Validation of PROMIS-PI in a Lumbar Decompression Cohort Through Correlation to Established Pain and Disability Metrics.

Abstract

Retrospective review. To validate using patient-reported outcome measurement information system-pain interference (PROMIS-PI) to assess outcomes in patients undergoing lumbar decompression surgery compared with well-established pain and disability measures. PROMIS outcomes provide valuable information, but the PROMIS-PI measure has not been validated in lumbar decompression. Patient data from a single-surgeon registry were queried to identify patients undergoing elective, primary lumbar decompression for disc herniation. Exclusion criteria included records missing patient-reported outcome measures (PROMs). PROMs included: PROMIS-PI, visual analog scale (VAS)-back, VAS-leg, and Oswestry disability index (ODI). The association between PROMIS-PI and the other PROMs was determined at preoperative, 6-week, 12-week, 6-month, 1-year, and 2-year time points using the Pearson paired correlation tests. MCID achievement rates were determined for all PROMs and correlations were calculated between PROMIS-PI MCID achievement rates and achievement rates for VAS-B, VAS-L, and ODI. A total of 102 patients were included. PROMIS-PI demonstrated a significant correlation to VAS-B at all periods ( P <0.0048, all) with a magnitude of correlation (| r |) ranging from 0.535 to 0.907. PROMIS-PI demonstrated a significant correlation to VAS-L at all periods ( P <0.0048, all) with a magnitude of correlation (| r |) ranging from 0.393 to 0.907. PROMIS-PI demonstrated a significant correlation to ODI ( P <0.0010, all) with a magnitude of correlation (| r |) ranging from 0.664 to 0.925. There were moderate correlations between MCID achievement rates between PROMIS-PI and all other PROMs studied ( P <0.0019, all) with correlation coefficients ranging from 0.367 to 0.406. PROMIS-PI demonstrated a significant correlation to VAS-back, VAS-L, and ODI metrics at preoperative and all postoperative follow-up periods. PROMIS-PI as a valid tool for the evaluation of patient-reported pain provides an additional metric that can guide pain management in patients undergoing spine surgery.