PROMIS Pain Interference Is Superior vs Numeric Pain Rating Scale for Pain Assessment in Foot and Ankle Patients

• Published in: Foot & ankle international Vol. 40; no. 2; pp. 139 - 144
• Main Authors: Bernstein, David N., Kelly, Meghan, Houck, Jeffrey R., Ketz, John P., Flemister, A. Samuel, DiGiovanni, Benedict F., Baumhauer, Judith F., Oh, Irvin
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-02-2019
• Subjects: Adult; Aged; Ankle - surgery; Female; Foot - surgery; Humans; Male; Middle Aged; Pain Measurement - methods; Pain, Postoperative; Patient Reported Outcome Measures; Preoperative Period; Reproducibility of Results; patient-reported outcomes; pain; value-based healthcare; PROMIS; surgical expectations
• ISSN: 1071-1007; 1944-7876
• DOI: 10.1177/1071100718803314

Background:
The Numeric Pain Rating Scale (NPRS) is a popular method to assess pain. Recently, the Patient-Reported Outcomes Measurement Information System (PROMIS) has been suggested to be more accurate in measuring pain. This study aimed to compare NPRS and PROMIS Pain Interference (PI) scores in a population of foot and ankle patients to determine which method demonstrated a stronger correlation with preoperative and postoperative function, as measured by PROMIS Physical Function (PF).
Methods:
Prospective PROMIS PF and PI and NPRS data were obtained for 8 common elective foot and ankle surgical procedures. Data were collected preoperatively and postoperatively at a follow-up visit at least 6 months after surgery. Spearman correlation coefficients were calculated to determine the relationship among NPRS (0-10) and PROMIS domains (PI, PF) pre- and postoperatively. A total of 500 patients fit our inclusion criteria.
Results:
PROMIS PF demonstrated a stronger correlation to PROMIS PI in both the pre- and postoperative settings (preoperative: ρ = −0.66; postoperative: ρ = −0.69) compared with the NPRS (preoperative: ρ = −0.32; postoperative:ρ = −0.33). Similar results were found when data were grouped by Current Procedural Terminology (CPT) code.
Conclusion:
PROMIS PI was a superior tool to gauge a patient’s preoperative level of pain and functional ability. This information may assist surgeons and patients in setting postoperative functional expectations and pain management.
Level of Evidence:
Level II, prognostic.