AI Article Synopsis

  • - The study examines the use of the Patient-Reported Outcomes Measurement Information System (PROMIS) to measure recovery outcomes in patients undergoing rotator cuff repair, focusing on the minimal clinically important difference (MCID) and substantial clinical benefit (SCB) associated with PROMIS scores.
  • - Out of 198 patients, 168 were analyzed; key threshold changes in PROMIS scores were identified, indicating the levels of improvement needed for patients to experience meaningful clinical benefits after surgery.
  • - Results showed that 81%, 65%, and 55% of patients reached MCID for upper extremity function, pain interference, and depression, respectively, while 71%, 61%, and 38% achieved SCB, with certain

Article Abstract

Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) has emerged as a valid and efficient means of collecting outcomes in patients with rotator cuff tears. The purpose of this study was to establish threshold score changes to determine minimal clinically important difference (MCID) and substantial clinical benefit (SCB) in PROMIS computer adaptive test (CAT) scores following rotator cuff repair (RCR). Additionally, we sought to identify potential risk factors for failing to achieve MCID and SCB.

Methods: Patients undergoing arthroscopic RCR were identified over a 24-month period. Only patients who completed both preoperative and postoperative PROMIS CAT assessments were included in this cohort. PROMIS CAT forms for upper extremity physical function (PROMIS-UE), pain interference (PROMIS-PI), and depression (PROMIS-D) were used with a minimum of 1.5-year follow-up. Statistical analysis was performed to determine threshold score changes to determine anchor-based MCID and SCB, as well as risk factors for failure to achieve significant clinical improvement following surgery.

Results: Of 198 eligible patients, 168 (84.8%) were included in analysis. ΔPROMIS-UE values of 5.8 and 9.7 (area under the curve [AUC] = 0.906 and 0.949, respectively) and ΔPROMIS-PI values of -11.4 and -12.9 (AUC = 0.875 and 0.938, respectively) were identified as threshold predictors of MCID and SCB achievement. On average, 81%, 65%, and 55% of patients achieved MCID for PROMIS-UE, PROMIS-PI, and PROMIS-D whereas 71%, 61%, and 38% of patients in the cohort, respectively, achieved SCB. MCID achievement in PROMIS-UE significantly differed according to risk factors, including smoking status (likelihood ratio [LR]: 9.8, P = .037), tear size (LR: 10.4, P < .001), distal clavicle excision (LR: 6.1, P = .005), and prior shoulder surgery (LR: 19.2, P < .001). Factors influencing SCB achievement for PROMIS-UE were smoking status (LR: 9.3, P = .022), tear size (LR: 8.0, P = .039), and prior shoulder surgery (11.9, P < .001). Significantly different rates of MCID and SCB achievement in PROMIS-PI for smoking status (LR: 7.0, P = .030, and LR: 5.2, P = .045) and prior shoulder surgery (LR: 9.1, P = .002, and LR: 7.4, P = .006) were also identified.

Discussion And Conclusion: The majority of patients showed clinically significant improvements that exceeded the established MCID for PROMIS-UE and PROMIS-PI following RCR. Patients with larger tear sizes, a history of prior shoulder surgery, tobacco users, and those who received concomitant distal clavicle excision were at risk for failing to achieve MCID in PROMIS-UE. Additionally, smokers and patients who underwent prior shoulder surgery demonstrated significantly lower improvements in pain scores following surgery.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jse.2022.01.125DOI Listing

Publication Analysis

Top Keywords

risk factors
16
rotator cuff
12
factors failure
8
failure achieve
8
minimal clinically
8
clinically difference
8
clinical benefit
8
promis computer
8
computer adaptive
8
adaptive test
8

Similar Publications

Importance: Gestational hypertension, preeclampsia, and eclampsia are established risk factors for stroke and dementia later in life. Whether these pregnancy complications are associated with an increased risk of new-onset neurological disorders within months to years after giving birth is not known.

Objective: To explore whether gestational hypertension, preeclampsia, and eclampsia are associated with new-onset migraine, headache, epilepsy, sleep disorder, or mental fatigue within months to years after giving birth.

View Article and Find Full Text PDF

Patterns of Social Connection Among Older Adults in England.

JAMA Netw Open

December 2024

Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom.

Importance: Issues related to social connection are increasingly recognized as a global public health priority. However, there is a lack of a holistic understanding of social connection and its health impacts given that most empirical research focuses on a single or few individual concepts of social connection.

Objective: To explore patterns of social connection and their associations with health and well-being outcomes.

View Article and Find Full Text PDF

Social Determinants of Health, Blood Pressure Classification, and Incident Stroke Among Chinese Adults.

JAMA Netw Open

December 2024

Hypertension Laboratory, Cardiovascular Disease Center of Guangdong Province, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.

Importance: Although cumulative evidence suggests that higher blood pressure (BP) and a greater burden of social determinants of health (SDOH) are associated with an increased risk of stroke, few studies have examined whether SDOH burden modifies the association between BP and stroke risk.

Objective: To evaluate whether the association between BP classification and stroke risk differs by SDOH burden among Chinese adults.

Design, Setting, And Participants: In this cohort study, analyses were conducted among 90 850 participants in the prospective subcohort of the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project, with recruitment from January 1, 2016, to December 31, 2020.

View Article and Find Full Text PDF

Assessment of insulin-degrading enzyme inhibitor for the treatment of corneal erosion in a rat model.

Graefes Arch Clin Exp Ophthalmol

December 2024

Department of Ophthalmology and Laboratory of Eye Research, Rabin Medical Center - Beilinson Hospital, Felsenstein Medical Research Center, 39 Jabotinski St., Petach Tikva, 49100, Israel.

Background: Diabetes poses a risk to diabetic keratopathy in up to two-thirds of patients. Insulin-degrading enzyme (IDE) is a protease that can break down insulin and several growth factors and may impair wound healing. Increased IDE levels have been found in fluid from diabetic skin ulcers.

View Article and Find Full Text PDF

Atrial Fibrillation in Patients with Breast Cancer: A Literature Review.

Cardiol Ther

December 2024

Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA, 01805, USA.

In addition to traditional risk factors, patients with breast cancer are at an increased risk of atrial fibrillation due to cancer itself and certain cancer therapies. Atrial fibrillation in these patients adds to their morbidity and mortality. The precise mechanisms leading to the increased atrial fibrillation in patients with breast cancer are not well understood.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!

A PHP Error was encountered

Severity: Notice

Message: fwrite(): Write of 34 bytes failed with errno=28 No space left on device

Filename: drivers/Session_files_driver.php

Line Number: 272

Backtrace:

A PHP Error was encountered

Severity: Warning

Message: session_write_close(): Failed to write session data using user defined save handler. (session.save_path: /var/lib/php/sessions)

Filename: Unknown

Line Number: 0

Backtrace: