Purpose
To examine the relation between the Patient-Reported Outcomes Measurement Information
System (PROMIS) domains of Pain Interference (PROMIS-PI), Depression (PROMIS-D), and
Physical Function (PROMIS-PF) for nonoperative patients presenting to our ambulatory
sports orthopaedic clinic with knee complaints and to determine whether patient demographic
characteristics influence PROMIS scores, particularly tobacco use.
Methods
All patients treated nonoperatively for a primary complaint of knee pain were recruited
for participation. Patients were included if they completed all 3 PROMIS questionnaires
prior to their clinical evaluation. Patients were excluded if their treatment plan
determined that surgical intervention was warranted. Survey results were compiled,
and statistical correlations were run between PROMIS domains and patient demographic
characteristics.
Results
A total of 527 PROMIS questionnaire sets were included. PROMIS-PF had a strong negative
correlation with PROMIS-PI (R = –0.75, P < .001) and a nearly moderate negative correlation with PROMIS-D (R = –0.47, P < .001). When evaluating patient demographic characteristics, we found a significant
decrease in physical function scores and increases in pain and depression scores in
both current and former tobacco users compared with nonsmokers. Differences in all
PROMIS domains between smokers and nonsmokers exceeded minimal clinically important
differences.
Conclusions
Our study showed an inverse correlation between PROMIS-PI and PROMIS-PF, as well as
between PROMIS-D and PROMIS-PI, in patients seen in the ambulatory setting for knee
complaints treated nonoperatively. A positive correlation was found between PROMIS-PI
and PROMIS-D. Tobacco use was a patient demographic factor found to significantly
impact PROMIS scores leading to minimal clinically important differences across all
3 PROMIS domains. The findings of this study may be used to identify patients at high
risk of poor outcomes.
Level of Evidence
Level III, observational study.
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Article info
Publication history
Accepted:
June 21,
2019
Received:
January 9,
2019
Footnotes
See commentary on page 3302
The authors report the following potential conflicts of interest or sources of funding: V.M. receives financial or material support from Stryker and Pinnacle and education support from Arthrex and Pinnacle. E.C.M. is a paid consultant for Smith & Nephew and receives publishing royalties and financial or material support from Springer. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2019 Published by Elsevier on behalf of the Arthroscopy Association of North America
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- Editorial Commentary: Mental Health and Tobacco Use Influence Functional Outcomes—Quod erat demonstrandum, or Not?!?ArthroscopyVol. 35Issue 12
- PreviewWhy does one patient achieve better results than another with nonoperative orthopaedic treatment? Aside from the specific underlying pathology of knee pain, there are demographic factors, including mental health, body mass index, tobacco use, and pain perception, that influence the clinical results and should be considered as part of the equation.
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