Luke Sang, Sarah Coufal, Ishaan Swarup, Sanjeev Sabharwal
{"title":"小儿下肢差异患者LLRS-AIM指数与LD-SRS和promise的相关性","authors":"Luke Sang, Sarah Coufal, Ishaan Swarup, Sanjeev Sabharwal","doi":"10.1097/BPO.0000000000002916","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to assess the reliability of the Limb Lengthening and Reconstruction Society AIM (LLRS-AIM) index, a scale for grading the severity of lower limb deformities by the physician, and its concordance with 2 patient-reported outcome measures, the Limb Deformity-Scoliosis Research Society (LD-SRS) and Patient-Reported Outcomes Measurement Information System (PROMIS) tools in pediatric patients with lower limb differences.</p><p><strong>Methods: </strong>This was a retrospective review of patients 18 years old or younger who presented to our institution with lower limb differences for surgical reconstruction between 2019 and 2024. All patients received the LD-SRS and PROMIS for completion before surgery. The LLRS-AIM index for patients was assessed by 2 independent evaluators, with intraclass correlation coefficients (ICCs) calculated to determine inter-rater agreement. Spearman correlations were performed between the LLRS-AIM Index with all LD-SRS and PROMIS domains. The Benjamini-Hochberg procedure was conducted to reduce the false discovery rate.</p><p><strong>Results: </strong>A total of 81 patients were included in this study. The LLRS-AIM Index had good and near-perfect inter-rater reliability across different levels of medical training (ICC=0.9). Overall, there were no correlations between the LLRS-AIM Index with LD-SRS and PROMIS domains (LD-SRS function: P=-0.26, P=0.18; PROMIS pain interference: P=0.10, P=0.63). Mental health-related LD-SRS and PROMIS domains showed no correlations with the physician-reported LLRS-AIM index (LD-SRS self image: P=0.10, P=0.63; PROMIS depression: P=-0.05, P=0.63).</p><p><strong>Conclusions: </strong>There is a high level of reproducibility for the LLRS-AIM index to evaluate the complexity of lower limb differences in pediatric patients. However, there are no correlations between the LLRS-AIM index with LD-SRS and PROMIS across all relevant domains. Further modifications to the LLRS-AIM index criteria and scoring weights may allow it to better assess patient outcomes in the pediatric population.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":"45 5","pages":"e457-e463"},"PeriodicalIF":1.4000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Correlation of the LLRS-AIM Index With LD-SRS and PROMIS in Pediatric Patients With Lower Limb Differences.\",\"authors\":\"Luke Sang, Sarah Coufal, Ishaan Swarup, Sanjeev Sabharwal\",\"doi\":\"10.1097/BPO.0000000000002916\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The purpose of this study was to assess the reliability of the Limb Lengthening and Reconstruction Society AIM (LLRS-AIM) index, a scale for grading the severity of lower limb deformities by the physician, and its concordance with 2 patient-reported outcome measures, the Limb Deformity-Scoliosis Research Society (LD-SRS) and Patient-Reported Outcomes Measurement Information System (PROMIS) tools in pediatric patients with lower limb differences.</p><p><strong>Methods: </strong>This was a retrospective review of patients 18 years old or younger who presented to our institution with lower limb differences for surgical reconstruction between 2019 and 2024. All patients received the LD-SRS and PROMIS for completion before surgery. The LLRS-AIM index for patients was assessed by 2 independent evaluators, with intraclass correlation coefficients (ICCs) calculated to determine inter-rater agreement. Spearman correlations were performed between the LLRS-AIM Index with all LD-SRS and PROMIS domains. The Benjamini-Hochberg procedure was conducted to reduce the false discovery rate.</p><p><strong>Results: </strong>A total of 81 patients were included in this study. The LLRS-AIM Index had good and near-perfect inter-rater reliability across different levels of medical training (ICC=0.9). Overall, there were no correlations between the LLRS-AIM Index with LD-SRS and PROMIS domains (LD-SRS function: P=-0.26, P=0.18; PROMIS pain interference: P=0.10, P=0.63). Mental health-related LD-SRS and PROMIS domains showed no correlations with the physician-reported LLRS-AIM index (LD-SRS self image: P=0.10, P=0.63; PROMIS depression: P=-0.05, P=0.63).</p><p><strong>Conclusions: </strong>There is a high level of reproducibility for the LLRS-AIM index to evaluate the complexity of lower limb differences in pediatric patients. However, there are no correlations between the LLRS-AIM index with LD-SRS and PROMIS across all relevant domains. Further modifications to the LLRS-AIM index criteria and scoring weights may allow it to better assess patient outcomes in the pediatric population.</p><p><strong>Level of evidence: </strong>Level III.</p>\",\"PeriodicalId\":16945,\"journal\":{\"name\":\"Journal of Pediatric Orthopaedics\",\"volume\":\"45 5\",\"pages\":\"e457-e463\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Pediatric Orthopaedics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/BPO.0000000000002916\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/9 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatric Orthopaedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BPO.0000000000002916","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/9 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Correlation of the LLRS-AIM Index With LD-SRS and PROMIS in Pediatric Patients With Lower Limb Differences.
Background: The purpose of this study was to assess the reliability of the Limb Lengthening and Reconstruction Society AIM (LLRS-AIM) index, a scale for grading the severity of lower limb deformities by the physician, and its concordance with 2 patient-reported outcome measures, the Limb Deformity-Scoliosis Research Society (LD-SRS) and Patient-Reported Outcomes Measurement Information System (PROMIS) tools in pediatric patients with lower limb differences.
Methods: This was a retrospective review of patients 18 years old or younger who presented to our institution with lower limb differences for surgical reconstruction between 2019 and 2024. All patients received the LD-SRS and PROMIS for completion before surgery. The LLRS-AIM index for patients was assessed by 2 independent evaluators, with intraclass correlation coefficients (ICCs) calculated to determine inter-rater agreement. Spearman correlations were performed between the LLRS-AIM Index with all LD-SRS and PROMIS domains. The Benjamini-Hochberg procedure was conducted to reduce the false discovery rate.
Results: A total of 81 patients were included in this study. The LLRS-AIM Index had good and near-perfect inter-rater reliability across different levels of medical training (ICC=0.9). Overall, there were no correlations between the LLRS-AIM Index with LD-SRS and PROMIS domains (LD-SRS function: P=-0.26, P=0.18; PROMIS pain interference: P=0.10, P=0.63). Mental health-related LD-SRS and PROMIS domains showed no correlations with the physician-reported LLRS-AIM index (LD-SRS self image: P=0.10, P=0.63; PROMIS depression: P=-0.05, P=0.63).
Conclusions: There is a high level of reproducibility for the LLRS-AIM index to evaluate the complexity of lower limb differences in pediatric patients. However, there are no correlations between the LLRS-AIM index with LD-SRS and PROMIS across all relevant domains. Further modifications to the LLRS-AIM index criteria and scoring weights may allow it to better assess patient outcomes in the pediatric population.
期刊介绍：
Journal of Pediatric Orthopaedics is a leading journal that focuses specifically on traumatic injuries to give you hands-on on coverage of a fast-growing field. You''ll get articles that cover everything from the nature of injury to the effects of new drug therapies; everything from recommendations for more effective surgical approaches to the latest laboratory findings.
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