P117. The use of patient-reported outcomes measurement information system (PROMIS) in spine surgery: a systematic review

Abstract

BACKGROUND CONTEXT PROMIS was developed to provide a time-saving, easy to administer patient outcome questionnaire that was adaptable to a variety of medical and surgical subspecialties. Numerous authors have examined the effectiveness of PROMIS in various areas of spine surgery. PURPOSE To assess the correlation of PROMIS with legacy patient-reported outcome measures in spine surgery STUDY DESIGN/SETTING Systematic review. OUTCOME MEASURES Correlation coefficient (r) of PROMIS PF, Pin, PIf, PB with legacy outcomes. METHODS A systematic search of the Pubmed, EMBASE, and Cochrane databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines was performed yielding 254 unique studies reporting on “PROMIS” in “spine.” Each study was independently reviewed. Fifty-four studies were selected for review, and 16 studies were selected for inclusion. RESULTS The pooled sample size yielded a total of 4,344 patients. In the cervical population, PROMIS physical function (PF), pain intensity (PIn), pain interference (PIf) and pain behavior (PB) all strongly correlated with the NDI (average |r|=0.64-0.76). PROMIS PF also strongly correlated with the mJOA (average |r|=0.66). Among patients with lumbar pathology and adult spinal deformities, the PF, PIn, PIf, PB, and social roles satisfaction (SR) all strongly correlated with the ODI (|r|=0.66-0.76). PF, PI, and anxiety (AX) also strongly correlated with the SRS-22/SRS-30. When comparing PROMIS to legacy measures of global health, PROMIS PF was strongly correlated with the SF-12 (|r|=0.67), while PROMIS AX and depression (D) correlated with the GAD and PHQ-8 measures. On average, all individual PROMIS domains required less time to complete (49.6-56 seconds) compared to ODI (176 seconds), NDI (190.3 seconds), SF-12 (214 seconds), and SF-36 PF (99 seconds). Responsiveness of PROMIS PF (ES=0.85, SRM=0.88), PIf (ES=1.14, SRM=0.92), and PB (ES=0.895) was comparable to ODI (ES=1.02, SRM=1.06), NDI (ES=0.75, SRM=0.96) and SF-12 (ES=0.675) CONCLUSIONS PROMIS PF, PIn, PIf and PB demonstrated strong correlations with NDI, mJOA, ODI, SRS, and SF-12 measures in various spine patient populations. Decreased time to completion and comparable responsiveness of PROMIS suggests that it may be used to assess patient-reported outcomes in spinal surgery patients. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.