Hiroko Matsumoto1,2, Joshua E Hyman1, Hitesh H Shah3, Wudbhav N Sankar4, Jennifer C Laine5, Charles T Mehlman6, Tim Schrader7, Derek M Kelly8, Scott B Rosenfeld9, Joseph A Janicki10, Mihir M Thacker11, Evan Trupia1, Molly F Mcguire12, Harry K W Kim12,13. 1. Department of Orthopaedic Surgery, Division of Pediatric Orthopaedic Surgery, Columbia University Medical Center. 2. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY. 3. Pediatric Orthopaedics Services, Department of Orthopaedics, Kasturba Medical College, Manipal Academy of Higher education, Manipal, Karnataka, India. 4. Department of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, PA. 5. Gillette Children's Specialty Healthcare, St. Paul, MN. 6. Division of Pediatric Orthopaedic Surgery, Cincinnati Children's Hospital, Cincinnati, OH. 7. Children's Physician Group-Orthopaedics and Sports Medicine, Children's Healthcare of Atlanta, Atlanta, GA. 8. Department of Orthopaedic Surgery, Le Bonheur Children's Hospital/Campbell Clinic, Memphis, TN. 9. Department of Orthopaedic Surgery, Texas Children's Hospital, Houston. 10. Division of Orthopaedic Surgery and Sports Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL. 11. Department of Orthopaedics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE. 12. Texas Scottish Rite Hospital for Children. 13. Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, TX.
Abstract
OBJECTIVES: Patient-reported outcomes (PRO) assessing health-related quality of life (HRQoL) are important outcome measures, especially in Legg-Calvé-Perthes disease (LCPD) where symptoms (pain and limping), activity restrictions, and treatments vary depending on the stage of the disease. The purpose of this study was to investigate the validity of the Patient-reported Outcomes Measurement Information System (PROMIS) for measuring HRQoL of patients with LCPD in various stages of the disease. METHODS: This is a multicenter validity study. Patients with LCPD between 4 and 18 years old were included and classified into modified Waldenström stages of disease: Early (1 or 2A), Late (2B or 3), or Healed (4). Seven PROMIS domains were collected, including Pain Interference, Fatigue, Mobility, Depression, Anger, Anxiety, and Peer Relationships. Convergent, discriminant, and known group validity was determined. RESULTS: A total of 190 patients were included (mean age: 10.4±3.1 y). All 7 domains showed the worst scores in patients in the Early stage (known group validity). Within each domain, all domains positively correlated to each other (convergent validity). Patients who reported more anxiety, depression, and anger were associated with decreased mobility and increased fatigue and pain. Peer relationships had no to weak associations with other domains (discriminant validity). CONCLUSIONS: PROMIS has construct validity in measuring the HRQoL of patients in different stages of LCPD, suggesting that PROMIS has potential to serve as a patient-reported outcome tool for this population. LEVEL OF EVIDENCE: Diagnostic level III study.
OBJECTIVES:Patient-reported outcomes (PRO) assessing health-related quality of life (HRQoL) are important outcome measures, especially in Legg-Calvé-Perthes disease (LCPD) where symptoms (pain and limping), activity restrictions, and treatments vary depending on the stage of the disease. The purpose of this study was to investigate the validity of the Patient-reported Outcomes Measurement Information System (PROMIS) for measuring HRQoL of patients with LCPD in various stages of the disease. METHODS: This is a multicenter validity study. Patients with LCPD between 4 and 18 years old were included and classified into modified Waldenström stages of disease: Early (1 or 2A), Late (2B or 3), or Healed (4). Seven PROMIS domains were collected, including Pain Interference, Fatigue, Mobility, Depression, Anger, Anxiety, and Peer Relationships. Convergent, discriminant, and known group validity was determined. RESULTS: A total of 190 patients were included (mean age: 10.4±3.1 y). All 7 domains showed the worst scores in patients in the Early stage (known group validity). Within each domain, all domains positively correlated to each other (convergent validity). Patients who reported more anxiety, depression, and anger were associated with decreased mobility and increased fatigue and pain. Peer relationships had no to weak associations with other domains (discriminant validity). CONCLUSIONS: PROMIS has construct validity in measuring the HRQoL of patients in different stages of LCPD, suggesting that PROMIS has potential to serve as a patient-reported outcome tool for this population. LEVEL OF EVIDENCE: Diagnostic level III study.
Authors: Sreten Franovic; Collin Schlosser; Eric Guo; Luke Hessburg; Noah A Kuhlmann; Kelechi R Okoroha; Eric C Makhni Journal: Orthop J Sports Med Date: 2021-01-29