关节镜下肩袖修复术后增加 PROMIS 疼痛工具是否能提高 PROMIS 上肢评分的灵敏度？

IF 2.9 2区医学 Q1 ORTHOPEDICS

Journal of Shoulder and Elbow Surgery Pub Date : 2025-02-01 DOI:10.1016/j.jse.2024.06.002

Matthew G. Alben DO , Paul V. Romeo MD , Aidan G. Papalia DO, MBA , Andrew J. Cecora BS , Young W. Kwon MD, PhD , Andrew S. Rokito MD , Joseph D. Zuckerman MD , Mandeep S. Virk MD

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引用次数: 0

摘要

导言：虽然患者报告结果测量信息系统（PROMIS）上肢（P-UE）已在上肢矫形术中得到验证，但在术后早期，该系统捕捉患者在关节镜下肩袖修复术（aRCR）后功能恢复情况的能力（通过其反应性来衡量）却微乎其微。本研究的主要目的是确定在 PROMIS UE 中添加 PROMIS 疼痛强度（P-Intensity）或疼痛干扰（P-Interference）评分是否能改善肩袖修复术后一年内的反应性：这项前瞻性纵向研究包括 100 名接受 aRCR 的患者。患者在术前和术后 2 周、6 周、3 个月、6 个月和 12 个月分别完成了 P-UE、P-Interference、P-Intensity、美国肩肘外科医生（ASES）和西安大略肩袖指数（WORC）评分。每个时间点相对于术前基线的反应性，对每个 PROM 进行单因素方差分析和事后分析。结果评分的反应性采用效应大小（ES）来确定，效应大小分为小（0.2）、中（0.5）或大（0.8）。在每个时间点确定这些工具之间的皮尔逊相关系数（r）：结果：单独使用 P-UE、P-Interference 和 P-Intensity，在术后一年内检测变化（阳性和阴性）的能力为中-大。在 P-UE 中加入 PROMIS 疼痛评分后，从 3 个月开始并在 12 个月的随访期间，该工具的反应性得到了提高（从中等效应大小提高到较大效应大小）。虽然增加疼痛评分会增加 PROMIS 的响应负担，但与传统结果评分的响应负担相比，响应负担仍然较低（p 结论：在接受 aRCR 的患者中增加 PROMIS 疼痛工具可提高 P-UE 功能评分的响应能力。

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Does the addition of Patient-Reported Outcome Measure Information System (PROMIS) pain instruments improve the sensitivity of PROMIS upper extremity scores after arthroscopic rotator cuff repair?

Background

Although Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (P-UE) has been validated in upper extremity orthopedics, its ability to capture a patient’s functional recovery after arthroscopic rotator cuff repair (aRCR), as measured by its responsiveness, is minimal in the early postoperative period. The primary purpose of this study is to determine if the addition of PROMIS Pain Intensity (P-Intensity) or Pain Interference (P-Interference) scores to PROMIS UE improves the responsiveness throughout the 1-year postoperative period after aRCR.

Methods

This prospective, longitudinal study included 100 patients who underwent aRCR. Patients completed P-UE, P-Interference, P-Intensity, American Shoulder and Elbow Surgeons, and Western Ontario Rotator Cuff Index scores preoperatively and at 2 weeks, 6 weeks, 3 months, 6 months, and 12 months after surgery. Responsiveness at each time point relative to preoperative baseline and 1-way analysis of variance with post hoc analysis was conducted for each PROM. The responsiveness of the outcome score was determined using the effect size, graded as small (0.2), medium (0.5), or large (0.8). The Pearson correlation coefficient (r) was determined between these instruments at each time point.

Results

In isolation, P-UE, P-Interference, and P-Intensity showed a medium-large ability to detect change (positive and negative) throughout the 1-year postoperative period. The addition of PROMIS pain scores to P-UE improved the responsiveness of the instrument (from medium to a large effect size) starting at 3 months and continued throughout the 12-month follow-up period. Although the addition of pain scores increases the response burden for PROMIS, this was still lower than the response burden for the legacy outcome scores (P < .05).

Conclusion

The addition of PROMIS pain instruments improves the responsiveness of the P-UE function score in patients undergoing aRCR.

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来源期刊

Journal of Shoulder and Elbow Surgery 医学-外科

CiteScore

6.50

自引率

23.30%

发文量

604

审稿时长

11.2 weeks

期刊介绍： The official publication for eight leading specialty organizations, this authoritative journal is the only publication to focus exclusively on medical, surgical, and physical techniques for treating injury/disease of the upper extremity, including the shoulder girdle, arm, and elbow. Clinically oriented and peer-reviewed, the Journal provides an international forum for the exchange of information on new techniques, instruments, and materials. Journal of Shoulder and Elbow Surgery features vivid photos, professional illustrations, and explicit diagrams that demonstrate surgical approaches and depict implant devices. Topics covered include fractures, dislocations, diseases and injuries of the rotator cuff, imaging techniques, arthritis, arthroscopy, arthroplasty, and rehabilitation.