PROMIS Instruments Correlate Better with Legacy Measures in Knee Cartilage Patients at Post-operative than at Pre-operative Assessment


To define the psychometric properties of the PROMIS Physical Function (PF), Pain Interference (PI) and Depression Computer Adaptive Test (CAT) in patients undergoing knee cartilage surgeries.


The PROMIS PF, PI and Depression CAT were administered preoperatively and at 6 months alongside legacy knee patient-reported outcome measures in patients undergoing knee cartilage surgeries. Statistical analysis consisted of time-to-completion, psychometric analysis for correlative strengths, absolute and relative floor and ceiling effects, and Cohen’s effect size.


Our study included 250 patients (57.2% male), averaging 1.87, 1.53, and 1.91 minutes for completion of the PF, PI, and Depression CATs, respectively. Pre-operatively, the PROMIS PF CAT and PI CATs wide ranges of correlation coefficients with respect to function (PF:0.14-0.72, PI:0.29-0.77) and health-related quality of life (HRQoL) PROMs (r=0.64-0.70). At six months, PROMIS PF CAT (r=0.82-0.93) and PI CAT (r=0.77-0.93) both exhibited excellent correlations with respect to legacy function and HRQoL PROMs except for the Marx (r=0.36-0.44). None of the PROMIS instruments exhibited any significant floor or ceiling effects.


The PROMIS PF, PI, and Depression CATs performed better with respect to legacy PROMs in the postoperative period than the preoperative period. In addition, PROMIS PF and PI measures perform best with respect to the IKDC, and no floor or ceiling effects were identified for PROMIS instruments. PROMIS instruments may be more suited to track outcomes post-operatively than establish preoperative baselines in cartilage surgery patients.