Purpose
To examine the preoperative performance of the Patient-Reported Outcomes Measurement
Information System (PROMIS) Upper Extremity (UE) Computer Adaptive Test (CAT) with
respect to legacy scores in patients receiving rotator cuff repair (RCR). In addition,
to define the impact of Workers' Compensation (WC) status on both performance and
floor and ceiling effects.
Methods
The PROMIS UE CAT was administered preoperatively alongside legacy patient-reported
outcome measures (PROMs) to patients undergoing isolated arthroscopic RCR from November
2017 to September 2018. Performance was assessed using Spearman correlation coefficients,
and floor and ceiling effects were examined.
Results
One hundred twenty-two patients (WC, n = 32; non-WC, n = 90; 62.3% male, 53.6 ± 11.5 years)
were included. PROMs assessing physical function (r = 0.41-0.77) correlated more strongly to the PROMIS UE CAT than did multidomain or
mental health PROMs (r = 0.25-0.61). In WC patients, the PROMIS UE CAT demonstrated diminished correlative
strength relative to shoulder function PROMs. WC patients also demonstrated relative
floor effects for Single Assessment Numerical Evaluation (SANE; 18.8%) and Constant-Murley
(15.6%) and relative ceiling effects for the Brief Resilience Scale (53.1%), Short
Form 12 Mental Component Score (50%), and Veterans Rand 12 Mental Component Score
(53.1%) and were more likely to report the minimum SANE score (P < .01) and the maximum Brief Resilience Scale score (P < .01). No absolute or relative floor/ceiling effects for the PROMIS UE CAT were
found.
Conclusions
Compared with a non-WC cohort, WC patients have significantly lower preoperative PROMIS
UE CAT scores, are more likely to report the absolute minimum and maximum scores for
various PROMs, and demonstrated relative floor and ceiling effects for PROMs assessing
mental health. The absence of significant floor/ceiling effects for the PROMIS UE
CAT may suggest improved outcome discrimination and may support the adoption of PROMIS
UE for the assessment of functional status in WC patients with rotator cuff pathology.
Level of Evidence
Level III, retrospective comparative trial.
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Article info
Publication history
Accepted:
May 13,
2019
Received:
January 16,
2019
Footnotes
The authors report the following potential conflicts of interest or sources of funding: B.F. receives support from Elsevier, Arthrex, Jace Medical, Smith & Nephew, Stryker, and Ossur. B.J.C. receives support from Aesculap/B.Braun, American Journal of Orthopedics, American Journal of Sports Medicine, Arthrex, Arthroscopy Association of North America, Athletico, Cartilage, Elsevier Publishing, International Cartilage Repair Society, Journal of Shoulder and Elbow Surgery, Journal of the American Academy of Orthopaedic Surgeons, JRF Ortho, National Institutes of Health (National Institute of Arthritis and Musculoskeletal and Skin Diseases and National Institute of Child Health and Human Development), Operative Techniques in Sports Medicine, Ossio, Regentis, Smith & Nephew, and Zimmer. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2019 by the Arthroscopy Association of North America
