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

Area of Science:

• Orthopedics
• Spine Surgery
• Health Outcomes Research

Background:

• Adult spine deformity (ASD) significantly impacts patient quality of life.
• Patient-Reported Outcomes Measurement Information System (PROMIS) is the NIH-recommended standard for patient-reported outcomes.
• Limited data exists on long-term (≥2 years) surgical outcomes for ASD using PROMIS compared to traditional measures.

Purpose of the Study:

• To evaluate health-related quality of life (HRQOL) in adult spine deformity (ASD) patients.
• Compare preoperative and minimum 2-year postoperative outcomes using legacy HRQOL instruments and the PROMIS computer adaptive testing (CAT) system.
• Assess changes in specific PROMIS domains including Pain Interference, Physical Function, and Social Health.

Main Methods:

• Prospective, multi-center observational study of adult patients with spine deformity.
• Patients completed legacy HRQOL questionnaires (SRS-22r, ODI, NRS, VR-12) and PROMIS CAT assessments preoperatively and at minimum 2-year follow-up.
• Statistical analysis compared preoperative and postoperative scores, and PROMIS scores to general population norms.

Main Results:

• Surgical treatment for ASD improved spinal alignment and all measured HRQOL and PROMIS scores (P<0.005).
• Preoperatively, 50-85% of ASD patients reported moderate-to-severe deficits across all PROMIS domains.
• Postoperatively, 52-88% of patients reported normal or mild deficits, with the greatest improvements observed in PROMIS social health domains.

Conclusions:

• This study provides the first minimum 2-year postoperative outcomes for ASD using PROMIS CAT.
• ASD surgery leads to significant improvements in PROMIS-assessed physical and mental health domains.
• The majority of ASD patients achieve normal or near-normal PROMIS scores by 2 years postoperative, particularly in social functioning.