The PROMIS PF CAT is an effective tool for outcome assessment in patients with isolated cartilage defects and correlates strongly with currently accepted PRO measures of physical function.
The Patient-Reported Outcomes Measurement Information System (PROMIS) was designed to advance patient-reported outcome (PRO) measurement tools using question banks for major health domains. The purpose of this study was to validate the PROMIS physical function computer adaptive test (PF CAT) with current PRO instruments in patients with isolated cartilage injuries.
Patients scheduled for osteochondral allograft or autograft transplant (OATS), microfracture, and chondroplasty completed PROMIS PF CAT, Knee Injury and Osteoarthritis Outcome Score (KOOS activities of daily living [ADL], pain, symptoms, sport, and quality of life [QOL]), Short Form-36 Health Survey (SF-36 physical function [PF] and Physical Component Summary [PCS]), and EuroQol-5 Dimension (EQ-5D) questionnaires. The Spearman correlation coefficient was used to compare instruments. Instrument correlations were defined as excellent (>0.7), excellent-good (0.61-0.69), good (0.4 to 0.6), and poor (<0.39), with significance was set to p<0.05.
A total of 293 knees in 275 patients (54.5% male) were analyzed. OATS was performed in 44 patients, microfracture in 97 patients, and chondroplasty in 160. The mean age was 34.0 +/- 14.7 and the mean BMI was 30.0 +/- 6.9. The PROMIS PF CAT had an excellent correlation with the SF-36 PF (r=0.819, p<0.001), SF-36 PCS (r=0.766, p<0.001), KOOS ADL (r=0.733, p<0.001), KOOS Sport (r=0.709, p<0.001), and EQ-5D (r=0.752, p<0.001) instruments; an excellent-good correlation with the KOOS pain (r=0.662, p<0.001), and KOOS QOL (r=0.640, p<0.001) scores; and a good correlation with the KOOS symptoms (r=0.519, p<0.001) scale. The PROMIS PF CAT had no floor or ceiling effects. The average number of questions answered was lowest in the PROMIS PF CAT (4.17). Dimensionality analyses demonstrated that the smallest amount of unexplained variance was present in the PROMIS PF CAT (3.6%).
The PROMIS PF CAT is an effective tool for outcome assessment in patients with isolated cartilage defects. It correlates strongly with currently accepted PRO measures of physical function with no ceiling and floor effects and a minimal time burden for completion.