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Clinical relevance of current patient-reported outcome measures for ankle fracture: surgeons' perspective
Kyle Schweser1, Emily Leary1,2, Ashley E Levack3
1Missouri Orthopaedic Institute and Department of Orthopaedic Surgery, School of Medicine, University of Missouri, Columbia, MO.
Objectives:
Determine the relevance of the most frequently used patient-reported outcome measures (PROMs) for monitoring patient recovery after ankle fracture, from the clinical perspective of orthopaedic trauma surgeons, given lack of validated PROMs.
Design:
Prospective cohort.
Setting:
Orthopaedic Trauma Association committee meetings, electronic correspondence.
Patients/Participants:
Orthopaedic trauma surgeons.
Intervention:
Delphi method for consensus activities.
Level Of Evidence:
IV.
Main Outcome Measurements:
Most clinically relevant PROMs for ankle fracture recovery.
Results:
Several English-language PROMs were identified based on use in literature and relevance to ankle fractures. 7 were selected by expert consensus. These are the Ankle Fracture Outcome of Rehabilitation Measure (A-FORM), Foot and Ankle Ability Measure (FAAM), American Academy of Orthopaedic Surgeons (AAOS), Foot and Ankle Disability Index (FADI) Score, Lower Extremity Functional Scale (LEFS), Olerud-Molander Ankle Score (OMAS), and Patient-Reported Outcome Measurement Information System Physical Function (PROMIS PF). The most clinically relevant PROM is the A-FORM, followed by the AAOS, LEFS, PROMIS PF, FADI, and OMAS, and the least clinically relevant overall, the FAAM.
Conclusions:
Understanding which PROM best matches physician expectations for tracking recovery is an important step toward a robust, evidence-based approach to patient care. The A-FORM was identified as the most clinically relevant among the most used PROMs. These results will aid surgeons, clinicians, and scientists to identify a uniformly, clinically relevant PROM for the treatment and study of outcomes and recovery after isolated ankle fracture.
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