P70. Completion rates for PROMIS-PF compared with legacy PROMs

Abstract

<h3>BACKGROUND CONTEXT</h3> Patient-Reported Outcomes Measurement Information System (PROMIS) utilizes computer adaptive testing (CAT) to accurately and efficiently assess patient improvement. Previous studies have highlighted the benefits of PROMIS over traditional "legacy" patient reported outcome measures (PROMs). However, literature comparing completion rates of PROMIS to those of legacy PROMs is scarce. <h3>PURPOSE</h3> To compare completion rates for PROMIS physical function (PF) with rates of legacy PROM completion following cervical spine procedures. <h3>STUDY DESIGN/SETTING</h3> Retrospective Cohort. <h3>PATIENT SAMPLE</h3> A total of 302 patients who underwent cervical spine procedures were included. <h3>OUTCOME MEASURES</h3> Perioperative characteristics including operative duration (from skin incision to closure), estimated blood loss (EBL), and postoperative length of stay were reported. Legacy PROMs such as Visual Analogue Scale (VAS) neck, VAS arm, neck disability index (NDI), and 12-Item Short-Form physical component summary (SF-12 PCS), as well as PROMIS-PF were included. <h3>METHODS</h3> A retrospective review was conducted of a prospectively maintained registry for cervical spine procedures from May 2015 to June 2020. Patients were excluded for procedures that were revisions or indicated for trauma, infection or malignancy. Patient demographics, preoperative medical conditions and spinal pathologies were collected. Perioperative characteristics including operative duration (from skin incision to closure), estimated blood loss (EBL), and postoperative length of stay were reported. Legacy PROMs such as Visual Analogue Scale (VAS) neck, VAS arm, neck disability index (NDI), and 12-Item Short-Form physical component summary (SF-12 PCS), as well as PROMIS-PF were administered at preoperative and postoperative (6-week, 12-week, 6-month, 1-year, and 2-year) timepoints. Descriptive statistics were performed for all preoperative and perioperative characteristics. McNemar's test was used to compare completion rates for each legacy PROM and PROMIS-PF at each timepoint. The overall percentage of surveys patients completed from the preoperative timepoint to 2-years for PROMIS-PF was compared with that of each legacy PROM using a paired t-test. <h3>RESULTS</h3> A total of 302 patients who underwent cervical spine procedures were included. The study cohort had a mean age of 50.0 years, was majority male (63.3%), non-obese (BMI <30 kg/m2; 57.6%), of White ethnicity (75.4%), and private insurance coverage (73.2%). The most common preoperative spinal pathology was central stenosis (63.6%). Mean perioperative variables were as follows: operative time 67.4 minutes, EBL 46.9 mL, length of stay 15.3 hours. Rates of survey completion were significantly lower for PROMIS-PF than for each legacy PROM from the preoperative timepoint through 6-months (all p<0.001). Survey completion rates did not significantly differ at 1-year. Rates of survey completion were greater for PROMIS-PF than for legacy PROMs at 2-years (p<0.001). The overall percentage of surveys completed was significantly lower for PROMIS-PF than for all legacy PROMs (p<0.001). <h3>CONCLUSIONS</h3> A greater proportion of cervical spine patients completed legacy PROMs at preoperative and earlier postoperative measurements. However, this difference was resolved by 1-year postoperatively and reversed by 2-years. Overall, patients completed a smaller percentage of assigned PROMIS-PF surveys than legacy PROMs. Although overall completion rates were lower for PROMIS-PF, patients may be more likely to complete PROMIS than legacy PROMs at long-term follow-up. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.