Purpose
To compare the use and responsiveness of Patient Reported Outcomes Measurement Information
System (PROMIS) to legacy patient-reported outcome measures (PROMs) in patients undergoing
hip arthroscopy for femoroacetabular impingement syndrome (FAIS) at 6-month follow-up.
Methods
Data from patients who underwent primary hip arthroscopy with routine capsular closure
between August 2018 and January 2019 for the treatment of FAIS were analyzed. Preoperative
outcomes, 6-month postoperative outcomes, and demographics were recorded. Primary
outcome measures included PROMIS Physical Function (PROMIS-PF), PROMIS Pain Interference
(PROMIS-PI), and PROMIS Depression. The legacy PROMs included Hip Outcome Score Activities
of Daily Living (HOS-ADL), Hip Outcome Score Sport Subscale (HOS-SS), and the international
hip outcome tool 12 questions (iHOT-12). Floor and ceiling effects along with the
responsiveness and Cohen’s d effect size of each PROM tool were calculated.
Results
Ninety-six patients with an average age and body mass index of 32.4 ± 11.9 years and
25.9 ± 6.1 kg/m2, respectively, were included in the final analysis. All outcomes were significantly
higher at 6 months compared with the preoperative level (P < .001) except for PROMIS Depression (P = .873). PROMIS-PF demonstrated excellent correlation with HOS-SS (r = 0.81; P < .001), very good correlation with HOS-ADL (r = 0.73; P < .001), and good correlation with iHOT-12 (r = 0.68; P < .001). No floor was observed for any measure. The effect size was large for all
outcomes, except PROMIS Depression (d = 0.04), but largest for iHOT12 (d = 1.87) followed by HOS-ADL (d = 1.29). The iHOT-12 was more responsive than PROMIS-PI (relative efficiency [RE] =
3.95), PROMIS-PF (RE = 4.13), HOS-ADL (RE = 2.26), and HOS-SS (RE = 3.84). HOS-SS
was similarly responsive to PROMIS-PI (RE=1.03) and PROMIS-PF (RE=1.08). However,
PROMIS-PF was overall the least responsive.
Conclusions
In patients at 6 months postoperatively from hip arthroscopy for FAIS, iHOT-12 was
the most responsive and had the largest effect size. In contrast, PROMIS-PF had a
lower effect size compared with legacy hip-specific PROMs. Additionally, PROMIS-PF
did not correlate as well with iHOT-12 compared with HOS-SS.
Level of Evidence
Level IV, case series.
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Article info
Publication history
Published online: July 13, 2020
Accepted:
July 3,
2020
Received:
January 31,
2020
See commentary on page 2998Footnotes
The authors report the following potential conflicts of interest or sources of funding: S.J.N. reports personal fees from Stryker, American Journal of Orthopedics, and Ossur. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2020 by the Arthroscopy Association of North America
ScienceDirect
Access this article on ScienceDirectLinked Article
- Editorial Commentary: Patient-Reported Outcomes Measurement Information System (PROMIS) Has Decreased Disease-Specific Responsiveness More Than Legacy Outcome Measures, But PROMIS and Legacy Measures Do Correlate: You Can’t Have Your Cake and Eat It TooArthroscopyVol. 36Issue 12
- PreviewA better understanding of hip-preservation patients lies in our ability to analyze and collect data. Collecting the appropriate outcome measures is required to improve treatments, personalize health care, and drive policy. Current research suggests legacy measures and Patient-Reported Outcomes Measurement Information System (PROMIS) measures can be used in data collection, but which measures are best? PROMIS computer-adaptive tests are an attractive outcome measure source because they allow for low-burden data capture with reduced completion times and limited floor and ceiling effects.
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