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
Objectives: To determine if the Patient-Reported Outcome Measurement Information System (PROMIS) physical function, pain interference, self-efficacy, and global rating of normal function (GRNF) scales are able to accurately characterize a patient’s acceptable symptom state (PASS).
Design: A cross-sectional analysis, using receiver operator curves and chi-square analysis to explore criteria to determine thresholds (80% and 95% sensitivity/specificity) for PASS that are applicable to PROMIS and GRNF scales.
Setting: Phone survey after primary care. Participants: Patients (NZ94) attending primary care for musculoskeletal problems. Interventions: Not applicable. Main Outcomes Measures: Accuracy and proportion of patients classified as PASS Yes or No.
Results: Receiver operator curve analysis showed significant area under the curve (AUC) values for each PROMIS scale (AUC>.72) and the GRNF rating (AUCZ.74). Identified PROMIS thresholds suggested PASS was achieved when scores were at or slightly worse than the US population average. A score of >7 and >4 characterized patients that were PASS Yes and No, respectively, on the GRNF rating. A moderate (80%) specificity/sensitivity criteria yielded 72.3%-73.5% accuracy for a majority of participants (>69.9%).
Conclusion: This analysis suggests the PROMIS and GRNF scales are able to characterize PASS status with moderate accuracy (w70%) for a large portion of patients (w70%). New to this study is the association of self-efficacy with PASS status. PROMIS scales at or slightly worse than the US population average characterized PASS status.
Houck, Jeff; Kang, Daniel; Cuddeford, Tyler; and Rahkola, Sarah, "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" (2018). Faculty Publications - School of Physical Therapy. 76.