What Outcomes Are Important for Patients After Pelvic Trauma? Subjective Responses and Psychometric Analysis of Three Published Pelvic-Specific Outcome Instruments
Bibliographic record
Abstract
OBJECTIVE: The measurement of functional outcomes in pelvic fracture patients remains difficult for authors. The authors aimed to test the construct validity, respondent burden, floor and ceiling effects, and patient perception of 3 previously published pelvic outcome questionnaires. DESIGN: Prospective case series. SETTING: Level I Trauma Center. PATIENTS: Those with surgically treated Orthopaedic Trauma Association (OTA) B and C pelvic ring disruption at greater than 12 months after treatment. INTERVENTION: None. MAIN OUTCOME MEASUREMENT: Majeed Pelvic Score, Orlando Pelvic Score, Iowa Pelvis Score, Short Form-36, and Short Musculoskeletal Functional Assessment (SMFA). RESULTS: The authors recruited 38 patients, 15 OTA C and 23 OTA B fractures, who had a mean of 57 months from surgery (13-115 months). Patients cited recreational/mobility difficulty (30), emotional stress and family strain (24), employment and financial difficulty (17), sleep disturbance and anxiety (9), and sexual function (6) as the most important consequences of their injuries. Each of the 3 pelvic outcome questionnaires showed a high correlation with the Physical Component Score of the SF-36, and both indices of the SMFA. None had a high correlation with the Mental Component Score of the SF-36, indicating that these scores do not capture psychologic distress and well-being, social functioning, and overall vitality. All 3 questionnaires demonstrated ceiling effects, with 21%, 18%, and 15% of respondents reporting the highest possible scores on the Iowa, Majeed, and Orlando scores, respectively. The time for completion was 3.6 ± 0.4 minutes for the Iowa score, 7.4 ± 0.4 for the Orlando score (not including radiographic assessment), and 2.6 ± 0.2 for the Majeed score. Fifteen patients preferred the Iowa score, 12 the Orlando score, and 11 the Majeed instrument. CONCLUSIONS: Three previously published pelvic outcome instruments were found to have strong construct validity based on correlation with the Physical Component Score of the SF-36 and both indices of the SMFA. Subjects identified mental and emotional outcomes as important consequences of their injury; however, none of the pelvic questionnaires measure these domains, as they all correlate poorly with the Mental Component Score of the SF-36. Ceiling effects limit the utility of the all 3 current instruments, and their reliability and responsiveness over time remain unknown. No currently available outcome instrument seems to captures all of the important consequences of these injuries.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.039 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".