Friday, September 28, 2018 10:45 AM–12:00 PM abstracts: how should we measure our success: 189. ODI cannot account for all of the variability in PROMIS scores in thoracolumbar patients

Abstract

BACKGROUND CONTEXT Computer adaptive testing is becoming increasingly common in assessing patient outcomes. The Patient Reported Outcome Measurement Information System (PROMIS) instruments of Physical Function, Pain Intensity and Pain Interference have been shown to correlate with established patient outcome metrics, though this relationship has yet to be investigated for patients with thoracolumbar spinal pathologies. PURPOSE The aim of this study was to study the relationship between PROMIS and ODI scores in thoracolumbar patients. STUDY DESIGN/SETTING Retrospective review of single institution clinical data and patient-reported outcome measures. PATIENT SAMPLE A total of 208 spine patients with a thoracolumbar (TL) diagnosis. OUTCOME MEASURES Legacy metrics: Oswestry Disability Index (ODI), Patient Reported Outcome Measurement Information System (PROMIS). METHODS Inclusion was patients greater than 18 years of age with a diagnosis related to the thoracolumbar spine (most common diagnoses included spinal stenosis, disc herniation, low back pain, disc degeneration, spondylolysis). Bivariate correlations assessed the linear relationships between ODI and PROMIS scores (Physical Function, Pain Intensity, and Pain Interference). Correlation cutoffs were used to assess patients with high and low correlation between ODI and PROMIS domains. Linear regression predicted the relationship of ODI to PROMIS outcomes. Statistical significance was set at P RESULTS A total of 208 patients with a thoracolumbar diagnosis were included (age 58.39 ± 73.32 years, 49% female). ODI correlated with PROMIS Physical Function (r=−0.737, P CONCLUSIONS There is a large amount of variability in PROMIS scores that ODI cannot account for. Certain ODI questions, such as walking, social life, and lifting ability correlate strongly with PROMIS while ODI questions such as sitting, standing and sleeping do not correlate well with PROMIS. Further work is required to assess these discrepancies and tease out the factors contributing to these differences.