====== PROMIS-PF ======

As the focus in [[spine surgery]] has shifted from radiographic to patient-centric [[outcome]]s, [[patient reported outcomes measures]] (PROMs) are becoming increasingly important. They are linked to patient [[satisfaction]], and are used to assess healthcare [[expenditure]], determine [[compensation]] and evaluate [[cost effectiveness]]. Thus, PROMs are important to various [[stakeholder]]s, including [[patient]]s, [[physician]]s, [[payer]]s and healthcare [[institution]]s. Thus, it is vital to establish methods to interpret and evaluate these [[outcome measure]]s.

To evaluate the correlation between [[Neck Disability Index]] (NDI), [[Patient Reported Outcome Measurement Information System Physical Function]] (PROMIS-PF) and [[Short Form-12 Physical Health Score]] (SF-12 PHS) in [[cervical spine surgery]] in order to determine the validity of [[PROMIS-PF]] in these patients.

Retrospective review of prospectively collected data PATIENT SAMPLE: Consecutive patients who underwent cervical surgery for degenerative spinal pathology with a minimum of 3 months follow-up OUTCOME MEASURES: Self-reported measures i.e. PROMs, including NDI, PROMIS-PF and SF-12 PHS METHODS: No funding was received for this study. The authors report no relevant conflict of interest. PROM collected pre-operatively and at each follow-up were analyzed using Pearson product-moment correlation.

Of the 121 patients included, 66 underwent [[ACDF]], 42 [[cervical]] [[disc replacement]], 13 [[posterior cervical decompression]] with or without [[fusion]]. A statistically significant improvement was achieved in all PROMs by 6 weeks and maintained at 1 year. Furthermore, the percentage of patients achieving an improvement greater than MCID was similar for NDI and PROMIS-PF, particularly at a follow-up of 3 months or more. A statistically significant negative correlation was seen between [[NDI]] and PROMIS-PF, which was moderate pre-operatively and in the early post-operative period (r= - 0.565 to -0.600), and strong at 3 months or longer follow-up (r=-0.622 to -0.705). A statistically significant, negative correlation was also seen between [[SF-12 PHS]] and NDI, which was moderate pre-operatively and at 6 weeks (r=-0.5551 to -0.566); and strong at all other time-points (r=-0.678 to -0.749). There was a statistically significant positive correlation between SF-12 PHS and [[PROMIS-PF]], which was strong to very-strong at all time-points (r=0.644 to 0.822), except at 2 weeks (r=0.570).

While [[NDI]] and [[SF-12]] have been used for several years, [[PROMIS]] is a new outcome measure that is increasingly being implemented. The results of this study demonstrate the convergent and discriminant validity of [[PROMIS-PF]], supported by the strong correlation between [[SF-12 PHS]] and [[PROMIS-PF]] at all time-points and the moderate correlation between NDI and PROMIS-PF pre-operatively and in the early post-operative period, respectively. Thus, while PROMIS-PF may not be a good surrogate for disease-specific outcome measures, it may extend value as a precise and efficient general health tool
((Vaishnav AS, Gang CH, Iyer S, McAnany S, Albert T, Qureshi SA. Correlation
between NDI, PROMIS and SF-12 in Cervical Spine Surgery. Spine J. 2019 Oct 31.
pii: S1529-9430(19)31063-0. doi: 10.1016/j.spinee.2019.10.017. [Epub ahead of
print] PubMed PMID: 31678044.
)).