Percent of Normal: A Pragmatic Patient-Reported Outcome Measure for the Orthopaedic Trauma Clinic. Issue 11 (November 2021)

• Record Type: Journal Article
• Authors: Parry, Joshua A.; Peterson, Shian L.; Strage, Katya E.; Hadeed, Michael; Heare, Austin; Stacey, Stephen C.; Mauffrey, Cyril
• Is Part Of: Journal of orthopaedic trauma. Volume 35:Issue 11(2021)
• Page Start: e429
• Page End: e432
• Publication Date: 2021-11
• Subjects: PROMs -- PROs -- single assessment numerical evaluation -- single numerical -- orthopaedic trauma -- humerus -- ankle -- acetabular -- pelvis -- fracture; Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000002078
• Languages: English
• ISSNs: 0890-5339

Abstract

Abstract : Objectives: To compare a single numerical patient-reported outcome measure (PROM) to general health and injury-specific PROMs. Design: Retrospective cohort. Setting: Urban Level 1 trauma center. Patients/Participants: The study included 175 patients with 34 humerus, 54 pelvis, 31 acetabular, and 56 ankle fractures. Main Outcome Measurements: Patients were administered 3 PROMs: the 12-item short-form (SF-12), an injury-specific PROM (QuickDASH—humerus; Majeed Pelvic Outcome Score (Majeed)—pelvis; modified Merle d'Aubigne score (Merle)—acetabular; Foot and Ankle Disability Index (FADI)—ankle, and the Percent of Normal (PON) PROM, a single numerical PROM, which asked, "How would you rate yourself, if 100% is back to normal?" Floor/ceiling effect, convergent validity, and responsiveness of PROMs were assessed. Results: None of the PROMs demonstrated a floor effect. The Merle was the only PROM with a ceiling effect (19%). The PON had a strong correlation with the QuickDASH (r = 0.78) and Majeed (r = 0.78); a moderate association with the SF-12 physical component score (r = 0.63), Merle (r = 0.67), and FADI (r = 0.55); and a weak association with the SF-12 mental component score (r = 0.22). The regression coefficient for change in PROM over time, a measure of responsiveness, was greater for the PON compared with the SF-12 physical component score/mental component score, Majeed, Merle, and FADI, but not the QuickDASH. Conclusions: The PON is a pragmatic PROM that can be easily administered in clinic by the physician to quickly assess and manage a variety of fractures, avoiding the disadvantages of nonrelative general or region-specific PROMs.