Skip to main content

Advertisement

SpringerLink
Log in

PROMIS: a valid and efficient outcomes instrument for patients with ACL tears

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The current study compares the Patient Reported Outcomes Information System Physical Function Computer Adaptive Test (PROMIS PF CAT) to traditional knee PRO instruments in a healthy population undergoing surgery for ACL injuries with the following objectives: (1) identify and determine the strength of any correlations between the scores of PROMIS PF CAT and current knee PROs or their subscales that measure physical function; (2) evaluate PROMIS PF CAT’s test burden; and (3) determine if PROMIS PF CAT has any floor or ceiling effects in this population.

Methods

Patients indicated for ACL surgery completed the Short Form-36 Physical Function (SF-36 PF), Knee Injury and Osteoarthritis Outcome Score (KOOS), Marx Knee Activity Rating Scale (Marx), the EuroQol 5-dimensions Questionnaire (EQ-5D), and PROMIS PF CAT. Correlations between PROs were defined as follows: High (≥ 0.7); high–moderate (0.61–0.69); moderate (0.4–0.6); moderate–weak (0.31–0.39); and weak (≤ 0.3). Floor or ceiling effects were considered significant if 15% or more patients reported the lowest or highest possible total score, respectively.

Results

100 patients participated with a mean age of 26 years (range 11–57). The PROMIS PF CAT demonstrated high correlations with SF-36 PF (r = 0.82, p < 0.01), EQ-5D (r = − 0.70, p < 0.01) KOOS ADL (r = 0.74, p < 0.01), and KOOS Sport (r = 0.70, p < 0.01). There were no ceiling or floor effects for PROMIS PF CAT (0%). The mean number of items completed for the PROMIS PF CAT was 4.2 (median 4; range 4–11).

Conclusions

The PROMIS PF CAT shows a high correlation with commonly employed PROs that also measure physical function with low test burden and without ceiling effects in this relatively young and healthy population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Amstutz HC, Sew Hoy AL, Clarke IC (1981) UCLA anatomic total shoulder arthroplasty. Clin Orthop Relat Res 155:7–20

    Google Scholar 

  2. Beaton DE, Katz JN, Fossel AH, Wright JG, Tarasuk V, Bombardier C (2001) Measuring the whole or the parts? Validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity. J Hand Ther 14:128–146

    Article  PubMed  CAS  Google Scholar 

  3. Cella D, Gershon R, Lai JS, Choi S (2007) The future of outcomes measurement: item banking, tailored short-forms, and computerized adaptive assessment. Qual Life Res 16(Suppl 1):133–141

    Article  PubMed  Google Scholar 

  4. Chakravarty EF, Bjorner JB, Fries JF (2007) Improving patient reported outcomes using item response theory and computerized adaptive testing. J Rheumatol 34:1426–1431

    PubMed  Google Scholar 

  5. Doring AC, Nota SP, Hageman MG, Ring DC (2014) Measurement of upper extremity disability using the patient-reported outcomes measurement information system. J Hand Surg Am 39:1160–1165

    Article  PubMed  Google Scholar 

  6. Fries J, Rose M, Krishnan E (2011) The PROMIS of better outcome assessment: responsiveness, floor and ceiling effects, and Internet administration. J Rheumatol 38:1759–1764

    Article  PubMed  Google Scholar 

  7. Fries JF, Bruce B, Cella D (2005) The promise of PROMIS: using item response theory to improve assessment of patient-reported outcomes. Clin Exp Rheumatol 23:S53–S57

    PubMed  CAS  Google Scholar 

  8. Garrard L, Price LR, Bott MJ, Gajewski BJ (2015) A novel method for expediting the development of patient-reported outcome measures and an evaluation of its performance via simulation. BMC Med Res Methodol 15:77

    Article  PubMed  PubMed Central  Google Scholar 

  9. Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51:737–755

    Article  PubMed  CAS  Google Scholar 

  10. Hoppe DJ, Bhandari M (2008) Evidence-based orthopaedics: a brief history. Indian J Orthop 42:104–110

    Article  PubMed  PubMed Central  Google Scholar 

  11. Huber EO, Meichtry A, de Bie RA, Bastiaenen CH (2016) Construct validity of change scores of the Chair Stand Test versus Timed Up and Go test, KOOS questionnaire and the isometric muscle strength test in patients with severe knee osteoarthritis undergoing total knee replacement. Man Ther 21:262–267

    Article  PubMed  Google Scholar 

  12. Hung M, Baumhauer JF, Brodsky JW, Cheng C, Ellis SJ, Franklin JD et al (2014) Psychometric comparison of the PROMIS physical function CAT with the FAAM and FFI for measuring patient-reported outcomes. Foot Ankle Int 35:592–599

    Article  PubMed  Google Scholar 

  13. Hung M, Baumhauer JF, Latt LD, Saltzman CL, SooHoo NF, Hunt KJ (2013) Validation of PROMIS (R) physical function computerized adaptive tests for orthopaedic foot and ankle outcome research. Clin Orthop Relat Res 471:3466–3474

    Article  PubMed  PubMed Central  Google Scholar 

  14. Hung M, Stuart AR, Higgins TF, Saltzman CL, Kubiak EN (2014) Computerized adaptive testing using the PROMIS physical function item bank reduces test burden with less ceiling effects compared to the short musculoskeletal function assessment in orthopaedic trauma patients. J Orthop Trauma 28:439–443

    Article  PubMed  Google Scholar 

  15. Hurwitz S (2003) Evidence-based medicine in orthopaedic surgery—a way to the future. Iowa Orthop J 23:61–65

    PubMed  PubMed Central  Google Scholar 

  16. Marchetti P, Binazzi R, Vaccari V, Girolami M, Morici F, Impallomeni C et al (2005) Long-term results with cementless Fitek (or Fitmore) cups. J Arthroplasty 20:730–737

    Article  PubMed  Google Scholar 

  17. Marx RG (2003) Knee rating scales. Arthroscopy 19:1103–1108

    Article  PubMed  Google Scholar 

  18. Marx RG, Stump TJ, Jones EC, Wickiewicz TL, Warren RF (2001) Development and evaluation of an activity rating scale for disorders of the knee. Am J Sports Med 29:213–218

    Article  PubMed  CAS  Google Scholar 

  19. McHorney CA, Ware JE Jr, Raczek AE (1993) The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31:247–263

    Article  PubMed  CAS  Google Scholar 

  20. Mohtadi NG, Chan DS, Hollinshead RM, Boorman RS, Hiemstra LA, Lo IK et al (2014) A randomized clinical trial comparing open and arthroscopic stabilization for recurrent traumatic anterior shoulder instability: two-year follow-up with disease-specific quality-of-life outcomes. J Bone Jt Surg Am 96:353–360

    Article  Google Scholar 

  21. Nguyen J, Marx R, Hidaka C, Wilson S, Lyman S (2016) Validation of electronic administration of knee surveys among ACL-injured patients. Knee Surg Sports Traumatol Arthrosc 25:3116–3122

    Article  PubMed  Google Scholar 

  22. Noyes FR, Barber SD, Mooar LA (1989) A rationale for assessing sports activity levels and limitations in knee disorders. Clin Orthop Relat Res 246:238–249

    Google Scholar 

  23. Nutton RW, McBirnie JM, Phillips C (1997) Treatment of chronic rotator-cuff impingement by arthroscopic subacromial decompression. J Bone Joint Surg Br 79:73–76

    Article  PubMed  CAS  Google Scholar 

  24. Rabin R, de Charro F (2001) EQ-5D: a measure of health status from the EuroQol Group. Ann Med 33:337–343

    Article  PubMed  CAS  Google Scholar 

  25. Roos EM, Lohmander LS (2003) The Knee injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes 1:64–64

    Article  PubMed  PubMed Central  Google Scholar 

  26. Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD (1998) Knee Injury and Osteoarthritis Outcome Score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther 28:88–96

    Article  PubMed  CAS  Google Scholar 

  27. Shoukri M (1998) Statistical methods for health sciences, 2nd edn. CRC Press, Pause

    Google Scholar 

  28. Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res Sep:43–49

    Google Scholar 

  29. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J et al (2007) Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 60:34–42

    Article  PubMed  Google Scholar 

  30. Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483

    Article  PubMed  Google Scholar 

  31. Wyer PC, Silva SA (2009) Where is the wisdom? I—a conceptual history of evidence-based medicine. J Eval Clin Pract 15:891–898

    Article  PubMed  Google Scholar 

Download references

Funding

No funding was provided for the completion of this study.

Author information

Authors and Affiliations

  1. The Department of Orthopedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 01008 JPP, Iowa City, IA 52242, USA

    Kyle John Hancock, Natalie Glass, Chris A. Anthony, Brian R. Wolf, Carolyn M. Hettrich, John Albright & Matt Bollier

  2. Division of Sports Medicine, Duke University, Durham, North Carolina, USA

    Annunziato Amendola

Authors
  1. Kyle John Hancock
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Natalie Glass
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chris A. Anthony
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Brian R. Wolf
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Carolyn M. Hettrich
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. John Albright
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Matt Bollier
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Annunziato Amendola
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kyle John Hancock.

Ethics declarations

Conflict of interest

Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Ethical approval

Each author certifies that his or her institution approved or waived approval for the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hancock, K.J., Glass, N., Anthony, C.A. et al. PROMIS: a valid and efficient outcomes instrument for patients with ACL tears. Knee Surg Sports Traumatol Arthrosc 27, 100–104 (2019). https://doi.org/10.1007/s00167-018-5034-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-018-5034-z

Keywords

Search

Navigation