1092 - Performance of PROMIS Global-10 to Legacy Instruments for Rotator Cuff Disease
Notice bibliographique
Résumé
Disclosures: Allen D. Nicholson (N), Hafiz F. Kassam (N), Steven D. Pan (N), Jacob E. Berman (N), Theodore A. Blaine (2-Tornier Company; 3B-Tornier, Zimmer Biomet; 4-Catalyst Orthoscience; 8-AAOS Now, SAGE.), David Kovacevic (8-Journal of Bone & Joint Surgery; 9-American Orthopaedic Association, AAOS.)Introduction: Patient-reported outcome (PRO) instruments are widely used in orthopaedics to measure self-assessed patient function and response to interventions. Recent efforts have focused on developing instruments that decrease patient burden and increase measurement precision. To that end, the NIH developed the Patient-Reported Outcomes Measurement Information System (PROMIS) databank using item-response theory to create a series of publicly available efficient PROs encompassing multiple health domains. Various PROMIS measures have been validated compared to gold-standard PROs for meniscal injury, shoulder arthroplasty, and shoulder instability but little data exist for rotator cuff injury. The PROMIS Global-10 consists of 10 items to assess physical health and mental health as well as provide an estimated EQ-5D score. This instrument has yet to be validated in specific patient cohorts such as rotator cuff pathology. The purpose of this study was to validate the PROMIS Global-10 for rotator cuff disease to gold standard legacy general health, limb-specific and disease-specific PROs. We hypothesized that (1) there is moderate to high correlation between the PROMIS Global-10 and gold standard PROs (ASES, EQ-5D, WORC), (2) PROMIS Global-10 will not show ceiling effects, and (3) estimated EQ-5D scores will show good correlation and low variance with actual EQ-5D scores.Methods: 323 patients with rotator cuff disease were prospectively enrolled before treatment. Each patient completed the PROMIS Global-10, EQ-5D, ASES shoulder assessment form, Single Assessment Numeric Evaluation (SANE), and those with known rotator cuff pathology completed the Western Ontario Rotator Cuff Index (WORC). Spearman correlations were calculated. Bland-Altman Agreement tests were conducted between estimated EQ-5D scores from PROMIS and actual EQ-5D scores. Ceiling and floor effects were assessed, defined as u226515% respondents with highest or lowest possible score. Results: Correlation between PROMIS Global-10 and EQ-5D was excellent (0.70 p<0.0001), as shown in Table 1. Correlation of the PROMIS physical scores was excellent-good with ASES (0.62, p<0.0001), good with WORC (0.47, p<0.0001), and good with SANE (0.41, p<0.0001). Correlation between PROMIS mental scores was poor with ASES (0.34, p<0.0001), WORC (0.32, p=0.0030), and SANE (0.24, p<0.0001). No floor or ceiling effects were found. Bland-Altman 95% limits of agreement for estimated EQ-5D scores ranged from 34% below to 31% above actual EQ-5D scores. Discussion: We validated the PROMIS Global-10 in patients with rotator cuff pathology. We found that (1) there was excellent correlation between the PROMIS Global-10 and EQ-5D, good to excellent correlation of the physical health score with gold standard PROs (ASES, EQ-5D, WORC), and poor correlation of the mental health score with gold standard PROs, (2) PROMIS instruments did not show ceiling effects, (3) PROMIS Global-10 showed decreased question burden compared to WORC, similar question burden compared to ASES, and more question burden than the EQ-5D and SANE, (4) PROMIS Global-10 estimated EQ-5D had good correlation with actual EQ-5D scores but high variance. This suggests PROMIS Global-10 is a reliable tool for outcome assessment in a population with rotator cuff pathology. The large variability in 95% limit of agreement suggests that the estimated EQ-5D scores from the PROMIS Global-10 cannot replace actual EQ-5D scores for economic and cost-effectiveness evaluations. Significance/Clinical Relevance: Considering the PROMIS instruments were created and supported by the NIH, it is likely to be adopted by institutions across the country. Further validation in specific patient populations, such as those with rotator cuff pathology, will allow for longitudinal measurement following medical and surgical interventions.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,020 | 0,042 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,024 | 0,014 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».