目的:比较骨科创伤患者伤前至1年恢复的患者报告结果测量信息系统身体功能(PROMIS-PF)与36项简表调查身体成分评分(SF36-PCS)的反应性。
方法:在1级创伤中心进行前瞻性队列研究。
方法:18岁以上骨盆骨科外伤患者,2017年至2018年之间的下肢或上肢。
方法:在基线时进行PROMIS-PF和SF36-PCS评估,3个月,6个月和12个月。通过计算标准化响应平均值(SRM),在时间点之间评估每种测量的响应性。超过最小临床重要差异(MCID)的患者比例,以及地板和天花板效果。
结果:包括68名在每个时间点完成评估的患者:平均年龄44.7岁,39名男性,平均损伤严重度评分(ISS)为7.4(范围:4-16)。SF-36在所有时间点的平均完成时间为5.6分钟,而PROMIS-PF为1.7分钟(p<0.01)。在所有时间点的测量之间的SRM是相当的。尽管在所有时间点之间有更大比例的患者获得SF36-PCS的MCID,这在6个月和12个月评估之间仅接近统计学意义(47.1%vs33.8%;p=0.15).PROMIS-PF在基线和12个月评估时显示出显著的上限效应,34例(50.0%)患者和7例(10.3%)患者在每个时间点达到最大评分,分别。
结论:PROMIS-PF具有更有利的应答者负担,其基于较低的完成时间和与SF-36PCS相当的应答性。然而,在基线损伤前和损伤后12个月时,天花板效应证明功能较高的患者对PROMIS-PF的反应性存在局限性.
OBJECTIVE: To compare the responsiveness of the Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF) to the 36-Item Short Form Survey Physical Component Score (SF36-PCS) in orthopaedic trauma patients from pre-injury to one year recovery.
METHODS: Prospective cohort study at a Level 1 trauma centre.
METHODS: Patients over the age of 18 with orthopaedic trauma injuries to the pelvis, lower extremity or upper extremity between 2017 and 2018.
METHODS: The PROMIS-PF and SF36-PCS assessments were conducted at baseline, 3 months, 6 months and 12 months. Responsiveness of each measure was assessed between time points by calculating the standardized response mean (SRM), the proportions of patients exceeding minimal clinically important difference (MCID), and the floor and ceiling effects.
RESULTS: Sixty-eight patients with completed assessments at every timepoint were included: mean age 44.7 years, 39 were male and mean Injury Severity Score (ISS) was 7.4 (range: 4-16). Mean time of completion for the SF-36 at all the time points was 5.6 min vs 1.7 min for the PROMIS-PF (p<0.01). The SRM was comparable between measures at all the time points. Although a greater proportion of patients achieved MCID for SF36-PCS between all the time points, this only approached statistical significance between the 6- and 12-month assessments (47.1% vs 33.8%; p = 0.15). There was a significant ceiling effect demonstrated with the PROMIS-PF at baseline and 12-month assessments, with 34 (50.0%) patients and 7 (10.3%) patients achieving the maximum scores at each time point, respectively.
CONCLUSIONS: PROMIS-PF has a more favourable responder burden based on lower time to completion and comparable responsiveness to the SF-36 PCS. However, there are limitations in responsiveness with the PROMIS-PF in patients who are higher functioning as demonstrated by the ceiling effects in patients at baseline pre-injury and at 12 months post-injury timepoints.