Impact of Time to Complete PROMIS-PF Surveys on the Scores of Patients Undergoing Lumbar Decompression.

Abstract

Patient-reported outcome measures (PROMs) are increasingly used for spinal surgery and may place additional burden in terms of time needed to complete. Few studies address the impact of time to complete (TTC) on PROMs. To determine whether length of TTC Patient-Reported Outcomes Measurement Information System physical function (PROMIS-PF) surveys impact scores in patients undergoing minimally invasive surgery (MIS) for lumbar decompression (LD). We conducted a retrospective review of LD patients from 2015 to 2020. Inclusion criterion was primary, single-level MIS LD. Patients undergoing multilevel procedures and patients without preoperative PROMIS-PF survey data were excluded. PROMIS-PF, and visual analog scale (VAS) for back and leg pain were all evaluated at preoperative, 6 weeks, 12 weeks, 6 months, and 1 year time points. A minimum clinically important difference was evaluated for PROMIS-PF and VAS back and leg. TTC was calculated as the difference in start and stop time for completed questionnaires. Improvement in outcome scores was determined using a t test. Differences in mean TTC among time points were assessed using 1-way analysis of variance. Correlation between PROMIS-PF and TTC or VAS back and leg was determined using Pearson correlation and categorized as: 0.1 ≤ |r| < 0.3 = weak; 0.3 ≤ |r| < 0.5 = moderate; |r|≥0.5 = strong. The study cohort included 91 patients. Mean age was 47 years, and 64.7% of patients were male. PROMIS-PF, VAS back, and VAS leg significantly improved at all postoperative time points. TTC did not significantly differ at any time point. PROMIS-PF and TTC were not significantly correlated at any time point (all P < 0.05), but PROMIS-PF was correlated with VAS back and leg (P < 0.015). PROMIS-PF significantly improved through 1 year. TTC did not significantly differ at any time point and was not correlated with PROMIS-PF scores. This suggests PROMIS-PF consistently places relatively low burden on patients and remains a valid measure to evaluate outcomes after LD. The utility of PROM surveys is increasingly appreciated in the context of spinal surgery; expansion of their use places additional burden on patients to complete surveys accurately and in a timely fashion. Length of TTC PROMIS-PF surveys does not impact scores in patients undergoing LD. 4.