Evaluation of PROMIS Scores 6 Weeks after Conservative Management of Carpometacarpal Thumb Arthritis

Patient-reported outcome measures are being increasingly emphasized to assign value to care‚ given the current trend toward pay-for-performance healthcare. We sought to determine if the Patient-reported Outcomes Measurement Information System (PROMIS), a general questionnaire, is sensitive enough to detect improvement after corticosteroid injection or splinting/hand therapy for thumb carpometacarpal (CMC) arthritis. METHODS: This is a retrospective study analyzing two groups with thumb CMC arthritis: 88 patients who received splinting/hand therapy and 6-week follow-up and 70 patients with steroid injection and 6-week follow-up. PROMIS Physical Function (PF), Pain Interference (PI), Depression, and Upper Extremity (UE) scores were collected at each visit. We used paired t-tests to compare 6-week follow-up scores to baseline scores within each group. RESULTS: The mean age for the steroid injection group was 60.1 years old, and it was 61.8 years old for the returning splinting/hand therapy group. There were no significant differences in PROMIS PF, PI, Depression, or UE scores for patients who returned after 6 weeks of treatment with splinting/hand therapy. Moreover, at 6 weeks postinjection, PROMIS PF and UE scores marginally increased, whereas PI and Depression scores decreased with statistical significance. CONCLUSIONS: Hand surgeons should be aware of the limitations of PROMIS when evaluating patients after conservative treatment for thumb CMC arthritis. There were no significant differences in PROMIS scores for patients with thumb CMC arthritis who returned after receiving splinting/hand therapy for 6 weeks. Meanwhile, PI scores can be used primarily to monitor for improvement after steroid injection for thumb CMC arthritis.