Correlation of PROMIS CAT with Validated Hip Outcome Scores in Patients Undergoing Hip Arthroscopy

Abstract

Objectives: Patient reported outcomes (PRO) following surgery is vital to determining treatment efficacy and is valuable for executing comparative trials. Traditional legacy measures used to assess outcomes of patients undergoing arthroscopic hip surgery have included the modified Harris Hip Score (mHHS), the Non-arthritic Hip Score (NAHS) and the Hip Outcome Score (HOS), among others. Each of these PROs have been touted for specific advantages and criticized for certain limitations. In addition, clinical results documented for each of these PROs cannot be easily compared with those from other measures employed in patients undergoing different procedures in varying anatomic locations. The Patient Reported Outcomes Measurement Information System (PROMIS) tool was developed by the National Institute of Health to provide efficient, precise and valid patientreported outcome data. While PROMIS has been broadly utilized due to its efficiency and generalizability, it has not yet been validated among patients undergoing hip arthroscopy. The purpose of this study was to determine whether the PORMIS Computer Adaptive Testing (CAT) tool demonstrates validity against commonly used legacy PRO measures among a population of patients undergoing arthroscopic hip surgery. Methods: A consecutive series of patients undergoing elective arthroscopic hip surgery at a single academic medical center from 4/22/15 to 3/11/16 were prospectively enrolled into an IRB approved. Patients who were under the age of 18 or who had undergone previous open or arthroscopic hip surgery were excluded. Eligible patients completed a series of outcome questionnaires including the visual analog pain scale (VAS), a hip outcome score (HOS; ADL and Sports Subscales), modified harris hip (mHHS), and non-arthritic hip score (NAHS) as well as the PROMIS CAT for pain, physical function and emotional distress (depression). Patients completed all questionnaires at their preoperative evaluation and at regular postoperative intervals (1 week, 6 weeks, 3 months). Outcome measure scores compared via the Pearson product correlation coefficient. Results: A total of 77 patents elected to be included in this study, 28 (36.8%) were male and 49 (64.5%) were female. The average age of study participants was found to be 38 years (range 18-69). With regards to questionnaire completion, data from all patient reported outcome measures were gathered from 77 patients at their preoperative clinical visit, 71 during their first postoperative follow up, 69 at 6 weeks and 58 at 3 months postoperatively. Pearson correlations between PROMIS Physical Function T scores and the HOS ADL, HOS Sports, NAHS and mHHS were found to be 0.858, 0.799, 0.773 and 0.830 respectively. With regards to pain, the Pearson correlation between the PROMIS Pain T score and the VAS for pain was found to be 0.599. Conclusion: The PROMIS tool was found to correlate well with current standards for patient reported outcome measures for individuals undergoing arthroscopic hip surgery. PROMIS Physical Function demonstrated high correlation with validated PRO. PROMIS Pain had moderate correlation with VAS Pain scores. With this information, the PROMIS tool can be used as a highly efficient and generalizable tool to collect pre- and postoperative data during clinical patient encounters.