Do patients judge success of treatment and patient acceptable symptom state based on current self-reported health status?
Main Article Content
Abstract
Background: Value-based care models call for better interpretation of patient-reported outcomes. Patients may reference health status differently when appraising if an intervention was successful versus if their current state is acceptable. The purpose of this study was to determine the association between success of treatment (SOT), patient acceptable symptom state (PASS), and PROMIS measure T-scores, following a single primary care physical therapy encounter.
Methods: Cross-sectional study. Ninety-two patients with musculoskeletal complaints were administered standard SOT and PASS questions, and PROMIS Physical Function, Pain Interference, and Self-Efficacy for Managing Symptoms measures. Association of PASS and SOT was determined using rank biserial correlation and chi-squared analysis. Accuracy of PROMIS T-scores to discriminate PASS and SOT was determined through receiver-operator curve analysis and likelihood ratios.
Results: There was significant association between PASS and SOT (r=.393, p<0.001; X2=15.7, p=0.001). The three PROMIS measures discriminated PASS with AUCs of 0.73 to 0.88 (accuracy 67.3% to 82.6%), Self-Efficacy being the strongest discriminator. Only Pain Interference T-scores discriminated SOT with AUC >0.70 (accuracy 76.1%).
Conclusion: PASS was more strongly associated with health status than SOT. Patients make a meaningful distinction between these two questions. Accurate clinician interpretation of PASS, SOT, and PROMIS T-scores can allow more targeted goal setting and treatment decision making.
Keywords:
patient reported outcome measures, PROMIS, primary care, physical therapy, musculoskeletal disease
Article Details
How to Cite
JACOBSON, Ryan P; KANG, Daniel; HOUCK, Jeff.
Do patients judge success of treatment and patient acceptable symptom state based on current self-reported health status?.
Medical Research Archives, [S.l.], v. 8, n. 8, aug. 2020.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/2196>. Date accessed: 19 apr. 2024.
doi: https://doi.org/10.18103/mra.v8i8.2196.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Papuga MO, Dasilva C, McIntyre A, Mitten D, Kates S, Baumhauer JF. Large-scale clinical implementation of PROMIS computer adaptive testing with direct incorporation into the electronic medical record. Health Syst. 2018;7(1):1-12.
2. Baumhauer JF. Patient-reported outcomes—Are they living up to their potential? N Engl J Med. 2017;377(1):6-9.
3. Porter ME. What is value in health care? N Engl J Med. 2010;363(26):2477-2481.
4. Field J, Holmes MM, Newell D. PROMs data: can it be used to make decisions for individual patients? A narrative review. Patient Relat Outcome Meas. Jul 2019;10:233-241.
5. Karimi M, Brazier J. Health, health-related quality of life, and quality of life: What is the difference? Pharmacoecon. 2016;34(7):645-649.
6. Ngamaba KH, Panagioti M, Armitage CJ. How strongly related are health status and subjective well-being? Systematic review and meta-analysis. Eur J Public Health. 2017;27(5):879-885.
7. Rumsfeld JS, Alexander KP, Goff DC, Jr., et al. Cardiovascular health: The importance of measuring patient-reported health status: A scientific statement from the American Heart Association. Circulation. 2013;127(22):2233-2249.
8. Batbaatar E, Dorjdagva J, Luvsannyam A, Savino MM, Amenta P. Determinants of patient satisfaction: A systematic review. Perspect Public Health. 2017;137(2):89-101.
9. Impellizzeri FM, Mannion AF, Naal FD, Hersche O, Leunig M. The early outcome of surgical treatment for femoroacetabular impingement: Success depends on how you measure it. Osteoarthr Cartil. 2012;20(7):638-645.
10. Roos EM, Boyle E, Frobell RB, Lohmander LS, Ingelsrud LH. It is good to feel better, but better to feel good: Whether a patient finds treatment 'successful' or not depends on the questions researchers ask. Br J Sports Med. 2019;53(23):1474-1478.
11. Strand V, Boers M, Idzerda L, et al. It's good to feel better but it's better to feel good and even better to feel good as soon as possible for as long as possible: Response criteria and the importance of change at OMERACT 10. J Rheumatol. 2011;38(8):1720-1727.
12. Anderson MR, Baumhauer JF, DiGiovanni BF, et al. Determining success or failure after foot and ankle surgery using patient acceptable symptom state (PASS) and Patient Reported Outcome Information System (PROMIS). Foot Ankle Int. 2018;39(8):894-902.
13. Hawthorne G, Sansoni J, Hayes L, Marosszeky N, Sansoni E. Measuring patient satisfaction with health care treatment using the Short Assessment of Patient Satisfaction measure delivered superior and robust satisfaction estimates. J Clin Epidemiol. 2014;67(5):527-537.
14. Kamper SJ, Maher CG, Mackay G. Global rating of change scales: a review of strengths and weaknesses and considerations for design. J Man Manip Ther. 2009;17(3):163-170.
15. Kvien TK, Heiberg T, Hagen KB. Minimal clinically important improvement/difference (MCII/MCID) and patient acceptable symptom state (PASS): What do these concepts mean? Ann Rheum Dis. 2007;66(Suppl 3):40-41.
16. Tubach F, Ravaud P, Baron G, et al. Evaluation of clinically relevant states in patient reported outcomes in knee and hip osteoarthritis: The patient acceptable symptom state. Ann Rheum Dis. 2005;64(1):34-37.
17. Houck J, Kang D, Cuddeford T, Rahkola S. Ability of patient-reported outcomes to characterize patient acceptable symptom state (PASS) after attending a primary care physical therapist and medical doctor collaborative service: A cross-sectional study. Arch Phys Med Rehabil. 2019;100(1):60-66.
18. Onida S, Shalhoub J, Moore HM, Head KS, Lane TRA, Davies AH. Factors impacting on patient perception of procedural success and satisfaction following treatment for varicose veins. Br J Surg. 2016;103(4):382-390.
19. Hossack T, Woo H. Validation of a patient reported outcome questionnaire for assessing success of endoscopic prostatectomy. Prostate Int. 2014;2(4):182-187.
20. Bernhardsson S, Larsson M, Johansson K, Oberg B. "In the physio we trust": A qualitative study on patients' preferences for physiotherapy. Physiother Theory Pract. 2017;33(7):535-549.
21. Steffens NM, Tucholka JL, Nabozny MJ, Schmick AE, Brasel KJ, Schwarze ML. Engaging patients, health care professionals, and community members to improve preoperative decision making for older adults facing high-risk surgery. JAMA Surgery. 2016;151(10):938-945.
22. Cody EA, Mancuso CA, Burket JC, Marinescu A, MacMahon A, Ellis SJ. Patient factors associated with higher expectations from foot and ankle surgery. Foot Ankle Int. 2017;38(5):472-478.
23. Brodke DS, Goz V, Voss MW, Lawrence BD, Spiker WR, Hung M. PROMIS PF CAT outperforms the ODI and SF-36 physical function domain in spine patients. Spine. 2017;42(12):921-929.
24. Hung M, Franklin JD, Hon SD, Cheng C, Conrad J, Saltzman CL. Time for a paradigm shift with computerized adaptive testing of general physical function outcomes measurements. Foot Ankle Int. 2014;35(1):1-7.
25. Papuga MO, Beck CA, Kates SL, Schwarz EM, Maloney MD. Validation of GAITRite and PROMIS as high-throughput physical function outcome measures following ACL reconstruction. J Orthop Res. 2014;32(6):793-801.
26. Papuga MO, Mesfin A, Molinari R, Rubery PT. Correlation of PROMIS physical function and pain CAT instruments with Oswestry Disability Index and Neck Disability Index in spine patients. Spine. 2016;41(14):1153-1159.
27. Amtmann D, Cook KF, Johnson KL, Cella D. The PROMIS initiative: Involvement of rehabilitation stakeholders in development and examples of applications in rehabilitation research. Arch Phys Med Rehabil. 2011;92(10 Suppl):S12-S19.
28. Jacobson R, Philbrook L, Kang D, Cuddeford T, Houck J. Does multidimensional health assessment using PROMIS scales enhance clinical decision-making for patients with orthopedic problems? A case series. Orthop Phys Ther Pract. 2018;30(4):528-536.
29. Costa Lda C, Maher CG, McAuley JH, Hancock MJ, Smeets RJ. Self-efficacy is more important than fear of movement in mediating the relationship between pain and disability in chronic low back pain. Eur J Pain. 2011;15(2):213-219.
30. Twomey R, Martin T, Temesi J, Culos-Reed SN, Millet GY. Tailored exercise interventions to reduce fatigue in cancer survivors: study protocol of a randomized controlled trial. BMC Cancer. 2018;18(1):757.
31. Yeh GY, Mu L, Davis RB, Wayne PM. Correlates of exercise self-efficacy in a randomized trial of mind-body exercise in patients with chronic heart failure. J Cardiopulm Rehabil Prev. 2016;36(3):186-194.
32. George SZ, Valencia C, Beneciuk JM. A psychometric investigation of fear-avoidance model measures in patients with chronic low back pain. J Orthop Sports Phys Ther. 2010;40(4):197-205.
33. Bandura A, O'Leary A, Taylor CB, Gauthier J, Gossard D. Perceived self-efficacy and pain control: opioid and nonopioid mechanisms. J Pers Soc Psychol. 1987;53(3):563-571.
34. Heiberg TT, Kvien TK, Mowinckel P, Aletaha D, Smolen JS, Hagen KB. Identification of disease activity and health status cut-off points for the symptom state acceptable to patients with rheumatoid arthritis. Ann Rheum Dis. 2008;67(7):967-971.
35. Tubach F, Ravaud P, Martin-Mola E, et al. Minimum clinically important improvement and patient acceptable symptom state in pain and function in rheumatoid arthritis, ankylosing spondylitis, chronic back pain, hand osteoarthritis, and hip and knee osteoarthritis: Results from a prospective multinational study. Arthritis Care Res. 2012;64(11):1699-1707.
36. Wright AA, Hensley CP, Gilbertson J, Leland JM, Jackson S. Defining patient acceptable symptom state thresholds for commonly used patient reported outcomes measures in general orthopedic practice. Man Ther. 2015;20(6):814-819.
37. Kang D, Rahkola S, Vandehaar C, et al. A study of outcomes following collaborative medical doctor/physical therapist primary care service for musculoskeletal problems. Orthop Phys Ther Pract. 2018;30(4):510-517.
38. Frogner BK, Harwood K, Andrilla CHA, Schwartz M, Pines JM. Physical therapy as the first point of care to treat low back pain: An instrumental variables approach to estimate impact on opioid prescription, health care utilization, and costs. Health Serv Res. 2018;53(6):4629-4646.
39. da C Menezes Costa L, Maher CG, Hancock MJ, McAuley JH, Herbert RD, Costa LO. The prognosis of acute and persistent low-back pain: a meta-analysis. CMAJ. 2012;184(11):E613-624.
40. Thompson JY, Byrne C, Williams MA, Keene DJ, Schlussel MM, Lamb SE. Prognostic factors for recovery following acute lateral ankle ligament sprain: a systematic review. BMC Musculoskel Dis. 2017;18(1):421.
41. Ader DN. Developing the Patient-Reported Outcomes Measurement Information System (PROMIS). Med Care. 2007;45(5):S1-2.
42. Cella D, Yount S, Rothrock N, et al. The Patient-Reported Outcomes Measurement Information System (PROMIS): Progress of an NIH roadmap cooperative group during its first two years. Med Care. 2007;45(5):S3-S11.
43. Rose M, Bjorner JB, Gandek B, Bruce B, Fries JF, Ware JE. The PROMIS physical function item bank was calibrated to a standardized metric and shown to improve measurement efficiency. J Clinical Epidemiol. 2014;67(5):516-526.
44. Amtmann D, Cook KF, Jensen MP, et al. Development of a PROMIS item bank to measure pain interference. Pain. 2010;150(1):173-182.
45. Gruber-Baldini AL, Velozo C, Romero S, Shulman LM. Validation of the PROMIS measures of self-efficacy for managing chronic conditions. Qual Life Res. 2017;26(7):1915-1924.
46. Quach CW, Langer MM, Chen RC, et al. Reliability and validity of PROMIS measures administered by telephone interview in a longitudinal localized prostate cancer study. Qual Life Res. 2016;25(11):2811-2823.
47. Bernstein DN, Kelly M, Houck JR, et al. PROMIS Pain Interference is superior vs Numeric Pain Rating Scale for pain assessment in foot and ankle patients. Foot Ankle Int. 2019;40(2):139-144.
48. Haynes W. Bonferroni Correction. In: Dubitzky W, Wolkenhauer O, Cho K-H, Yokota H, eds. Encyclopedia of Systems Biology. New York, NY: Springer New York; 2013:154.
49. Mandrekar JN. Receiver operating characteristic curve in diagnostic test assessment. J Thorac Oncol. 2010;5(9):1315-1316.
50. Perkins NJ, Schisterman EF. The inconsistency of "optimal" cutpoints obtained using two criteria based on the receiver operating characteristic curve. Am J Epidemiol. 2006;163(7):670-675.
51. Obuchowski NA. Determining sample size for ROC studies: What is reasonable for the expected difference in tests' ROC areas? Acad Radiol. 2003;10(11):1327-1328.
52. Tubach F, Dougados M, Falissard B, Baron G, Logeart I, Ravaud P. Feeling good rather than feeling better matters more to patients. Arthritis Rheum. 2006;55(4):526-530.
2. Baumhauer JF. Patient-reported outcomes—Are they living up to their potential? N Engl J Med. 2017;377(1):6-9.
3. Porter ME. What is value in health care? N Engl J Med. 2010;363(26):2477-2481.
4. Field J, Holmes MM, Newell D. PROMs data: can it be used to make decisions for individual patients? A narrative review. Patient Relat Outcome Meas. Jul 2019;10:233-241.
5. Karimi M, Brazier J. Health, health-related quality of life, and quality of life: What is the difference? Pharmacoecon. 2016;34(7):645-649.
6. Ngamaba KH, Panagioti M, Armitage CJ. How strongly related are health status and subjective well-being? Systematic review and meta-analysis. Eur J Public Health. 2017;27(5):879-885.
7. Rumsfeld JS, Alexander KP, Goff DC, Jr., et al. Cardiovascular health: The importance of measuring patient-reported health status: A scientific statement from the American Heart Association. Circulation. 2013;127(22):2233-2249.
8. Batbaatar E, Dorjdagva J, Luvsannyam A, Savino MM, Amenta P. Determinants of patient satisfaction: A systematic review. Perspect Public Health. 2017;137(2):89-101.
9. Impellizzeri FM, Mannion AF, Naal FD, Hersche O, Leunig M. The early outcome of surgical treatment for femoroacetabular impingement: Success depends on how you measure it. Osteoarthr Cartil. 2012;20(7):638-645.
10. Roos EM, Boyle E, Frobell RB, Lohmander LS, Ingelsrud LH. It is good to feel better, but better to feel good: Whether a patient finds treatment 'successful' or not depends on the questions researchers ask. Br J Sports Med. 2019;53(23):1474-1478.
11. Strand V, Boers M, Idzerda L, et al. It's good to feel better but it's better to feel good and even better to feel good as soon as possible for as long as possible: Response criteria and the importance of change at OMERACT 10. J Rheumatol. 2011;38(8):1720-1727.
12. Anderson MR, Baumhauer JF, DiGiovanni BF, et al. Determining success or failure after foot and ankle surgery using patient acceptable symptom state (PASS) and Patient Reported Outcome Information System (PROMIS). Foot Ankle Int. 2018;39(8):894-902.
13. Hawthorne G, Sansoni J, Hayes L, Marosszeky N, Sansoni E. Measuring patient satisfaction with health care treatment using the Short Assessment of Patient Satisfaction measure delivered superior and robust satisfaction estimates. J Clin Epidemiol. 2014;67(5):527-537.
14. Kamper SJ, Maher CG, Mackay G. Global rating of change scales: a review of strengths and weaknesses and considerations for design. J Man Manip Ther. 2009;17(3):163-170.
15. Kvien TK, Heiberg T, Hagen KB. Minimal clinically important improvement/difference (MCII/MCID) and patient acceptable symptom state (PASS): What do these concepts mean? Ann Rheum Dis. 2007;66(Suppl 3):40-41.
16. Tubach F, Ravaud P, Baron G, et al. Evaluation of clinically relevant states in patient reported outcomes in knee and hip osteoarthritis: The patient acceptable symptom state. Ann Rheum Dis. 2005;64(1):34-37.
17. Houck J, Kang D, Cuddeford T, Rahkola S. Ability of patient-reported outcomes to characterize patient acceptable symptom state (PASS) after attending a primary care physical therapist and medical doctor collaborative service: A cross-sectional study. Arch Phys Med Rehabil. 2019;100(1):60-66.
18. Onida S, Shalhoub J, Moore HM, Head KS, Lane TRA, Davies AH. Factors impacting on patient perception of procedural success and satisfaction following treatment for varicose veins. Br J Surg. 2016;103(4):382-390.
19. Hossack T, Woo H. Validation of a patient reported outcome questionnaire for assessing success of endoscopic prostatectomy. Prostate Int. 2014;2(4):182-187.
20. Bernhardsson S, Larsson M, Johansson K, Oberg B. "In the physio we trust": A qualitative study on patients' preferences for physiotherapy. Physiother Theory Pract. 2017;33(7):535-549.
21. Steffens NM, Tucholka JL, Nabozny MJ, Schmick AE, Brasel KJ, Schwarze ML. Engaging patients, health care professionals, and community members to improve preoperative decision making for older adults facing high-risk surgery. JAMA Surgery. 2016;151(10):938-945.
22. Cody EA, Mancuso CA, Burket JC, Marinescu A, MacMahon A, Ellis SJ. Patient factors associated with higher expectations from foot and ankle surgery. Foot Ankle Int. 2017;38(5):472-478.
23. Brodke DS, Goz V, Voss MW, Lawrence BD, Spiker WR, Hung M. PROMIS PF CAT outperforms the ODI and SF-36 physical function domain in spine patients. Spine. 2017;42(12):921-929.
24. Hung M, Franklin JD, Hon SD, Cheng C, Conrad J, Saltzman CL. Time for a paradigm shift with computerized adaptive testing of general physical function outcomes measurements. Foot Ankle Int. 2014;35(1):1-7.
25. Papuga MO, Beck CA, Kates SL, Schwarz EM, Maloney MD. Validation of GAITRite and PROMIS as high-throughput physical function outcome measures following ACL reconstruction. J Orthop Res. 2014;32(6):793-801.
26. Papuga MO, Mesfin A, Molinari R, Rubery PT. Correlation of PROMIS physical function and pain CAT instruments with Oswestry Disability Index and Neck Disability Index in spine patients. Spine. 2016;41(14):1153-1159.
27. Amtmann D, Cook KF, Johnson KL, Cella D. The PROMIS initiative: Involvement of rehabilitation stakeholders in development and examples of applications in rehabilitation research. Arch Phys Med Rehabil. 2011;92(10 Suppl):S12-S19.
28. Jacobson R, Philbrook L, Kang D, Cuddeford T, Houck J. Does multidimensional health assessment using PROMIS scales enhance clinical decision-making for patients with orthopedic problems? A case series. Orthop Phys Ther Pract. 2018;30(4):528-536.
29. Costa Lda C, Maher CG, McAuley JH, Hancock MJ, Smeets RJ. Self-efficacy is more important than fear of movement in mediating the relationship between pain and disability in chronic low back pain. Eur J Pain. 2011;15(2):213-219.
30. Twomey R, Martin T, Temesi J, Culos-Reed SN, Millet GY. Tailored exercise interventions to reduce fatigue in cancer survivors: study protocol of a randomized controlled trial. BMC Cancer. 2018;18(1):757.
31. Yeh GY, Mu L, Davis RB, Wayne PM. Correlates of exercise self-efficacy in a randomized trial of mind-body exercise in patients with chronic heart failure. J Cardiopulm Rehabil Prev. 2016;36(3):186-194.
32. George SZ, Valencia C, Beneciuk JM. A psychometric investigation of fear-avoidance model measures in patients with chronic low back pain. J Orthop Sports Phys Ther. 2010;40(4):197-205.
33. Bandura A, O'Leary A, Taylor CB, Gauthier J, Gossard D. Perceived self-efficacy and pain control: opioid and nonopioid mechanisms. J Pers Soc Psychol. 1987;53(3):563-571.
34. Heiberg TT, Kvien TK, Mowinckel P, Aletaha D, Smolen JS, Hagen KB. Identification of disease activity and health status cut-off points for the symptom state acceptable to patients with rheumatoid arthritis. Ann Rheum Dis. 2008;67(7):967-971.
35. Tubach F, Ravaud P, Martin-Mola E, et al. Minimum clinically important improvement and patient acceptable symptom state in pain and function in rheumatoid arthritis, ankylosing spondylitis, chronic back pain, hand osteoarthritis, and hip and knee osteoarthritis: Results from a prospective multinational study. Arthritis Care Res. 2012;64(11):1699-1707.
36. Wright AA, Hensley CP, Gilbertson J, Leland JM, Jackson S. Defining patient acceptable symptom state thresholds for commonly used patient reported outcomes measures in general orthopedic practice. Man Ther. 2015;20(6):814-819.
37. Kang D, Rahkola S, Vandehaar C, et al. A study of outcomes following collaborative medical doctor/physical therapist primary care service for musculoskeletal problems. Orthop Phys Ther Pract. 2018;30(4):510-517.
38. Frogner BK, Harwood K, Andrilla CHA, Schwartz M, Pines JM. Physical therapy as the first point of care to treat low back pain: An instrumental variables approach to estimate impact on opioid prescription, health care utilization, and costs. Health Serv Res. 2018;53(6):4629-4646.
39. da C Menezes Costa L, Maher CG, Hancock MJ, McAuley JH, Herbert RD, Costa LO. The prognosis of acute and persistent low-back pain: a meta-analysis. CMAJ. 2012;184(11):E613-624.
40. Thompson JY, Byrne C, Williams MA, Keene DJ, Schlussel MM, Lamb SE. Prognostic factors for recovery following acute lateral ankle ligament sprain: a systematic review. BMC Musculoskel Dis. 2017;18(1):421.
41. Ader DN. Developing the Patient-Reported Outcomes Measurement Information System (PROMIS). Med Care. 2007;45(5):S1-2.
42. Cella D, Yount S, Rothrock N, et al. The Patient-Reported Outcomes Measurement Information System (PROMIS): Progress of an NIH roadmap cooperative group during its first two years. Med Care. 2007;45(5):S3-S11.
43. Rose M, Bjorner JB, Gandek B, Bruce B, Fries JF, Ware JE. The PROMIS physical function item bank was calibrated to a standardized metric and shown to improve measurement efficiency. J Clinical Epidemiol. 2014;67(5):516-526.
44. Amtmann D, Cook KF, Jensen MP, et al. Development of a PROMIS item bank to measure pain interference. Pain. 2010;150(1):173-182.
45. Gruber-Baldini AL, Velozo C, Romero S, Shulman LM. Validation of the PROMIS measures of self-efficacy for managing chronic conditions. Qual Life Res. 2017;26(7):1915-1924.
46. Quach CW, Langer MM, Chen RC, et al. Reliability and validity of PROMIS measures administered by telephone interview in a longitudinal localized prostate cancer study. Qual Life Res. 2016;25(11):2811-2823.
47. Bernstein DN, Kelly M, Houck JR, et al. PROMIS Pain Interference is superior vs Numeric Pain Rating Scale for pain assessment in foot and ankle patients. Foot Ankle Int. 2019;40(2):139-144.
48. Haynes W. Bonferroni Correction. In: Dubitzky W, Wolkenhauer O, Cho K-H, Yokota H, eds. Encyclopedia of Systems Biology. New York, NY: Springer New York; 2013:154.
49. Mandrekar JN. Receiver operating characteristic curve in diagnostic test assessment. J Thorac Oncol. 2010;5(9):1315-1316.
50. Perkins NJ, Schisterman EF. The inconsistency of "optimal" cutpoints obtained using two criteria based on the receiver operating characteristic curve. Am J Epidemiol. 2006;163(7):670-675.
51. Obuchowski NA. Determining sample size for ROC studies: What is reasonable for the expected difference in tests' ROC areas? Acad Radiol. 2003;10(11):1327-1328.
52. Tubach F, Dougados M, Falissard B, Baron G, Logeart I, Ravaud P. Feeling good rather than feeling better matters more to patients. Arthritis Rheum. 2006;55(4):526-530.