PROMIS CAT Outperforms Legacy Measures and Demonstrates Patient Health Domain Normalization at Minimum Two-Year...

Prospective, multicenter analysis.

Evaluate preoperative and minimum two-year postoperative health-related quality of life (HRQOL) outcomes for adult spine deformity (ASD) using legacy HRQOL measures and computer adaptive testing (CAT) version of the patient-reported outcome measurement information system (PROMIS).

PROMIS is the NIH recommended measure for patient-reported outcomes. No data exists evaluating minimum two-year ASD surgical outcomes using PROMIS CAT compared with legacy HRQOL measures.

ASD patients above 18 years of age were enrolled into a prospective, multicenter, observational study. Patients were administered legacy HRQOLs (SRS-22r, ODI, NRS back and leg pain, VR-12) and PROMIS CAT for Pain Interference, Physical Function, Satisfaction with Participation in Social Roles, Satisfaction with Participation in Discretionary Social Activities, Depression, and Anxiety. Preoperative and minimum two-year postoperative HRQOL scores were compared and ASD PROMIS scores were compared with general population PROMIS values.

One hundred forty-four of 190 patients had complete data at minimum two-year follow-up. Mean preoperative values included: age=62.6 years, scoliosis=34.2°, SVA=74.2 mm, PI-LL=16.7. At mean 2.3-year follow-up surgical treatment improved spine alignment (scoliosis=14.7°, SVA=34.5 mm, and PI-LL=4.5°; P <0.0001). All legacy HRQOL and PROMIS scores improved from preoperative to minimum two-year postoperative ( P <0.005). Referencing PROMIS scores to normative values demonstrated 50% to 85% of ASD patients preoperatively reported moderate-severe deficits in all domains. At minimum two-year postoperative 52% to 88% of ASD patients reported normal values-mild deficits in all PROMIS domains. PROMIS social health domains demonstrated the greatest improvement.

This is the first study evaluating minimum two-year ASD surgical outcomes using PROMIS CAT. ASD patients demonstrated postoperative improvements in all PROMIS health domains, with the social health domains improving most. The majority of ASD patients reported normal PROMIS values at minimum two years postoperative.