Summary

In pre-operative patients with FAIS, the PROMIS physical function has good to excellent correlation with disease specific legacy patient reported outcomes

Abstract

Introduction

The Patient-Reported Outcome Measurement Information System (PROMIS) is a novel patient-centered measurement tool that seeks to standardize health outcome assessment across interventions. PROMIS is being increasingly investigated within orthopaedic surgery however the performance of PROMIS for patients with femoroacetabular impingement syndrome (FAIS) is unknown. The purpose of this study was to evaluate the performance of PROMIS in patients presenting pre-operatively with FAIS.

Methods

The PROMIS Physical Function 20a was administered pre-operatively to patients with FAIS (December 2017 to April 2018). In addition to PROMIS measures, the modified Harris Hip Score (mHHS), the Hip Outcome Score both activities of daily living (HOS-ADL) and sports sub scale (HOS Sports), the international hip outcome tool – 12 (iHOT-12), the 12-Item short form survey (SF-12) and veterans rand 12-item health survey (VR-12) were administered. Correlation was defined as excellent (>0.8), very good (0.71-0.8), good (0.61-0.7), fair (0.41-0.6) and poor (0.21-0.4).

Results

Patient data was collected in 83 FAI patients with mean age and BMI of 32.3 years and 24.7 kg/m2 respectively. The majority of patients were female (N=60, 72.3%). Mean scores for legacy outcome measures were as follows: HOS ADL – 62.2, HOS Sports – 38.3, mHHS – 57.3, iHOT-12 – 31.5, SF-12 mental component scale (MCS) – 50.1, SF-12 physical component scale (PCS) – 35.0, VR-12 MCS – 52.2, VR-12 PCS – 37.2. Mean PROMIS T-score was 40.9 + 1.6 (S.E.). PROMIS demonstrated excellent correlation with the HOS ADL (r=0.88, p<0.001). There was very good correlation with HOS Sport (r=0.79, p<0.01), mHHS (r=0.79, p<0.01), iHOT-12 (r=0.75, p<0.01), SF-12 PCS (r=0.72, p<0.01) and VR-12 PCS (r=0.77, p<0.01). Correlation between PROMIS and SF-12 MCS (r=0.35 p=0.005), and VR-12 MCS (r=0.44, p<0.01) was poor. Patients younger than 40 years had higher PROMIS scores compared to patients above 40 (41.8 vs 38.7; p=0.036).

Conclusions

In pre-operative patients with FAIS, the PROMIS PF-20a has good to excellent correlation with disease specific legacy patient reported outcomes. There is poor correlation between PROMIS and general health mental component scales however. Clinical and Demographic factors such as age may influence PROMIS scores. Continued work is needed to assess how PROMIS tracks over time and with surgical intervention.