Patient Reported Outcome Measurements in Adult Spinal Deformity: A Narrative Review

Study DesignNarrative review.ObjectivesTo review the current state-of-the-art in patient reported outcome measurements (PROMs) in adult spinal deformity (ASD) surgery.MethodsPubMed was queried for publications related to PROM usage in ASD. PROM properties including responsiveness to change and thresholds for clinically relevant change were reviewed.ResultsDespite many reports using PROMs in ASD, there are little data to support superiority of any particular PROM. The Scoliosis Research Society-22r is a disease-specific measure that is responsive to change across pain, function, and self-image domains. The Patient Reported Outcome Measurement Information System (PROMIS) is a domain-specific measure available in computer adaptive tests, which may reduce question burden and ease administration for both patients and providers. Minimum clinically important differences, minimum detectable changes, and patient-acceptable symptom states have been proposed.ConclusionsPROMs are an essential component of modern, value-based ASD care, irrespective of academic pursuits. The SRS-22r is a validated disease specific measure, though this may be supplanted by computer-adaptive tests such as PROMIS to reduce the question burden. There is no PROMIS question set for self-image, which must be developed to cover all pertinent ASD domains.