1092 - Performance of PROMIS Global-10 to Legacy Instruments for Rotator Cuff Disease
Bibliographic record
Abstract
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.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.020 | 0.042 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.024 | 0.014 |
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".