PROMIS correlation with NDI and VAS measurements of physical function and pain in surgical patients with cervical disc herniations and radiculopathy

2019 ◽  
Vol 31 (4) ◽  
pp. 519-524 ◽  
Author(s):  
Robert J. Owen ◽  
Adam Z. Khan ◽  
Steven J. McAnany ◽  
Colleen Peters ◽  
Lukas P. Zebala
Keyword(s):  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Cervical Disc ◽  
Strong Negative Correlation ◽  
Positive Correlation ◽  
Arm Pain ◽  
Pain Scores ◽  
Patient Reported ◽  
Disc Herniations

OBJECTIVEThe aim of this study was to compare the patient-reported outcome measures Neck Disability Index (NDI) and visual analog scale (VAS) with the Patient Reported Outcomes Measurement Information System (PROMIS) physical function (PF) and pain interference (PI) measures, respectively, and to determine their correlations in a surgical population longitudinally.Legacy outcome measures such as NDI and VAS are essential for analyzing treatments in spine surgery for cervical disc herniations with radiculopathy. Despite their usefulness, administrative burdens impose limits on completion of these measures. PROMIS was developed as a patient outcome measure in order to improve reporting of patient symptoms and function and to reduce administrative burden. Despite early positive results of PROMIS in orthopedics, NDI and VAS scores have not been compared with PROMIS scores in patients with cervical disc herniations with radiculopathy.METHODSEighty patients undergoing surgery for cervical disc herniations with radiculopathy were included. All patients were treated at the same tertiary spine center. Patients were seen and PROMIS PF and PI, NDI, and VAS arm and neck pain scores were collected preoperatively and at 1 year postoperatively. Correlations between NDI, VAS, and PROMIS PF and PI were quantified using Pearson correlation coefficients. Two-tailed Student t-tests were used to demonstrate correlation significance, with alpha = 0.05.RESULTSAll 80 (100%) patients completed all preoperative questionnaires. Fifty-seven (72%) and 75 (94%) patients completed all questionnaires at baseline and at the 6-month and 1-year follow-ups, respectively. PROMIS PF and NDI scores demonstrated a strong negative correlation, with Pearson r values of −0.81, −0.77, and −0.75 at baseline, 6 months, and 1 year. PROMIS PI and VAS neck pain scores demonstrated a moderately positive correlation, with Pearson r values of 0.51, 0.61, and 0.6. PROMIS PI and VAS arm pain scores demonstrated a moderately positive correlation, with Pearson r values of 0.46, 0.47, and 0.45.CONCLUSIONSPROMIS PF scores have a strong negative correlation with NDI scores at baseline and in the postoperative course in patients undergoing surgery for cervical disc herniations with radiculopathy. PROMIS PI scores have a moderately positive correlation with VAS neck and arm pain scores at baseline and in the postoperative course. Surgeons may factor these correlation results into the interpretation of patient-reported outcome measures in patients with cervical radiculopathy. Use of PROMIS PF and PI for this patient population may reduce administrative burden while providing reliable outcomes data.

scholarly journals Exaggerated Pre-Operative Patient Reported Visual Analog Pain Scale, A Retrospective review of 201 consecutive surgical patients

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Kevin Martin ◽  
Laura Dawson ◽  
Kenneth Cameron ◽  
Jeffrey Van Buren
Keyword(s):  
Outcome Measures ◽  
Nursing Staff ◽  
Healthcare Providers ◽  
Office Visit ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Vas Score ◽  
Pain Scores ◽  
Significant Difference ◽  
Patient Reported

Category: Patient Reported Outcomes Introduction/Purpose: The visual analog scale (VAS) is a reliable and validated measure of patient reported acute pain. The clinical implications of the VAS in patients with chronic pain or postoperative pain is less clear. As patient reported outcome measures are becoming the standard of care throughout the orthopaedic community, interpretation and clinical applications are still under investigation. The aim of the current study was to evaluate preoperative patient reported VAS score reported to nursing staff as compared to the surgeon at the same clinical visit. Our hypothesis was that there would be no difference in the scores reported by a single patient to two different healthcare providers during the same clinic visit. Methods: The current study was a retrospective cohort of 201 consecutive foot and ankle patients treated by a signal surgeon. The patients were asked by the nursing staff to rate their pain intensity using a standard horizontal VAS 0-10, from “no pain” to the “worst possible pain”. At the same office visit the patients were asked by the treating surgeon to rate their pain using the same VAS. Dependent t-tests were calculated to evaluate mean differences in VAS pain reported by each patient to two different healthcare professional. All data were analyzed using STATA v10.1 with an alpha level of p<0.05. Results: The results demonstrate that patients reported higher pain scores to the surgeon within 81% of the encounters, nursing staff 8% and equal 11%. On average the VAS score reported to the surgeon (6.17 ±2.12) was significantly higher higher than that reported to the nursing staff (3.30 ±2.26), respectively. The mean difference between the scores was 2.87 ±2.46 (p=<0.001). Conclusion: The current study demonstrates a clear and significant difference in patient reported pain scores between that given to nursing staff verses the treating surgeon. The cause for the exaggerated pain scores is unclear, but does lead surgeons to consider patients may have a predetermined desire for surgery. The findings of this study may also have implications for comparing patient reported outcome measures prior to surgery to post-surgical outcomes depending on who administers the instrument.

scholarly journals Distal Pole Resection of the Scaphoid for the Treatment of Scaphotrapeziotrapezoid Osteoarthritis

Hand ◽  
2017 ◽  
Vol 14 (2) ◽  
pp. 230-235 ◽  
Author(s):  
Merel J.-L. Berkhout ◽  
Yara Bachour ◽  
Daan Wessing ◽  
Marco J. P. F. Ritt
Keyword(s):  
Outcome Measures ◽  
Surgical Techniques ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Consecutive Series ◽  
Pain Scores ◽  
Distal Pole ◽  
Patient Reported ◽  
Dorsal Intercalated Segment Instability ◽  
Objective Functional

Background: Distal pole resection of the scaphoid is one of the surgical techniques applied for the treatment of painful scaphotrapeziotrapezoid osteoarthritis (STT-OA). Methods: In this retrospective study, we evaluated midterm outcomes in a consecutive series of patients who underwent distal pole resection of the scaphoid: 13 patients (15 wrists) with a mean follow-up of 4.1 years. We examined objective functional and patient-reported outcome measures. In addition, we assessed the degree of dorsal intercalated segment instability (DISI) and postoperative complications. Results: All patients scored within a normal range on objective functional and patient-reported outcome measures. We observed a mild postoperative DISI deformity with an average lunocapitate angle of 22° (range, 0°-44°), which did not correlate with pain scores. In the opposite wrists, with and without STT-OA, the average lunocapitate angle was 6° (range, 0°-20°). Conclusions: According to this study, midterm results for distal pole resection of the scaphoid are satisfactory.

scholarly journals Comparison of Visual Analog Pain Score Reported to Physician vs Nurse in Postoperative Foot and Ankle Patients

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0005
Author(s):  
Trevor McBride ◽  
Kevin Martin ◽  
Aaron Joseph Wilke ◽  
Jamie Chisholm
Keyword(s):  
Outcome Measures ◽  
Nursing Staff ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Clinic Visit ◽  
Time Interval ◽  
Foot And Ankle ◽  
Pain Scores ◽  
Patient Reported ◽  
Vas Scores

Category: Patient Reported Outcome Measures Introduction/Purpose: The relativity of pain adds to the increasing ambiguity of deciding proper treatment procedures. Reliable and validated patient reported outcome measures have attempted to solve this problem, but there are still flaws due to the subjective nature of pain. This study is the third part to two previous studies that found both operative and new nonoperative patients overemphasize their pain scores when reporting to the treating physician as compared to a nurse. This current study aims to examine if this phenomenon holds true with orthopedic postoperative patients. The importance of this study is to observe this phenomenon, as to better understand subjective pain scores. We hypothesize there will be no differences in postoperative patients’ pain scores when reporting to a treating physician versus a nurse. Methods: This study is a retrospective cohort of consecutive postoperative foot and ankle patients treated by a single surgeon. The patients were asked to rate their pain intensity by the nursing staff and then by the surgeon using a standard horizontal visual analog scale (VAS) 0 to 10, from “no pain” to “worst pain” at 2, 6, and 12 weeks postoperatively. Differences in reported pain levels were analyzed within each clinic visit. Results: Two hundred and one patients each with 3 follow up encounters were included in our cohort. The mean 2, 6, and 12- week postoperative VAS scores reported to the physician were 2.85, 2.04, and 2.33 respectively; in comparison, the scores reported to the nurse were 2.52 (p=0.0005), 1.77 (p=0.002), and 2.02 (p=0.005) respectively. There was no significant relationship between time and type of provider. Conclusion: This study found that postoperative patients report their pain more consistently to physicians and nursing staff with no clinically significant differences noted. These findings stand in stark contrast to our two previous studies which noted new and preoperative patients reported significantly higher VAS scores to the physician. The reason for reporting inconstancies is unclear, but postoperatively patients no longer need to emphasize their impairments or injury. Postoperatively, they also have a defined time interval and more acute recollection of their pain potentially leading to more consistency in reporting.

Impact of Depression on Patient-Reported Outcome Measures After Lumbar Spine Decompression

Spine ◽  
2018 ◽  
Vol 43 (6) ◽  
pp. 434-439 ◽  
Author(s):  
Robert K. Merrill ◽  
Lukas P. Zebala ◽  
Colleen Peters ◽  
Sheeraz A. Qureshi ◽  
Steven J. McAnany
Keyword(s):  
Lumbar Spine ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Reported

Preoperative Opioid Use in Patients Undergoing Common Hand Surgeries

Hand ◽  
2021 ◽  
pp. 155894472097412
Author(s):  
Ali Aneizi ◽  
Dominique Gelmann ◽  
Dominic J. Ventimiglia ◽  
Patrick M. J. Sajak ◽  
Vidushan Nadarajah ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Hand Surgery ◽  
Patient Characteristics ◽  
Patient Reported Outcome Measures ◽  
Pain Scale ◽  
Patient Reported Outcome ◽  
Measurement Information ◽  
Opioid Use ◽  
Patient Reported ◽  
Opioid Users

Background: The objectives of this study were to determine the baseline patient characteristics associated with preoperative opioid use and to establish whether preoperative opioid use is associated with baseline patient-reported outcome measures in patients undergoing common hand surgeries. Methods: Patients undergoing common hand surgeries from 2015 to 2018 were retrospectively reviewed from a prospective orthopedic registry at a single academic institution. Medical records were reviewed to determine whether patients were opioid users versus nonusers. On enrollment in the registry, patients completed 6 Patient-Reported Outcomes Measurement Information System (PROMIS) domains (Physical Function, Pain Interference, Fatigue, Social Satisfaction, Anxiety, and Depression), the Brief Michigan Hand Questionnaire (BMHQ), a surgical expectations questionnaire, and Numeric Pain Scale (NPS). Statistical analysis included multivariable regression to determine whether preoperative opioid use was associated with patient characteristics and preoperative scores on patient-reported outcome measures. Results: After controlling for covariates, an analysis of 353 patients (opioid users, n = 122; nonusers, n = 231) showed that preoperative opioid use was associated with higher American Society of Anesthesiologists class (odds ratio [OR], 2.88), current smoking (OR, 1.91), and lower body mass index (OR, 0.95). Preoperative opioid use was also associated with significantly worse baseline PROMIS scores across 6 domains, lower BMHQ scores, and NPS hand scores. Conclusions: Preoperative opioid use is common in hand surgery patients with a rate of 35%. Preoperative opioid use is associated with multiple baseline patient characteristics and is predictive of worse baseline scores on patient-reported outcome measures. Future studies should determine whether such associations persist in the postoperative setting between opioid users and nonusers.

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