Abstract
Purpose
PROMIS is becoming the most commonly utilized patient-reported outcome measure (PROM) in adult orthopaedics, but its adoption has lagged in pediatrics. Limited baseline data exists in pediatric-specific orthopaedic diagnoses. The objective of this study was to determine baseline PROMIS scores in patients with idiopathic scoliosis and to evaluate for correlations with the SRS-22.
Methods
This was a retrospective analysis of prospectively collected data from six tertiary care pediatric hospitals between July 2016 and July 2018. Patients with a diagnosis of idiopathic scoliosis, adequate radiographs for measurement and completion of PROMIS and SRS-22 questionnaires from the same visit were included. Only the first visit during the study period was included for each subject. Post-operative patients were excluded. Spearman correlations were performed between four PROMIS domains (Pain interference [PI], Mobility [M], Peer Relationships [PR] and Upper Extremity [UE]) and SRS-22 domains. PROMIS scores are calibrated such that 50 is the median value in a population and 10 points is equivalent to one standard deviation.
Results
986 patients with a mean age of 14.6 years were included, 79.8% of which were female. The mean major curve was 33.0° (range: 10–102). The major curve was thoracic in 56.5%, thoracolumbar in 24.4% and lumbar in 19.1% of subjects. The mean PROMIS domain scores were: Pain Interference 44.5 (IQR 17.7); Mobility 52.7 (IQR 12.5); Peer Relationships 55.7 (IQR 15.0); Upper Extremity 53.4 (IQR 7.7). Correlations existed between PROMIS Pain Interference and SRS-22 pain (r = 0.704, p < 0.001) and PROMIS Mobility and SRS-22 function (r = 0.53, p < 0.001). Significant ceiling effects existed in SRS-22 Function (29.9%), Pain (19.2%) and Satisfaction (30.3%) but only for PROMIS Peer Relationships (42.1%).
Conclusions
PROMIS domain scores for patients with AIS are within normal population limits. PROMIS correlates well with SRS-22 in overlapping domains, and fewer domains demonstrate a ceiling effect. There was no relationship between the magnitude of scoliosis and PROMIS domain scores.
Level of evidence
II.
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All of the below authors made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work. They also drafted the work or revised it critically for important intellectual content. Additionally, they gave final approval of the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Daniel Bouton: Data collection, writing-original draft preparation and approval of the final version of the manuscript, agree to be accountable for the work. Graham Fedorak: Data collection, writing-original draft preparation and approval of the final version of the manuscript, agree to be accountable for the work. Donna Jean Oeffinger: Data collection, writing-original draft preparation and approval of the final version of the manuscript, agree to be accountable for the work. Pernendu Gupta: Data collection, writing-original draft preparation and approval of the final version of the manuscript, agree to be accountable for the work. Scott Luhmann: Data collection, writing-original draft preparation and approval of the final version of the manuscript, agree to be accountable for the work. Peter Stasikelis: Data collection, writing-original draft preparation and approval of the final version of the manuscript, agree to be accountable for the work. Michal Szczodry: Data collection, writing-original draft preparation and approval of the final version of the manuscript, agree to be accountable for the work. Vishwas Talwalkar: Data collection, writing-original draft preparation and approval of the final version of the manuscript, agree to be accountable for the work. Man Hung: Data collection, writing-original draft preparation and approval of the final version of the manuscript, agree to be accountable for the work.
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Daniel Bouton is a consultant for Medtronic. This is not relevant to this manuscript. Graham Fedorak has no relevant conflict of interest. Donna Jean Oeffinger has no relevant conflict of interest. Pernendu Gupta has no relevant conflict of interest. Scott Luhmann has no relevant conflict of interest. Peter Stasikelis has no relevant conflict of interest. Michal Szczodry is a consultant for DePuy-Synthes. This is not relevant to this manuscript. Vishwas Talwalkar has no relevant conflict of interest. Man Hung has no relevant conflict of interest.
Ethics approval/IRB approval
The study was approved by the Shriners Hospitals for Children Institutional Review Board and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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Consent was not obtained for this retrospective study.
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Consent was not obtained for this retrospective study.
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Research performed at Shriners Hospitals for Children.
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Bouton, D., Fedorak, G., Oeffinger, D.J. et al. Baseline patient reported outcome measurement information system (PROMIS) scores in children with idiopathic scoliosis and their relation to the SRS-22. Spine Deform 10, 63–68 (2022). https://doi.org/10.1007/s43390-021-00388-2
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DOI: https://doi.org/10.1007/s43390-021-00388-2