Wednesday, September 26, 2018 7:35 AM–9:00 AM ePosters: P87. Determination of clinically meaningful PROMIS severity ranges for adult spinal deformity

Abstract

BACKGROUND CONTEXT PROMIS provides severity ranges for scores in many domains. These ranges are determined based on the general population, using a normalized mean score of 50 and standard deviation of 10. However, patients who present for Adult Spinal Deformity (ASD) surgery have worse scores on average compared to the general population, making PROMIS severity ranges clinically meaningless in the care of ASD patients. PURPOSE To determine PROMIS severity ranges specific to ASD patients. STUDY DESIGN/SETTING Retrospective review. PATIENT SAMPLE A total of 146 lumbar and cervical adult spinal deformity patients with PROMIS Computerized Adaptive Tests (CATs). OUTCOME MEASURES PROMIS Pain Interference, Physical Function, Fatigue, Anxiety, Depression, Sleep Disturbance, and Satisfaction with Participation in Social Roles CATs METHODS Preoperative PROMIS scores in Pain Interference, Physical Function, Fatigue, Anxiety, Depression, Sleep Disturbance, and Satisfaction with Participation in Social Roles were obtained for 146 ASD surgical patients. To create a severity classification of PROMIS scores specific to ASD patients, the average and standard deviation (SD) for each PROMIS domain were calculated for the ASD cohort. Scores 1.0-2.0 SD worse than the mean were considered “moderately worse” than the average for ASD patients, scores 2.0 or more SD worse than the mean were “severely worse,” and scores 1.0 or more SD better than the mean were “moderately better.” RESULTS 146 ASD patients were included (avg. age 59.8 years; 32.2% male; 81.8% White, 13.3% African American, 4.9% other). Average PROMIS score and severity ranges were determined as follows: Pain Interference average: 65.3, moderately better: 80.5; Physical Function average: 32.8, moderately better: >40.4, moderately worse: 17.6-25.2, severely worse: 77.3; Anxiety average: 55.6, moderately better: 76.0; Depression average: 52.4, moderately better: 74.6; Sleep Disturbance average: 55.8, moderately better: 75.6; Satisfaction with Participation in Social Roles average: 38.0, moderately better: >46.8; moderately worse: 20.3-29.1; severely worse: CONCLUSIONS While PROMIS provides severity ranges useful for the general population, on average, patients who present for adult spinal deformity surgery have scores worse than the general population. This analysis provides clinically meaningful PROMIS severity ranges in seven domains for these patients. These ranges will allow surgeons to better assess severity in their patients and will aid in point-of-care decision-making.