Can Only 4 Questions Yield Meaningful Patient Outcome Measures?

Guy and Computer for PROMIS O'Buzz.jpgIn today’s data-driven, evidence-based world of orthopaedics, capturing accurate information about a patient’s physical function can require patients to answer dozens of separate questions. In the June 7, 2017 edition of JBJS, Hancock et al. investigate whether the computer-based tool called PROMIS (Patient-Reported Outcomes Measurement Information System) PF CAT is more efficient than and just as reliable as the more burdensome function-evaluation instruments.

In short, the answer is yes. Among a group of otherwise healthy patients scheduled to undergo meniscal surgery, the PROMIS PF CAT scores were generally highly correlated with traditional patient-reported physical-function measures, such as the SF-36 Physical Function instrument and the KOOS Sport and Quality-of-Life scores.

In contrast to the more traditional fixed-length questionnaires, the PROMIS PF CAT presents an initial item to the patient, and uses the response to that to select the most informative next item. That process continues only until a predefined level of precision is reached, at which point the test ends. The vast majority (89%) of the patients in this study completed the PROMIS PF CAT after answering only four items.

Considering its strong correlation with other widely accepted measurement tools and its efficiency, the authors conclude that PROMIS PF CAT “may be a good alternative for evaluating physical function in meniscal injury populations,” and that it could help “reduce burnout and maintain high response rates” in a time-constrained health care environment.

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