PROMIS pain interference, and PROMIS fatigue), mental health measures (PROMIS depressive symptoms and PROMIS anxiety), and social health measures (PROMIS peer relationships)? METHODS: Between 2013 and 2020, 211 patients with Perthes disease at a single institution were assigned six PROMIS measures to assess physical, mental, and social health. Patients who met the following eligibility criteria were analyzed: age 8 to 14 years old, completion of six PROMIS measures, English-speaking, and active stage of Perthes disease (Waldenstrom Stage I, II, or III). Weightbearing and activity restrictions were clinically recommended to patients in the initial through early reossification stages of Perthes disease when patients had increasing pain, loss of hip motion, loss of hip containment, progression of femoral head deformity, increased hip synovitis, and femoral head involvement on magnetic resonance imaging (MRI), or as a postoperative regimen. Patients were categorized into four intervention groups based on weightbearing and activity regimen. We excluded 111 patients who did not meet the inclusion criteria. The following six pediatric self-report PROMIS measures were assessed: mobility, pain interference, fatigue, depressive symptoms, anxiety, and peer relationships. Analysis of variance (ANOVA) was used to compare differences between the mean PROMIS T-scores of these weightbearing/activity regimens. Results were assessed with a significance of p < 0.05 and adjusted for Waldenstrom stage, gender, age of diagnosis, and history of major surgery using multivariate regression analysis. RESULTS: After controlling for confounding variables, the mild- (β regression coefficient -15 [95% CI -19 to -10]; p < 0.001), moderate- (β -19 [95% CI -24 to -14]; p < 0.001), and severe- (β -25 [95% CI -30 to -19]; p < 0.001) restriction groups were associated with worse mobility T-scores compared with the no-restriction group, but no association was detected for the pain interference or fatigue measures. Weightbearing and activity restrictions were not associated with mental health measures (depressive symptoms and anxiety). Weightbearing and activity restrictions were not associated with social health measures (peer relationships). Earlier Waldenstrom stage was associated with worse pain interference (β 10 [95% CI 2 to 17]; p = 0.01) and peer relationships scores (β -8 [95% CI -15 to -1]; p = 0.03); female gender was linked with worse depressive symptoms (β 7 [95% CI 2 to 12]; p = 0.005) and peer relationships scores (β -6 [95% CI -12 to 0]; p = 0.04); and earlier age at diagnosis was associated with worse peer relationships scores (β 1 [95% CI 0 to 2]; p = 0.03). History of major surgery had no connection to any of the six PROMIS measures. CONCLUSION: We found that weightbearing and activity restriction treatments are associated with poorer patient-reported mobility in the active stages of Perthes disease after controlling for confounding variables, but not pain interference, fatigue, depressive symptoms, anxiety, or peer relationships. Understanding how these treatments are associated with Perthes disease patients' quality of life can aid in decision-making for providers, help set expectations for patients and their parents, and provide opportunities for better education and preparation. Because of the chronic nature of Perthes disease, future studies may focus on longitudinal trends in patient-reported outcomes to better understand the overall impact of this disease and its treatment.