Patient-Reported Outcome Measures: The Accuracy of Patient-Reported Revision Spinal Surgery

Abstract

Purpose Patient reported outcome measures form a major part of registry data collection and, beyond functional outcome scores, may be uti- lised to establish whether patients have undergone revision spinal surgery and additionally whether this was performed at the same or a different spinal level. Therefore, the aim was to establish the accuracy of patients’ reported revision surgery. Methods 4,237 patients who completed PROMS at 3 months postopera- tively between August 2011 and August 2015 were included in the study. The surgical history of these patients was accessed to com- pare it with the answers obtained from the patients’ questionnaire. Any intervention including revision surgery, management of compli- cations, and spinal injection from the time of the last lumbar surgery to date of the questionnaire were noted and compared with the re- sponses given by patients. Results A number of 4,133 patients reported no further surgeries. 4,128 out of 4,133 patients were truly negative, and 5 were false nega- tive as they had further surgical interventions. 104 patients report- ed revision surgery. 72 patients out of 104 were truly positive and described the correct segment, whereas, the remaining 32 patients were falsely positive. This is because they had no surgeries, spinal injections, or surgery at a different level. Thus, the sensitivity of this question was found to be 93.5%, specificity 99.2%, and accuracy of the question 99.1%. Conclusions This study demonstrates the utility of this question to assess the revision surgery rates in spinal surgery. However, with the lower than expected sensitivity, revision rates may be reported by patients as higher than they actually are