PROMIS Physical Function Instruments Compare Favorably to Legacy Patient Reported Outcome Measures in Upper and Lower Extremity Orthopedic Patients: A Systematic Review of the Literature.

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PURPOSE: The purpose of this systematic review is to compare Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) with traditional ("legacy") patient reported outcome measures (PROMs) in regard to correlations, ease of use, and quality criteria for upper (UE) and lower extremity (LE) orthopedic conditions.

METHODS: A systematic search of the PubMed/MEDLINE database was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify published articles that referenced the various PROMIS PF measures. Two authors independently reviewed selected studies. The search returned 857 studies, 85 of which were selected for independent review by two authors. Of these, 54 were selected for inclusion. Mixed linear models were performed to assess for differences between legacy PROMs and PROMIS measures.

RESULTS: The combined sample size of all included studies yielded 6,074 UE and 9,366 LE patients. Overall, PROMIS PF measures demonstrated strong correlations with legacy PROMs among UE (weighted Pearson correlation, 0.624, standard error [SE] = 0.042; weighted Spearman correlation, 0.566, SE = 0.042) and LE patients (weighted Pearson correlation, 0.645, SE = 0.062; weighted Spearman correlation, 0.631, SE = 0.041). PROMIS PF questionnaires completed by UE patients had fewer questions than legacy PROMs (5.9 vs 17.7, P = 0.0093) and were completed in less time (90.5 vs 223.8 seconds, P = 0.084). PROMIS PF questionnaires completed by LE patients had fewer questions than legacy PROMs (4.81 vs 15.33, P < 0.001) and were completed in less time (63.6 vs 203.2 seconds, P = 0.0063). The differences for the reliability measures were not significant.

CONCLUSIONS: PROMIS PF scores correlate strongly with commonly used legacy PROMs in orthopedics, particularly in UE and LE patients. PROMIS PF forms can be administered efficiently and to a broad patient population while remaining highly reliable. Therefore, they can be justified for standardized use among orthopedic patients with UE and LE conditions, improving the ability to aggregate and compare outcomes in orthopedic research.

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ePub ahead of print