Purpose
To evaluate publication trends of Patient-Reported Outcomes Measurement Information
System (PROMIS) in hip preservation literature, assess the usage of PROMIS as an outcome
measure, and evaluate correlations of all available published PROMIS domains with
legacy patient-reported outcomes (PROs).
Methods
The PubMed, Scopus, Cochrane Central Register of Controlled Trials, and Google Scholar
databases were queried for articles evaluating PROMIS scores among hip preservation
populations. Inclusion criteria consisted of studies with Level IV evidence or above
(per the Sackett et al. levels of evidence), such as case series and cohort studies,
reporting on perioperative use of hip PROMIS scores. Exclusion criteria consisted
of arthroplasty and trauma studies. Patient demographics, PROMIS usage, and PROMIS
Pearson or Spearman correlation coefficients to historic PROs were recorded for each
study.
Results
Fifteen articles published between 2017 and 2021 were included in the analysis, with
the majority (75%) published between 2020 and 2021. Studies assessing postoperative
outcomes had follow-up periods ranging from 6 months to 5 years. The most common PROMIS
domain reported was Physical Function (PF), and there was varying usage of other domains
including Pain Intensity, Anxiety, and Depression. PROMIS validity was most often
assessed in comparison to the modified Harris Hip Score (mHHS) by calculating the
Pearson coefficient, which assumes normal data distribution, or Spearman coefficient,
which is rank-based and does not require normal data distribution. Studies comparing
PROMIS-PF with mHHS reported Pearson coefficients ranging from 0.49 to 0.72 and Spearman
coefficients ranging from 0.67 to 0.71.
Conclusions
There has been a chronologic increase in PROMIS usage in hip preservation literature.
PROMIS demonstrates moderate-to-strong correlations with legacy PROs, but there is
substantial heterogeneity in follow-up periods, PROMIS domains used, and statistical
methodology. The current data show that PROMIS is not as responsive as historically
used, validated PROs in quantitatively assessing function and pain in hip preservation
patients.
Clinical Relevance
Surgeons using PROMIS solely should be aware that the score may not be as responsive
as legacy PROs in closely assessing improvements or deterioration in patient performance
after hip preservation surgery. Rather than being used alone, PROMIS may be useful
as a replacement for a group of legacy PROs. Thus, when used alongside select legacy
PROs, overall questionnaire burden can be reduced while maintaining a high level of
accuracy in assessing health status.
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Article info
Publication history
Published online: July 07, 2022
Accepted:
June 23,
2022
Received:
January 14,
2022
Footnotes
See commentary on pages 851 and 853
The authors report the following potential conflicts of interest or sources of funding: S.J.N. reports royalties and consulting fees from Stryker Corporation, Springer, Arthrex, Ossur, Linvatec, Smith & Nephew, DJ Orthopaedics, Miomed, Athletico, Allosource, and Elite Orthopaedics. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2022 by the Arthroscopy Association of North America
