loading page

Using gold standard patient-reported outcome measures in clinical practice -- a new approach to facilitate their use
  • +2
  • Vikram Madan,
  • Avi Elbaz,
  • Amit Mor,
  • Yiftah Beer,
  • Matthew Bartels
Vikram Madan
Montefiore Medical Center

Corresponding Author:[email protected]

Author Profile
Avi Elbaz
AposTherapy Research Group
Author Profile
Amit Mor
AposTherapy Research Group
Author Profile
Yiftah Beer
Assaf Harofeh Medical Center
Author Profile
Matthew Bartels
Montefiore Medical Center
Author Profile

Abstract

Purpose: To analyze two gold-standard patient-reported outcome measures (PROMs) in knee OA (WOMAC and SF-36) and determine which questions are the most reflective of the overall score. Methods: This was a retrospective study on 4,983 patients with primary knee pain. Patients had WOMAC and SF-36 at two-time points, pre-treatment and after three months of treatment. A decision tree classifier supported with a linear mix model regression was applied to determine, identify, and categorize the most influential questions that determine the overall score in each of the questionnaires. Results: For SF-36, the most influential items were Q22 (39%), Q32 (24%), Q11 (19%), Q25 (19%). For WOMAC, the most influential predictors were Q14 (39%), Q10 (24%) and Q15 (21%). A significant improvement in WOMAC and SF-36 was seen after three months of treatment (P<0.01). For SF-36, the main predictor items were Q11, Q22 and Q32, Regression model R2 = 0.841, p<0.01, t[55.62]=0.001, Beta for Q22=0.409, Q32=0.352, Q11=0.278. For WOMAC, the main predictor items were Q10 and Q15, Regression model R2 = 0.930, p<0.01, t[35.4]=0.001, Beta for Q15=0.548, Q10=0.4639. Conclusion: Two questions from the WOMAC questionnaire predicts 93% of the overall score and four questions form the SF-36 predict 84%. The creation of a clinically meaningful assessment tool based on larger scientifically validated PROMs will help to facilitate its use by clinicians and acceptance by patients in clinical practice.