Does Multidimensional Health Assessment Using PROMIS Scales Enhance Clinical Decision-making for Patients with Orthopedic Problems? A Case Series.

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, a...

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Published in:Orthopedic Physical Therapy Practice Vol. 30; no. 4; pp. 528 - 537
Main Authors: Jacobson, Ryan, Philbrook, Li-Zandre, Dan Kang, Cuddeford, Tyler, Houck, Jeff
Format: case study pictorial research tables/charts Journal Article
Published: Orthopaedic Section, APTA, Inc. 2018
Online Access:View this record in EBSCOhost
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      dt: 2018
      vid: 30
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      pub: Orthopaedic Section, APTA, Inc.
      place: La Crosse, Wisconsin
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        atl: Does Multidimensional Health Assessment Using PROMIS Scales Enhance Clinical Decision-making for Patients with Orthopedic Problems? A Case Series.
      aug:
        au:
          Jacobson, Ryan
          Philbrook, Li-Zandre
          Dan Kang
          Cuddeford, Tyler
          Houck, Jeff
        affil: George Fox University, Newberg, OR
      sug:
        subj:
          Decision Making, Clinical
          Musculoskeletal Diseases
          Multidimensional Scaling
          Low Back Pain Rehabilitation
          Human
          Female
          Young Adult
          Adult
          Middle Age
          Oregon
          Orthopedic Care
          Scales
          Descriptive Statistics
          Pearson's Correlation Coefficient
          Hypothesis
          Qualitative Studies
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
      ab: 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.
      pubtype: Periodical
      doctype:
        case study
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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