Application of PROMIS scores in patients with non-arthritic hip pain presenting to sports medicine clinic
Bermudez A, Franovic S, Moeller J, and Makhni EC. Application of PROMIS scores in patients with non-arthritic hip pain presenting to sports medicine clinic. Clin J Sport Med 2019; 29(2):154.
Clin J Sport Med
Purpose: The use of PROMIS as a standardized clinical outcome metric is rapidly growing and we hope to drive its applicability forward by defining expected PROMIS domain values in patients presenting with subjective hip pain and identifying which patient-centric factors may influence these ranges. Methods: From June 2017 to July 2018, all patients presenting with hip-related pain to a fellowship-trained sports medicine surgeon were retrospectively reviewed. Patient-reported outcomes from pre- and non-operative patients were collected by way of 3 PROMIS CAT forms: Physical Function (PF), Pain Interference (PI) and Depression (DE). Patient demographic data was used in analysis of PROMIS scores. Results: Two hundred fifty-two patients (156 female) met our inclusion criteria and completed all 3 PROMIS CAT forms (aged 14-78; average age 40.9). Mean PROMIS PF, PI and DE were 40.77 ± 7.1, 61.51 ± 6.4, and 49.7 ± 9.3, respectively (Ave ± SD). Significant differences were measured between populations below and above our median age (39.72) in all 3 domains (P = 0.000). Females under 40 years of age showed significantly lower PF scores (t = 23.06, P = 0.0027) and higher PI scores (t = 2.36, P = 0.0134) than males under 40 years old. PI showed a strong, inverse correlation with PF (R = 20.802, P = 0.000). No appreciable correlation was found between pre- and non-operative PROMIS values and socioeconomic status (median household income), race, ethnicity, employment status, or smoking status. Conclusions: In patients with hip pain, PROMIS CAT scores are significantly affected by patient age and gender. Furthermore,PI plays an important role inthe variability ofPF scores and is shown to strongly influence the PF domain among all populations observed. These discoveries help establish values unique to patients' sex and age in order to improve the assessment of injury severity and recovery protocol. Significance: In evaluating patients with hip pain utilizing PROMIS domains, values should be congruent with the patients' age and sex to aid in accurately assessing the necessity, or lack thereof, for operative intervention in utilizing respective reference ranges.