Comparing Patient-Reported Outcomes Measurement Information System Computer Adaptive Testing With Existing Measures After Operative Interventions for Extremity Fractures

• Published in: Value in health Vol. 26; no. 8; pp. 1235 - 1241
• Main Authors: Havermans, Roos J.M., Lansink, Koen W.W., Gosens, Taco, de Jongh, Mariska A.C.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2023
• Subjects: Computer Adaptive Testing; Computers; extremity fracture; Fractures, Bone - surgery; Humans; Information Systems; Patient Reported Outcome Measures; patient-reported outcomes measure; Patient-Reported Outcomes Measurement Information System; Prospective Studies; recovery; Upper Extremity - injuries; Upper Extremity - surgery; Computer Adaptive Testing; extremity fracture; recovery; Patient-Reported Outcomes Measurement Information System; patient-reported outcomes measure
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2023.02.014

Patient-Reported Outcomes Measurement Information System (PROMIS) enables the use of computer adaptive testing (CAT). The aim of this prospective cohort study was to compare the most commonly used disease-specific instruments with PROMIS CAT questionnaires in patients with trauma.
All patients with trauma (ages 18-75) who underwent an operative intervention for an extremity fracture between June 1, 2018, and June 30, 2019, were included. The disease-specific instruments were the Quick Disabilities of the Arm, Shoulder, and Hand for upper extremity fractures and the Lower Extremity Functional Scale (LEFS) for lower extremity fractures. Pearson’s correlation (r) between the disease-specific instruments and the PROMIS CAT questionnaires (PROMIS Physical Function, PROMIS Pain Interference, and PROMIS Ability to Participate in Social Roles and Activities) was calculated at week 2, week 6, month 3, and month 6. Construct validity and responsiveness were calculated.
A total of 151 patients with an upper extremity fracture and 109 patients with a lower extremity fracture were included. At month 3 and month 6, the correlation was strong between the LEFS and PROMIS Physical Function (r = 0.88 and r = 0.90, respectively), and at month 3, the correlation was strong between the LEFS and PROMIS Social Roles and Activities (r = 0.72). At week 6, month 3, and month 6, there was a strong correlation between the Quick Disabilities of the Arm, Shoulder, and Hand and PROMIS Physical Function (r = 0.74, r = 0.70, and r = 0.76, respectively).
The PROMIS CAT measures are acceptably related to existing non-CAT instruments and may be a useful tool during follow-up after operative interventions for extremity fractures.
•Patient-Reported Outcomes Measurement Information System computer adaptive testing (CAT) questionnaires could be used as a supplement to outpatient visits to provide insight into perceived health and the domain of experienced limitations. Knowledge about the results and the clinical consequences has yet to grow, but using these questionnaires could enhance communication between clinicians and patients.•Patient-Reported Outcomes Measurement Information System CAT measures are acceptably related to existing non-CAT instruments, resulting in a lower response burden than that with injury-specific instruments.