SRS-22r legacy scores can be accurately translated to PROMIS scores in adult spinal deformity patients

Abstract

BACKGROUND CONTEXTPatient-Reported Outcomes Measurement Information System (PROMIS) facilitates comparisons of treatment effectiveness across populations and diseases. In adult spinal deformity (ASD), the disease-specific Scoliosis Research Society-22r (SRS-22r) tool assesses outcomes. Existing data must be translated to PROMIS to make comparisons. PURPOSETo develop and validate a method to translate SRS-22r scores to PROMIS scores in surgical ASD patients. STUDY DESIGNRetrospective cohort study. PATIENT SAMPLEA total of 158 ASD surgery patients from an ongoing registry of patients who underwent spine surgery at a tertiary care center from 2015 to 2017 were included. OUTCOME MEASURESPROMIS and SRS-22r questionnaires were completed at 387 visits (150 preoperative [derivation sample]; 237 postoperative [validation sample]). METHODSUsing the derivation sample, we modeled PROMIS domains as functions of age and SRS-22r domains using linear regression. The most parsimonious model was selected. In the validation cohort, we used the derived regression equations to estimate PROMIS scores from SRS-22r scores. RESULTSThe following significant associations were found (p<.001): PROMIS Pain Interference is dependent on age and SRS-22r Pain, Physical Function, and Patient Satisfaction; PROMIS Physical Function is dependent on age and SRS-22r Pain and Physical Function; PROMIS Anxiety is dependent on SRS-22r Mental Health; PROMIS Depression is dependent on age and SRS-22r Mental Health; and PROMIS Satisfaction with Social Roles is dependent on age and SRS-22r Pain, Physical Function (p=.011), Mental Health, and Patient Satisfaction. Correlations were strong to very strong between estimated and actual PROMIS scores in the validation cohort (p<.001): Pain Interference, r=0.78; Physical Function, r=0.66; Anxiety, r=0.83; Depression, r=0.80; and Satisfaction with Social Roles, r=0.71. CONCLUSIONSPROMIS scores estimated from SRS-22r scores using our model correlate strongly with actual PROMIS scores. SRS-22r scores may be translated to PROMIS scores in all evaluated domains for ASD patients. Orthopedic surgeons can use this method to compare legacy measures with PROMIS scores.