PROMIS Pain Interference Is Superior vs Numeric Pain Rating Scale for Pain Assessment in Foot and Ankle Patients

Foot Ankle Int. 2019 Feb;40(2):139-144. doi: 10.1177/1071100718803314. Epub 2018 Oct 4.


Background:: The Numeric Pain Rating Scale (NPRS) is a popular method to assess pain. Recently, the Patient-Reported Outcomes Measurement Information System (PROMIS) has been suggested to be more accurate in measuring pain. This study aimed to compare NPRS and PROMIS Pain Interference (PI) scores in a population of foot and ankle patients to determine which method demonstrated a stronger correlation with preoperative and postoperative function, as measured by PROMIS Physical Function (PF).

Methods:: Prospective PROMIS PF and PI and NPRS data were obtained for 8 common elective foot and ankle surgical procedures. Data were collected preoperatively and postoperatively at a follow-up visit at least 6 months after surgery. Spearman correlation coefficients were calculated to determine the relationship among NPRS (0-10) and PROMIS domains (PI, PF) pre- and postoperatively. A total of 500 patients fit our inclusion criteria.

Results:: PROMIS PF demonstrated a stronger correlation to PROMIS PI in both the pre- and postoperative settings (preoperative: ρ = -0.66; postoperative: ρ = -0.69) compared with the NPRS (preoperative: ρ = -0.32; postoperative:ρ = -0.33). Similar results were found when data were grouped by Current Procedural Terminology (CPT) code.

Conclusion:: PROMIS PI was a superior tool to gauge a patient's preoperative level of pain and functional ability. This information may assist surgeons and patients in setting postoperative functional expectations and pain management.

Level of evidence:: Level II, prognostic.

Keywords: PROMIS; pain; patient-reported outcomes; surgical expectations; value-based healthcare.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Ankle / surgery*
  • Female
  • Foot / surgery*
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement / methods*
  • Pain, Postoperative
  • Patient Reported Outcome Measures*
  • Preoperative Period
  • Reproducibility of Results