These authors sought to correlate the Patient Reported Outcomes Measurement Information System Upper Extremity (PROMIS UE) score with preexisting validated outcomes scores, American Shoulder and Elbow Surgeons score (ASES), and Constant score (CS) in patients with idiopathic adhesive capsulitis (AC).
The final cohort included 100 patients with AC of which there were 72% female and 87% right hand dominant, with a mean age of 55 years.
The PROMIS UE required fewer question responses (5.02 ±1.84) compared to the fixed questions burden with ASES (12) and CS (9).
The PROMIS UE displayed excellent correlation with both the ASES (r = 0.80, 95% [CI:20 0.72, 0.86], p < 0.001) and CS (r = 0.76, 95% CI [0.67, 0.83], p < 0.001).
Neither ceiling nor floor effects were present.
The authors concluded that "the PROMIS UE displayed comparable efficacy to commonly used legacy outcome scores (ASES and CS) in adhesive capsulitis. A lower question burden with the PROMIS UE carries a potential for wider acceptibility with the researchers and patients with shoulder pathology"
Comment: Reports on the use of PROMIS need to examined in the light of "what question should we be asking?" The wonderful benefit of simple patient reported outcome measures (ASES, Simple Shoulder Test), is that they are inexpensive and easily accessible to patients in clinic and at their homes (mail, email, on line) so that long term followup of the maximal number of patients is facilitated.
The Constant score fails in these regards because clinical measurements are required using a goniometer and dynamometer which mandate that the patient return to the office for examination.
The PROMIS system also fails in these regards because access to a computer and training in the use of the system is required, both of which factors may interfere with patient participation.
The observation that the PROMIS approach reduces the "question burden" from 12 to 5 does not offset its "access burden".
The key to clinical outcome research is facilitating the long term followup for the maximum number of patients. Evidence is lacking that the PROMIS approach is helpful in this regard.
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