Using the "Patient Generated Index" in Spine Surgery in an Appalachian Population

In most health care fields, outcomes are becoming increasingly scrutinized and may play a role in "pay for performance;" therefore, selecting the most appropriate outcomes measures for the populations being studied or treated has evolved into a key aspect of outcomes monitoring. One way to assess patient goals is to administer a "patient generated index" (PGI). The philosophical underpinning of the PGI is that the person living the life is the best judge of the quality of that life. The PGI has been utilized in low back pain, as well as in adult spinal deformity surgery, however, it has not been previously utilized in an Appalachian population. The PGI was administered by means of self-report to 80 new patients with back pain who presented for assessment in the neurosurgery clinic. Participants completed an acceptability survey and written comments as well as compliance were analyzed. Findings indicate that the PGI in its earliest form did not meet acceptable levels for use in this Appalachian subspecialist clinic setting. This study contributes to the growing body of knowledge on patient reported outcomes and more specifically, the importance of utilizing patient generated responses to map improvements in quality of life for patients over time.