Relationship Between PROMIS Computer Adaptive Tests and Legacy Hip Measures Among Patients Presenting to a Tertiary Care Hip Preservation Center

Abstract

Background:

Legacy hip outcome measures may be burdensome to patients and sometimes yield floor or ceiling effects. Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive tests (CATs) allow for low-burden data capture and limited ceiling and floor effects.

Purpose/Hypothesis:

The purpose of this study was to determine whether the PROMIS CAT domains demonstrate correlation against commonly used legacy patient-reported outcome measures in a population of patients presenting to a tertiary care hip preservation center. The authors hypothesized the following: (1) PROMIS CAT scores based on physical function (PF), pain interference (PIF), pain behavior, and pain intensity would show strong correlation with the following legacy scores: modified Harris Hip Score (mHHS), International Hip Outcome Tool–12 (iHOT-12), Hip Outcome Score (HOS) Sports and Activities of Daily Living subscales, and Veterans RAND–6D (VR-6D) utility measure. (2) The mental and physical health portions of the VR-6D legacy measure would show weak correlation with mental- and psychosocial-specific PROMIS elements—depression, anxiety, fatigue, sleep, and ability to participate in social roles and activities. (3) All PROMIS measures would exhibit fewer floor and ceiling effects than legacy scores.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

Prospective data were collected on 125 patients in the hip preservation clinics. Enrollees completed legacy scores (visual analog scale for pain, mHHS, iHOT-12, HOS, and VR-6D) and PROMIS CAT questionnaires (PF, PIF, pain behavior, anxiety, depression, sleep, social roles and activities, pain intensity, fatigue). Spearman rank correlations were calculated, with r_s values of 0 to 0.3 indicating negligible correlation; 0.3 to 0.5, weak correlation; 0.5 to 0.7, moderately strong correlation; and >0.7, strong correlation. Floor and ceiling effects were evaluated.

Results:

As anticipated, the PF-CAT yielded strong correlations with the iHOT-12, mHHS, HOS–Sports, HOS–Activities of Daily Living, and VR-6D, with r_s values of 0.76, 0.71, 0.81, 0.87, and 0.71, respectively. The PIF-CAT was the only pain score to show moderately strong to strong correlation with all 14 patient-reported outcome measures. A strong correlation was observed between the VR-6D and the social roles and activities CAT (r_s = 0.73). The depression CAT had a significant floor effect at 19%. No additional floor or ceiling effect was present for any other legacy or PROMIS measure.

Conclusion:

The PF-CAT shows strong correlation with legacy patient-reported outcome scores among patients presenting to a tertiary care hip preservation center. The PIF-CAT also correlates strongly with legacy and PROMIS measures evaluating physical and mental well-being. PROMIS measures are less burdensome and demonstrate no floor or ceiling effects, making them a potential alternative to legacy patient-reported outcome measures for the hip.

Keywords

PROMIS hip arthroscopy hip preservation

Get full access to this article

View all access options for this article.

References

Anthony

Glass

Hancock

Bollier

Wolf

Hettrich

CM.

Performance of PROMIS instruments in patients with shoulder instability. Am J Sports Med. 2017;45(2):449-453.

Beckmann

Hung

Voss

Crum

Bounsanga

Tyser

AR.

Evaluation of the patient-reported outcomes measurement information system upper extremity computer adaptive test. J Hand Surg Am. 2016;41(7):739-744.e734.

Beleckas

Padovano

Guattery

Chamberlain

Keener

Calfee

RP.

Performance of Patient-Reported Outcomes Measurement Information System (PROMIS) upper extremity (UE) versus physical function (PF) computer adaptive tests (CATs) in upper extremity clinics. J Hand Surg Am. 2017;42(11):867-874.

Broderick

DeWitt

Rothrock

Crane

Forrest

CB.

Advances in patient-reported outcomes: the NIH PROMIS measures. EGEMS (Wash DC). 2013;1(1):1015.

Brodke

Saltzman

Brodke

DS.

PROMIS for orthopaedic outcomes measurement. J Am Acad Orthop Surg. 2016;24(11):744-749.

Chen

Yuen

Ortiz-Declet

Litrenta

Maldonado

Domb

BG.

Selective debridement with labral preservation using narrow indications in the hip: minimum 5-year outcomes with a matched-pair labral repair control group. Am J Sports Med. 2018;46(2):297-304.

Childs

Canham

Kenney

Silas

Adler

Giordano

BD.

Correlation of PROMIS CAT with validated hip outcome scores in patients undergoing hip arthroscopy. Orthop J Sports Med. 2017;5(7)(suppl 6):2325967117S2325900451.

Degen

Bernard

Pan

et al . Hip arthroscopy utilization and associated complications: a population-based analysis. J Hip Preserv Surg. 2017;4(3):240-249.

Domb

Rabe

Walsh

Chaharbakhshi

Perets

Outpatient robotic-arm total hip arthroplasty surgical technique. Surg Technol Int. 2016;29:235-239.

10.

Engel-Yeger

Keren

Berkovich

Sarfaty

Merom

The role of physical status versus mental status in predicting the quality of life of patients with lumbar disk herniation. Disabil Rehabil. 2018;40(3):302-308.

11.

Gagnier

Huang

Mullins

et al . Measurement properties of patient-reported outcome measures used in patients undergoing total hip arthroplasty: a systematic review. JBJS Rev. 2018;6(1):e2.

12.

Griffin

Parsons

Mohtadi

Safran

MR.

A short version of the International Hip Outcome Tool (iHOT-12) for use in routine clinical practice. Arthroscopy. 2012;28(5):611-616.

13.

Hagell

Westergren

Arestedt

Beware of the origin of numbers: standard scoring of the SF-12 and SF-36 summary measures distorts measurement and score interpretations. Res Nurs Health. 2017;40(4):378-386.

14.

Hancock

Glass

Anthony

et al . Performance of PROMIS for healthy patients undergoing meniscal surgery. J Bone Joint Surg Am. 2017;99(11):954-958.

15.

Harris

Taylor

Thielke

Payne

Gonzalez

Conde

JG.

Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377-381.

16.

Harris

WH.

Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51(4):737-755.

17.

Hobby

Lutchman

Powell

Sharp

DJ.

The distress and risk assessment method (DRAM). J Bone Joint Surg Br. 2001;83(1):19-21.

18.

Hung

Baumhauer

Latt

Saltzman

SooHoo

Hunt

KJ.

Validation of PROMIS (R) physical function computerized adaptive tests for orthopaedic foot and ankle outcome research. Clin Orthop Relat Res. 2013;471(11):3466-3474.

19.

Hung

Clegg

Greene

Weir

Saltzman

CL.

A lower extremity physical function computerized adaptive testing instrument for orthopaedic patients. Foot Ankle Int. 2012;33(4):326-335.

20.

Hung

Hon

Cheng

et al . Psychometric evaluation of the lower extremity computerized adaptive test, the modified Harris Hip Score, and the Hip Outcome Score. Orthop J Sports Med. 2014;2(12):2325967114562191.

21.

Hung

Saltzman

Greene

et al . Evaluating instrument responsiveness in joint function: the HOOS JR, the KOOS JR, and the PROMIS PF CAT. J Orthop Res. 2018;36(4):1178-1184.

22.

Hung

Stuart

Cheng

et al . Predicting the DRAM mZDI using the PROMIS anxiety and depression. Spine (Phila Pa 1976). 2015;40(3):179-183.

23.

Hung

Stuart

Higgins

Saltzman

Kubiak

EN.

Computerized adaptive testing using the PROMIS physical function item bank reduces test burden with less ceiling effects compared with the short musculoskeletal function assessment in orthopaedic trauma patients. J Orthop Trauma. 2014;28(8):439-443.

24.

Jacobs

Peabody

Duncan

et al . Development of the HOOSglobal to assess patient-reported outcomes in patients undergoing hip preservation procedures. Am J Sports Med. 2018; 46(4):940-946.

25.

Kwon

Sawatzky

Examining gender-related differential item functioning of the Veterans Rand 12-item Health Survey. Qual Life Res. 2017;26(10):2877-2883.

26.

Lerch

Todorski

IAS

Steppacher

et al . Prevalence of femoral and acetabular version abnormalities in patients with symptomatic hip disease: a controlled study of 538 hips. Am J Sports Med. 2018;46(1):122-134.

27.

Makhni

Meadows

Hamamoto

Higgins

Romeo

Verma

NN.

Patient Reported Outcomes Measurement Information System (PROMIS) in the upper extremity: the future of outcomes reporting?

J Shoulder Elbow Surg. 2017;26(2):352-357.

28.

Maradit Kremers

Schilz

Van Houten

et al . Trends in utilization and outcomes of hip arthroscopy in the United States between 2005 and 2013. J Arthroplasty. 2017;32(3):750-755.

29.

Martin

Philippon

MJ.

Evidence of validity for the hip outcome score in hip arthroscopy. Arthroscopy. 2007;23(8):822-826.

30.

Mohtadi

Griffin

Pedersen

et al . The development and validation of a self-administered quality-of-life outcome measure for young, active patients with symptomatic hip disease: the International Hip Outcome Tool (iHOT-33). Arthroscopy. 2012;28(5):595-605.

31.

Mukaka

MM.

Statistics corner: a guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2012;24(3):69-71.

32.

Ortiz-Declet

Iacobelli

Yuen

Perets

Chen

Domb

BG.

Birmingham hip resurfacing vs total hip arthroplasty: a matched-pair comparison of clinical outcomes. J Arthroplasty. 2017;32(12):3647-3651.

33.

Papaliodis

Banffy

Limpisvasti

et al . The development and validation of a subjective assessment tool for the hip in the athletic population. Am J Sports Med. 2017;45(11):2517-2523.

34.

Perets

Walsh

Yuen

Domb

BG.

Robot-assisted total hip arthroplasty: clinical outcomes and complication rate. Int J Med Robot. 2018;14(4):e1912.

35.

Ramisetty

Kwon

Mohtadi

Patient-reported outcome measures for hip preservation surgery—a systematic review of the literature. J Hip Preserv Surg. 2015;2(1):15-27.

36.

Robins

Anderson

Zhang

Presson

Burks

Greis

PE.

Convergent validity of the patient-reported outcomes measurement information system’s physical function computerized adaptive test for the knee and shoulder injury sports medicine patient population. Arthroscopy. 2017;33(3):608-616.

37.

Saltzman

Kuhns

Basques

et al . The influence of body mass index on outcomes after hip arthroscopic surgery with capsular plication for the treatment of femoroacetabular impingement. Am J Sports Med. 2017;45(10):2303-2311.

38.

Selim

Rogers

Fleishman

et al . Updated US population standard for the Veterans RAND 12-Item Health Survey (VR-12). Qual Life Res. 2009;18(1):43-52.

39.

Selim

Rogers

Qian

Brazier

Kazis

LE.

A preference-based measure of health: the VR-6D derived from the Veterans RAND 12-Item Health Survey. Qual Life Res. 2011;20(8):1337-1347.

40.

Sheean

Schmitz

Ward

et al . Assessment of disability related to femoroacetabular impingement syndrome by use of the Patient-Reported Outcome Measure Information System (PROMIS) and objective measures of physical performance. Am J Sports Med. 2017;45(11):2476-2482.

41.

Stone

Jacobs

Luo

et al . High degree of variability in reporting of clinical and patient-reported outcomes after hip arthroscopy. Am J Sports Med. 2018;46(12):3040-3046.

42.

Terwee

Bot

de Boer

et al . Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34-42.

43.

Thorborg

Tijssen

Habets

et al . Patient-reported outcome (PRO) questionnaires for young to middle-aged adults with hip and groin disability: a systematic review of the clinimetric evidence. Br J Sports Med. 2015;49(12):812.

44.

Tyser

Beckmann

Franklin

et al . Evaluation of the PROMIS physical function computer adaptive test in the upper extremity. J Hand Surg Am. 2014;39(10):2047-2051.e2044.