scholarly journals The PROMIS Global Health Questionnaire Correlates With the QuickDASH in Patients With Upper Extremity Illness

Hand ◽  
2017 ◽  
Vol 13 (1) ◽  
pp. 118-121 ◽  
Author(s):  
Nicky Stoop ◽  
Mariano E. Menendez ◽  
Jos J. Mellema ◽  
David Ring
Keyword(s):  
Mental Health ◽  
Global Health ◽  
Upper Extremity ◽  
Patient Reported Outcomes ◽  
Global Mental Health ◽  
Pearson Correlation ◽  
Measurement Information ◽  
Consistent Finding ◽  
Patient Reported ◽  
Mental Health Subscale

Background: The objective of this study is to evaluate the construct validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health instrument by establishing its correlation to the Quick-Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire in patients with upper extremity illness. Methods: A cohort of 112 patients completed a sociodemographic survey and the PROMIS Global Health and QuickDASH questionnaires. Pearson correlation coefficients were used to evaluate the association of the QuickDASH with the PROMIS Global Health items and subscales. Results: Six of the 10 PROMIS Global Health items were associated with the QuickDASH. The PROMIS Global Physical Health subscale showed moderate correlation with QuickDASH and the Mental Health subscale. There was no significant relationship between the PROMIS Global Mental Health subscale and QuickDASH. Conclusions: The consistent finding that general patient-reported outcomes correlate moderately with regional patient-reported outcomes suggests that a small number of relatively nonspecific patient-reported outcome measures might be used to assess a variety of illnesses. In our opinion, the blending of physical and mental health questions in the PROMIS Global Health makes this instrument less useful for research or patient care.

Characteristics of Clients Seeking Yoga Therapy in a University-Based Student Clinic

2020 ◽  
Author(s):  
Steffany Moonaz ◽  
Marlysa Sullivan ◽  
Daryl Nault ◽  
Irene Bright-Dumm ◽  
Ryan Bradley
Keyword(s):  
Mental Health ◽  
Patient Reported Outcomes ◽  
The United States ◽  
Study Data ◽  
Measurement Information ◽  
Physical And Mental Health ◽  
Yoga Therapy ◽  
Highly Educated ◽  
Clinical Encounters ◽  
Patient Reported

Abstract Yoga therapy is an emerging profession with recent development of educational competencies, training program accreditation, and practitioner certification. In the United States, most yoga therapy training programs are studio-based and data on mentored clinical encounters are lacking. This study aimed to characterize the client population in a university-based mentored student clinic. As part of a larger feasibility study, data were collected at all clinic visits for 70 consenting clients. Data collected included demographic characteristics, reasons for pursuing care, use of other healthcare approaches, and the Patient-Reported Outcomes Measurement Information System (PROMIS) for physical and mental health. Participants were mostly middle-aged, White, and highly educated. Common reasons for pursuing care were pain and mental health. Most used multiple healthcare approaches. Average scores for most patient-reported outcomes fell within normal range at baseline. Future studies are needed to better characterize yoga therapy users and to expand access for populations in whom the modality is underutilized despite emerging evidence of relevance.

scholarly journals The Influence of Preoperative Deformity Severity in Postoperative Patient Reported Outcomes in Adult Acquired Flatfoot

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0002
Author(s):  
Bopha Chrea ◽  
Cesar de Cesar Netto ◽  
Jonathan H. Garfinkel ◽  
Jonathan Day ◽  
Guilherme H. Saito ◽  
...  
Keyword(s):  
Mental Health ◽  
Pain Intensity ◽  
Subtalar Joint ◽  
Patient Reported Outcomes ◽  
Global Mental Health ◽  
Multivariate Regression Analysis ◽  
Pain Interference ◽  
T Score ◽  
Metatarsal Angle ◽  
Patient Reported

Category: Ankle; Hindfoot; Other Introduction/Purpose: Adult acquired flatfoot deformity (AAFD) is a complex deformity. Previous work has demonstrated correlation between postoperative foot alignment and patient-reported outcomes. While this work has provided essential targets for surgeons performing flatfoot reconstruction, there is an absence of data that would enable surgeons to predict which patients are likely to have greater or less improvement after surgery based on their preoperative deformity. Conventional radiographs alone may not provide enough detail to isolate individual elements of the deformity. Weightbearing CT (WBCT) allows for far more precise analysis in this regard. We hypothesized that there would be a set of parameters defining preoperative alignment on WBCT that would predict which patients are at risk for a lower magnitude of postoperative improvement in patient-reported outcomes (PROs). Methods: In this retrospective IRB-approved study, patients that underwent surgical flatfoot reconstruction after having a preoperative standing WBCT were identified. Preoperative WBCT images were evaluated by two independent/blinded observers. Multiple parameters related to preoperative alignment and AAFD severity were measured in the sagittal, coronal and transverse planes. Parameters measured included talus-first metatarsal angle; distances between the floor and the navicular, medial cuneiform and cuboid; subtalar joint horizontal angle; superior talar - inferior talar angle; subtalar joint subluxation; talonavicular uncoverage angle; hindfoot moment arm (HMA); and foot and ankle offset (FAO). Prospectively collected data regarding preoperative and postoperative PROs was evaluated. Six PROs components were assessed: physical function; pain interference, pain intensity, global mental health, global physical health and depression. Multivariate regression analysis and a partition prediction model were used to assess the correlation between preoperative alignment and improvement in PROs. P-values of less than 0.05 were considered significant. Results: A total of 51 patients with a preoperative WBCT and postoperative PROs scores were identified and included. Demographic data is shown in Table 1. Multivariate regression analysis demonstrated that preoperative alignment significantly correlated with improvement in three out six components of PROs: pain interference, pain intensity and global mental health. The strongest predictor of improvement in PROMIS physical function t-score was medial cuneiform to floor distance, for pain interference t-score: cuboid to floor distance, for pain intensity: subtalar joint subluxation, for depression t-score: superior talar - inferior talar angle, and for global physical and mental health t-scores: sagittal talus-first metatarsal angle. Conclusion: Our analysis yielded readily identifiable cutoffs for WBCT measurements, where values above or below were correlated with significant differences in the magnitude of PRO score change. Interestingly, measures of sagittal plane collapse and hindfoot valgus were the most predictive of score changes. This data provides useful information for surgeons counseling patients prior to flatfoot reconstruction. Future work using this data to develop prediction models for postoperative outcomes would be valuable, as would studies using WBCT to evaluate the relationship between postoperative corrected alignment and PROs. Complete results are shown in the attached Table.

scholarly journals How should we define clinically significant improvement on Patient-Reported Outcomes Measurement Information System (PROMIS) for patients undergoing Knee Meniscal Surgery?

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0045
Author(s):  
Yining Lu ◽  
Benedict Nwachukwu ◽  
Alexander Beletsky ◽  
Bhavik Patel ◽  
Adam Yanke ◽  
...  
Keyword(s):  
Mental Health ◽  
Information System ◽  
Physical Health ◽  
Patient Reported Outcomes ◽  
Measurement Information ◽  
Outcomes Measurement ◽  
Patient Reported ◽  
Meniscal Surgery ◽  
Measurement Information System ◽  
Clinically Significant

Objectives: The Patient-Reported Outcomes Measurement Information System (PROMIS) attempts to optimize patient reported outcome (PRO) instruments by utilizing item response theory (IRT) and computer adaptive testing (CAT). Relatively little is known about clinically significant outcome (CSO) improvements on the PROMIS Physical Function (PF) CAT. The objective of this study is to define the minimal clinically important difference (MCID), substantial clinical benefit (SCB) and patient-acceptable symptom state (PASS) of the PROMIS PF CAT in arthroscopic meniscal surgery. Methods: The PROMIS PF CAT, Short Form-12 Health Survey (SF-12 physical health [PCS] and mental health [MCS]), Veterans Rand-12 Health Survey (VR-12 physical health [PH] and mental health [MH]), and the Marx Activities Ratings Scale were administered pre- and post- operatively to patients undergoing arthroscopic meniscal surgery. Six months postoperatively, patients graded their knee function based on a domain-specific anchor question. Answers to the anchor questions were dichotomized to indicate achievement of SCB and MCID. A satisfaction anchor question was used to indicate achievement of PASS. Receiver operating characteristic (ROC) analysis determined the relevant psychometric values. Cutoff analysis was performed to find preoperative PRO scores predicting CSO achievement. Results: Sixty patients (N = 27, 45% female) were included, with mean age of 45.0 ± 14.0 years and average follow up of 24.0 + 1.2 weeks. The most common indication for knee arthroscopy was partial meniscectomy (N = 53; 88.3%) followed by meniscal repair (N = 7; 11.7%). MCID on PROMIS PF was calculated to be 2.08 (AUC: 0.75, 95% CI: 0.57 - 0.94). Net score improvement equivalent to achievement of SCB was found to be 7.41 (AUC: 0.77, 95% CI: 0.55 – 0.99). PASS was found to be 45.47 (AUC: 0.89, 95% CI: 0.79-0.99). Preoperative score below 37.6 on the PROMIS PF CAT predicted achievement of MCID (AUC: 0.76, 95% CI: 0.64-0.88), while scores above 41.7 predicted achievement of PASS (AUC: 0.76, 95% CI: 0.63-0.89). Absence of pre-existing arthritis and higher baseline functional status were also found to be statistically significant predictors of achieving CSOs. Conclusion: Our study defined MCID, SCB, and PASS, for the PROMIS PF CAT. We found that a pre-operative score below 37.6 was predictive for achieving a meaningful clinical change with surgery, while a pre-operative score above 41.7 was predictive of achievement of an acceptable post-operative health state. [Table: see text][Table: see text][Table: see text][Figure: see text]

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