AO Spine Adult Spinal Deformity Patient Profile: A Paradigm Shift in Comprehensive Patient Evaluation in Order to Optimize Treatment and Improve Patient Care.

Abstract

Modified Delphi study. Adult spinal deformity (ASD) is an increasingly recognized condition, comprising a spectrum of pathologies considerably impacting patients' health and functional status. Patients present with a combination of pain, disability, comorbidities and radiological deformity. The study aims to propose a systematic approach of gathering information on the factors that drive decision-making by developing a patient profile. The present study comprises of 3 parts. Part 1: Development of prototype of patient profile: The data from the Core Outcome Study on SCOlisis (COSSCO) by Scoliosis Research Society (SRS) was categorized into a conceptual framework. Part 2: Modified Delphi study: Items reaching >70% agreement were included in a 4 round iterative process with 51 panellists across the globe. Part 3: Pilot testing-feasibility: Content validity and usability were evaluated quantitatively. The profile consisted of 4 <i>domains. <b>1. General health</b></i> with demographics and comorbidities, <b><i>2.Spine-specific health</i></b> with spine related health and neurological status, <b><i>3. Imaging</i></b> with radiographic and MRI parameters and <b><i>4. Deformity type</i></b>. Each domain consisted of 1 or 2 components with various <i>factors</i> and their measuring instruments. Profile was found to have an excellent content validity (I-CVI_r 0.78-1.00; Ave-CVI 0.92) appropriateness, relevance and usefulness. The present study, is first to provide a universally applicable multimodal ASD patient profile to methodically describe patients. Physicians are encouraged to assess ASD patients holistically using this profile and not just based on radiographic findings.