Prospective Validation of Patient-Reported Outcomes Measurement Information Systems (PROMIS) CAT Scores in a Hip Preservation Population

OBJECTIVES: Current Hip Patient Reported Outcome Scores (PROs) are not universally obtained, centers use different forms to try to interpret treatment outcomes, and are limited by floor and ceiling effects. Legacy scores of Modified Harris Hip Score (mHHS), International Hip Outcome Tool (iHOT), and Hip Outcomes Score (HOS) are common place and used in the literature. Patient compliance for legacy PROs have been shown to limit proper data collection. PROMIS measures were developed through NIH funding, vetted against a population norm and PROMIS Computer Adaptive Testing (CAT) has been shown in recent literature to compare well with knee and shoulder legacy scores, and are completed in a quicker amount of time. We hypothesize that in a hip preservation population, the CAT PROMIS Profile V2.0 and PROMIS physical function (PF) would show high correlation with legacy scores of (mHHS, iHOT, and HOS). METHODS: After obtaining IRB approval, power analysis revealed 86 patients were needed to detect a significant difference. 100 patients were prospectively enrolled. Patients were asked to complete the iHOT-12, mHHS, HOS and then complete the CAT PROMIS Profile v 2.0. Inclusion criteria for the current study included all Initial encounter and single follow-up patients that have completed the CAT portion and started the legacy scores before opting out. Exclusion criteria will be any patient with a repeat encounter, patients under the age of 18 or a patient that did not complete the legacy or CAT scores. Repeat encounters were excluded due to statistical analysis assuming independence among observers. Correlation between instruments was defined as excellent (>0.7), excellent-good (0.7-0.61), good (0.6-0.4), and poor (0.3-0.2). RESULTS: Demographics of 75 females and 25 males, mean BMI 26.3, and mean age 36.1 (range 18-67). The PROMIS Physical function, Pain Intensity, and Ability to Participate in Social Roles showed excellent correlation with the iHOT-12 (r=0.71 P<0.001), mHHS (r=0.8 P<0.001) and HOS (r=0.82 P<0.001). Patients averaged 21.6 questions to complete all seven arms of the PROMIS Profile. No patient experienced a ceiling effect utilizing the PROMIS Profile CAT. CONCLUSION: The PROMIS Profile allows for an in-depth look at patients’ dysfunction, not asked in current legacy scores. The PROMIS Physical function and Pain Intensity show excellent correlation with iHOT-12, mHHS and HOS. The CAT PROMIS Profile, shows no observed ceiling effect and can be considered to replace current legacy measures in hip preservation.