Predicting Patient-Centered Outcomes from Spine Surgery Using Risk Assessment Tools: a Systematic Review

Area of Science:

• Spine surgery outcomes research
• Clinical prediction modeling
• Patient-centered care

Background:

• Risk assessment tools are crucial for evaluating surgical candidates and their potential outcomes.
• Predicting patient-centered outcomes like pain, disability, and quality of life post-spine surgery remains a challenge.
• Existing tools often incorporate demographic, medical history, and patient-reported measures.

Purpose of the Study:

• To systematically review and evaluate risk assessment tools for predicting patient-centered outcomes in cervical, thoracic, and lumbar spine surgery.
• To identify tools that utilize patient-reported outcome measures (PROMs) for predicting outcomes.
• To assess the current literature on the clinical utility of these predictive tools.

Main Methods:

• A systematic review was conducted following PRISMA guidelines.
• Searched for studies identifying risk assessment tools using PROMs for spine surgery outcomes.
• Included 13 articles from an initial pool of 8128 studies.

Main Results:

• Risk assessment tools demonstrated fair to excellent model performance (c-index: 0.63-0.84).
• Models predicted various patient-centered outcomes: return to work (3 models), pain (9 models), physical functioning/disability (5 models), quality of life (6 models), and psychosocial disposition (2 models).
• The review synthesized evidence on the predictive capabilities and clinical utility of these tools.

Conclusions:

• Risk assessment tools show promise in predicting key patient outcomes after spine surgery.
• Further research is necessary to refine and validate these tools for broader clinical application.
• Understanding the benefit-risk ratio through these tools can aid surgical decision-making.