Performance of PROMIS Computer Adaptive Testing As Compared With Established Instruments for Multiple-Ligament Knee...

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Biostatistics

Background:

• The Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive testing (CAT) is a validated patient-reported outcome metric for various knee injuries, but not yet for multiligament knee injuries.
• The Multiligament Quality of Life (MLQOL) questionnaire is a disease-specific instrument for multiligament knee injuries and can serve as a gold standard for PROMIS validation.

Purpose of the Study:

• To validate the PROMIS CAT for patients with multiligament knee reconstruction.
• To hypothesize that PROMIS CAT modules would correlate with Lysholm knee score, Tegner activity scale, and MLQOL, and that PROMIS CAT would be more concise and avoid floor/ceiling effects.

Main Methods:

• A cohort study (Level of evidence, 2) of 30 patients with multiligament knee injuries.
• Patients completed PROMIS CAT for Physical Function, Mobility, and Pain Interference, along with Lysholm, Tegner, and MLQOL questionnaires.
• Spearman correlations assessed agreement, and floor/ceiling effects were evaluated.

Main Results:

• PROMIS Pain Interference showed excellent correlation with MLQOL Activity Limitations (r = 0.71, P < .0001).
• Strong correlations were found between PROMIS Physical Function/Mobility and MLQOL Activity Limitations (r ≈ -0.62, P < .0002).
• No floor or ceiling effects were observed for the PROMIS CAT.

Conclusions:

• PROMIS CAT demonstrates good correlation with established outcome measures for multiligament knee injuries.
• PROMIS CAT is a concise and valid adjunct to injury-specific tools for multiligament knee injuries.
• Clinicians should consider implementing PROMIS CAT due to its broad validity across knee injury types.