PROMIS CAT Outperforms Legacy Measures and Demonstrates Patient Health Domain Normalization at Minimum Two-Year Follow-Up After Adult Spine Deformity Surgery
Bibliographic record
Abstract
STUDY DESIGN: Prospective, multicenter analysis. OBJECTIVE: Evaluate preoperative and minimum two-year postoperative health-related quality of life (HRQOL) outcomes for adult spine deformity (ASD) using legacy HRQOL measures and computer adaptive testing (CAT) version of the patient-reported outcome measurement information system (PROMIS). SUMMARY OF BACKGROUND DATA: PROMIS is the NIH recommended measure for patient-reported outcomes. No data exists evaluating minimum two-year ASD surgical outcomes using PROMIS CAT compared with legacy HRQOL measures. MATERIALS AND METHODS: ASD patients above 18 years of age were enrolled into a prospective, multicenter, observational study. Patients were administered legacy HRQOLs (SRS-22r, ODI, NRS back and leg pain, VR-12) and PROMIS CAT for Pain Interference, Physical Function, Satisfaction with Participation in Social Roles, Satisfaction with Participation in Discretionary Social Activities, Depression, and Anxiety. Preoperative and minimum two-year postoperative HRQOL scores were compared and ASD PROMIS scores were compared with general population PROMIS values. RESULTS: One hundred forty-four of 190 patients had complete data at minimum two-year follow-up. Mean preoperative values included: age=62.6 years, scoliosis=34.2°, SVA=74.2 mm, PI-LL=16.7. At mean 2.3-year follow-up surgical treatment improved spine alignment (scoliosis=14.7°, SVA=34.5 mm, and PI-LL=4.5°; P <0.0001). All legacy HRQOL and PROMIS scores improved from preoperative to minimum two-year postoperative ( P <0.005). Referencing PROMIS scores to normative values demonstrated 50% to 85% of ASD patients preoperatively reported moderate-severe deficits in all domains. At minimum two-year postoperative 52% to 88% of ASD patients reported normal values-mild deficits in all PROMIS domains. PROMIS social health domains demonstrated the greatest improvement. CONCLUSION: This is the first study evaluating minimum two-year ASD surgical outcomes using PROMIS CAT. ASD patients demonstrated postoperative improvements in all PROMIS health domains, with the social health domains improving most. The majority of ASD patients reported normal PROMIS values at minimum two years postoperative.
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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 | 0.008 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 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".