Validation of Patient-reported Outcomes Measurement Information System Computer Adaptive Tests in Lumbar Disk Herniation Surgery

J Am Acad Orthop Surg. 2019 Feb 1;27(3):95-103. doi: 10.5435/JAAOS-D-17-00300.


Introduction: Inadequate validation, floor/ceiling effects, and time constraints limit utilization of standardized patient-reported outcome measures. We aimed to validate Patient-reported Outcomes Measurement Information System (PROMIS) computer adaptive tests (CATs) for patients treated surgically for a lumbar disk herniation.

Methods: PROMIS, CATs, Oswestry Disability Index, and Short Form-12 measures were administered to 78 patients treated with lumbar microdiskectomy for symptomatic disk herniation with radiculopathy.

Results: PROMIS CATs demonstrated convergent validity with legacy measures; PROMIS scores were moderately to highly correlated with the Oswestry Disability Index and Short Form-12 physical component scores (r = 0.41 and 0.78, respectively). PROMIS CATs demonstrated similar responsiveness to change compared with legacy measures. On average, the PROMIS CATs were completed in 2.3 minutes compared with 5.7 minutes for legacy measures.

Discussion: The PROMIS CATs demonstrate convergent and known groups' validity and are comparable in responsiveness to legacy measures. These results suggest similar utility and improved efficiency of PROMIS CATs compared with legacy measures.

Levels of evidence: Level II.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Disability Evaluation
  • Diskectomy / statistics & numerical data*
  • Female
  • Health Information Systems*
  • Humans
  • Intervertebral Disc Degeneration / surgery*
  • Intervertebral Disc Displacement / surgery*
  • Lumbar Vertebrae / surgery
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures*
  • Postoperative Period
  • Reproducibility of Results
  • Treatment Outcome
  • Young Adult

Supplementary concepts

  • Intervertebral disc disease