Duke Activity Status Index Versus PROMIS Computer Adaptive Testing-Physical Function for Preoperative Assessment.

Area of Science:

• Medical Assessment
• Surgical Risk Stratification
• Patient-Reported Outcomes

Background:

• Preoperative assessment of physical function is crucial for surgical risk stratification.
• Existing tools like the Duke Activity Status Index (DASI) have limitations.
• The Patient-Reported Outcomes Measurement Information System Computer Adaptive Testing-Physical Function (PROMIS CAT-PF) is a newer assessment tool.

Purpose of the Study:

• To compare the performance of PROMIS CAT-PF against DASI.
• To evaluate their utility in predicting adverse postoperative outcomes.
• To determine if PROMIS CAT-PF can serve as an alternative for preoperative physical function assessment.

Main Methods:

• Retrospective analysis of adult patients undergoing elective surgery.
• Collected DASI and PROMIS CAT-PF scores within 90 days preoperatively.
• Assessed correlation with metabolic equivalents from stress tests.
• Evaluated prediction of a composite outcome (death or myocardial injury within 30 days).

Main Results:

• DASI (Spearman's 0.46) showed a numerically better correlation with metabolic equivalents than PROMIS CAT-PF (Spearman's 0.39), but not statistically significant.
• Both DASI (AUC 0.712) and PROMIS CAT-PF (AUC 0.773) demonstrated fair predictive utility for adverse outcomes.
• The correlation between DASI and PROMIS CAT-PF scores was weak (κ=0.509).

Conclusions:

• PROMIS CAT-PF performs comparably to DASI in assessing physical function.
• PROMIS CAT-PF shows a slight incremental benefit in predicting adverse postoperative outcomes.
• PROMIS CAT-PF is a viable alternative for preoperative physical function assessment.