Concurrent Validity and Comparative Responsiveness of PROMIS-SF Versus Legacy Measures in the Cervical and Lumbar Spine Population: Longitudinal Analysis from Baseline to Postsurgery.

Abstract

The aim of our study was to evaluate the change in Patient-Reported Outcome Measurement Information System (PROMIS) scores at baseline, 3 months, and 12 months postprocedure and correlate with legacy measures. We analyzed patients in 3 cohorts: lumbar, cervical, and the pooled cohort from our database, 2014-2017. Outcome variables were PROMIS items of pain interference, emotional distress and physical function, EuroQol 5 dimensions, visual analog scale, Oswestry Disability Index/Neck Disability Index, back, leg/neck and arm pain scales, and Patient Satisfaction Index. Patients with lumbar and cervical diseases constituted 55.3% (n = 52) and 44.7% (n = 42) of patients, respectively. There was a significant change in median PROMIS pain interference (65.5 to 57.6), anxiety (56.3 to 48.4), depression (51.2 to 37.1), and physical function (37.2 to 42.6) at baseline and 3 months, respectively. Similarly, change in these scores from baseline to 12 months was significant (n = 48). Compared with change in median Neck Disability Index and Oswestry Disability Index from baseline to 12 months (24.0 to 10.0; P = 0.0004 and 19.0 to 10.0; P < 0.0001), change in median PROMIS physical function score in the same cohort was 38.7 to 45.4 (P = 0.0025) and 37.2 to 41.8 (P < 0.0001), respectively. There was significant correlation between PROMIS pain interference/physical function and the legacy measures at 3 months. PROMIS items correlated with legacy measures at baseline and postsurgery. Patients undergoing spine surgery improved in their patient-reported outcomes from baseline to 3 months after surgery and the gain were maintained at 12 months.