| Sumario: | Background and Purpose: Patient Reported Outcomes Measurement Information System (PROMIS) scales efficiently assess patient problems in multiple generic health domains. The purpose of this study was to describe how scores on 4 PROMIS scales--physical function (PF), pain interference (PI), fatigue, and self-efficacy (SE)-- were used to determine treatment in a group of patients with orthopedic problems. Methods: Patients (n=45) with musculoskeletal pain were administered the PROMIS scales at initial evaluation. Scores were coded for severity to determine a key health domain (PF/PI, fatigue, or SE) that became the priority for treatment. Three case descriptions are presented. Findings: High proportions of PROMIS scores (45-65%) were "mild" or "severe." Only 35.6% of patients fit the PF/PI key health domain, with 35.6% categorized SE and 28.9% fatigue. Cases illustrate a distinct treatment approach for each key health domain. Clinical Relevance: Generic health domains captured by PROMIS provide a new framework for clinical decision-making and patient engagement. The generic health domains provide a quick efficient method to target specific areas of health. Conclusion: Two-thirds of patients with orthopedic diagnoses presented with problems outside of the typical PF/PI domain captured by current patient-reported outcomes. Combining the PF and PI domains was supported by strong convergent validity. Case examples illustrate how identifying key health domains influences patient interactions and clinical decision-making.
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