PROMIS Utilization in Pediatric Orthopaedics: A Scoping Review

Area of Science:

• Orthopaedic Surgery
• Health Outcomes Research
• Pediatric Medicine

Background:

• A standardized patient-reported outcome metric is lacking in orthopaedics.
• The Patient-Reported Outcomes Measurement Information System (PROMIS) was developed by the NIH for efficient health assessment.
• No prior study has summarized PROMIS use in pediatric orthopaedics.

Purpose of the Study:

• To conduct a scoping review of studies utilizing PROMIS in the pediatric orthopaedic population.
• To identify trends in PROMIS application and frequently used domains.
• To assess the presence of ceiling and floor effects in pediatric orthopaedic PROMIS studies.

Main Methods:

• A comprehensive literature search was conducted across major databases (Ovid Medline, Embase, Scopus, Cochrane) from 2010 to August 2021.
• 1961 unique citations were identified, with 51 studies ultimately included after full-text review.
• Studies were categorized by anatomical region or sub-specialty.

Main Results:

• The use of PROMIS in pediatric orthopaedics has significantly increased, with most studies published in 2020-2021.
• Hand and Upper Extremity (25.5%) and Sports (23.5%) were the most common sub-specialties studied.
• Pain Interference (76.5%), Mobility (60.8%), and Upper Extremity (54.9%) were the most frequently assessed PROMIS domains.

Conclusions:

• PROMIS utilization in pediatric orthopaedics has grown substantially, indicating increasing adoption by clinicians.
• Significant ceiling effects were noted for Upper Extremity and floor effects for Pain Interference.
• PROMIS measures are deemed efficient, reliable, and effective for assessing patient outcomes in pediatric orthopaedics.