A Pilot Study of Patient-Reported Outcome Measures Across a Broad Sample of Surgical Patients

Patient-reported outcomes (PROs) have the potential to aid in surgical decision-making, predict surgical outcomes, assess recovery, and evaluate long-term success. We performed a pilot study testing the ability to use PROs in a broad surgical population in preparation for wide spread use.

Surgical patients completed five Patient-Reported Outcome Measurement Information System (PROMIS) measures during their preoperative encounter in the preanesthesia clinic and again postoperatively via emailed link. Preoperative to postoperative changes in PROMIS scores, factors related to completion of postoperative measures, intercorrelations between PROMIS measures, and numbers of patients with normal function, and mild, moderate, and severe deficits in PROMIS scores were analyzed.

A total of 393 patients undergoing surgery in 8 specialties completed preoperative PROMIS measures; 239 (60.8%) completed them postoperatively. Physical function (P < 0.0001), pain (P < 0.0001), and cognitive function (P = 0.03) PROMIS scores significantly worsened after surgery but not mental PROMIS scores (P = 0.48). Hispanic and sicker patients had lower completion rates of postoperative measures. Intercorrelations were very high (>0.80) among the physical function and self-efficacy for activities of daily living PROMIS measures. Physical function and pain PROMIS measures had the largest number of patients in the "severe" range after surgery.

Patients across a broad surgical population completed PROMIS measures successfully, both preoperatively and postoperatively, although the postoperative completion rate was lower than other studies reported in the literature. PROMIS scores were reflective of the effects of surgery. Some of the PROMIS measures were highly correlated suggesting that some measures could be eliminated or replaced with measures assessing other important effects of surgery. Consideration could be made to alert health care providers about patients having PROs in the "severe" range for potential intervention.