Purpose
To evaluate the reliability, construct validity, and responsiveness of the lower extremity–specific
Patient-Reported Outcomes Measurement Information System (PROMIS) Mobility (MO) bank
in patients who underwent hip arthroscopic surgery for femoroacetabular impingement.
Methods
Patients who underwent primary hip arthroscopic surgery at a large academic musculoskeletal
specialty center between November 2019 and November 2020 completed the following baseline
and 6-month measures: PROMIS MO, PROMIS Pain Interference (PI), PROMIS Physical Function
(PF), modified Harris Hip Score, International Hip Outcome Tool 33, visual analog
scale, and Single Assessment Numeric Evaluation. Construct validity was evaluated
using Spearman correlation coefficients. The number of questions until completion
was recorded as a marker of test burden. The percentage of patients scoring at the
extreme high (ceiling) or low (floor) for each measure was recorded to measure inclusivity.
Responsiveness was tested by comparing differences between baseline and 6-month measures,
controlling for age and sex, using generalized estimating equations. Magnitudes of
responsiveness were assessed through the effect size (Cohen d).
Results
In this study, 660 patients (50% female patients) aged 32 ± 14 years were evaluated.
PROMIS MO showed a strong correlation with PROMIS PF (r = 0.84, P < .001), the International Hip Outcome Tool 33 (r = 0.73, P < .001), PROMIS PI (r = –0.76, P < .001), and the modified Harris Hip Score (r = 0.73, P < .001). Neither PROMIS MO, PROMIS PI, nor PROMIS PF met the conventional criteria
for floor or ceiling effects (≥15%). The mean number of questions answered (± standard
deviation) was 4.7 ± 2.1 for PROMIS MO, 4.1 ± 0.6 for PROMIS PI, and 4.1 ± 0.6 for
PROMIS PF. From baseline to 6 months, the PROMIS and legacy measures exhibited significant
responsiveness (P < .05), with similar effect sizes between the patient-reported outcome measures.
Conclusions
This longitudinal study reveals that in patients undergoing hip arthroscopy, PROMIS
MO computerized adaptive testing maintains high correlation with legacy hip-specific
instruments, significant responsiveness to change, and low test burden compared with
legacy measures, with no ceiling or floor effects at 6-month postoperative follow-up.
Level of Evidence
Level IV, retrospective case series.
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Article Info
Publication History
Published online: April 22, 2022
Accepted:
March 18,
2022
Received:
October 4,
2021
Footnotes
The authors report the following potential conflicts of interest or sources of funding: A.S.R. is a paid consultant for Arthrex , Ceramtec, Medtronic , Moximed, Pfizer , and Smith & Nephew; owns stock or stock options in ConforMIS and Enhatch; receives research support from DePuy Mitek-Synthes and Stryker; and receives intellectual property royalties from DePuy (A Johnson & Johnson Company) and Stryker Mako, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
The data in this study have been presented during an E-poster presentation (paper No. 19882) at the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine 2021 Global Congress (virtual platform). The manuscript has not previously been submitted and is not under consideration for publication elsewhere.
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© 2022 by the Arthroscopy Association of North America
