Evaluation of the PROMIS Physical Function Computer Adaptive Test in Patients Undergoing Knee Surgery

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Health Outcomes Research

Background:

• Assessing functional status after knee surgery is crucial for patient care.
• The Patient-Reported Outcomes Measurement Information System physical function (PROMIS PF) computer adaptive test is a newer measure for evaluating physical function.
• The International Knee Documentation Committee (IKDC) Subjective Knee Form is a widely used patient-reported outcome measure for knee function.

Purpose of the Study:

• To compare the performance of the PROMIS PF computer adaptive test against the IKDC Subjective Knee Form in assessing functional status in knee surgery patients.
• To identify demographic, clinical, and psychosocial factors associated with PROMIS PF and IKDC scores in an urban surgical population.

Main Methods:

• A cross-sectional analysis was conducted on data from 412 patients undergoing various knee surgeries at a single institution.
• Bivariate and multivariable statistical analyses were employed to determine significant independent predictors of outcome scores.
• The correlation between PROMIS PF and IKDC scores was assessed, along with the presence of floor and ceiling effects.

Main Results:

• PROMIS PF and IKDC scores demonstrated a strong correlation (r_s = 0.71, p < 0.001), with no significant floor or ceiling effects observed for either measure.
• Lower body mass index, absence of preoperative opioid use, lower Charlson comorbidity index, employment, and lower income were independently associated with better PROMIS PF and IKDC scores.
• Patients undergoing total knee arthroplasty reported significantly lower scores on both PROMIS PF and IKDC compared to other knee surgery types.

Conclusions:

• The PROMIS PF computer adaptive test is a valid and reliable tool for assessing physical function in knee surgery patients, performing comparably to the established IKDC Subjective Knee Form.
• Demographic, clinical, and psychosocial factors significantly influence patient-reported functional outcomes after knee surgery.
• These findings support the use of PROMIS PF in clinical practice and research for knee surgery patients, highlighting the importance of considering patient-specific factors in outcome assessment and management.