eP577 - Psychometric Assessment of PROMIS-29 as a Measure of Recovery After Colorectal Surgery

ePoster Presenter(s)

• 

  Francesca Fermi, MD (she/her/hers)

  Resident in General Surgery/ MSc candidate
  San Raffaele Hospital (Italy)/McGill University (Montreal)
  Montreal General Hospital/ McGill University
  Faenza, Emilia-Romagna, Italy

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Author(s)

• SS

  Samin Shirzadi, MD, MPH

  Research Assistant
  Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre
  Montreal, Quebec, Canada

  Disclosure information not submitted.
• GO

  Ghadeer Olleik, MSc

  PhD candidate
  Mcgill University
  Montreal, Quebec, Canada

  Disclosure information not submitted.
• 

  Makena Pook, PhD(c) (they/them/theirs)

  Doctoral Student
  McGill University
  McGill University
  Montreal, QC, Canada

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• ML

  Maxime Lapointe-Gagner, MSc

  Medical Student
  McGill University
  Montreal, Quebec, Canada

  Disclosure information not submitted.
• SA

  Sarah Al Ben Ali, MD

  Surgical resident
  Department of General Surgery, McGill University, Canada, Quebec, Montreal
  Montreal, Quebec, Canada

  Disclosure information not submitted.
• TN

  Tahereh Najafi, n/a

  Researcher
  Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
  Montreal, Quebec, Canada

  Disclosure information not submitted.
• NA

  Naser Alali, MB BCh BAO

  Resident
  McGill Univeristy
  Montreal, Quebec, Canada

  Disclosure information not submitted.
• KD

  Katy Dmowski, BSc

  Graduate Student (MSc)
  Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University. Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
  Montreal, Quebec, Canada

  Disclosure information not submitted.
• PK

  Pepa Kaneva, MSc

  Research Assistant
  McGill University
  Montreal, Quebec, Canada

  Disclosure information not submitted.
• NP

  Nicolò Pecorelli, n/a

  Assistant Professor of Surgery
  Vita-Salute San Raffaele University
  Milano, Lombardia, Italy

  Disclosure information not submitted.
• LF

  Liane Feldman, MD

  Professor of Surgery
  McGill University
  montreal, Quebec, Canada

  Disclosure information not submitted.
• MB

  Marylise Boutros, MD (she/her/hers)

  Professor of Surgery
  Dr Marylise Boutros - Colorectal Surgeon, Cleveland Clinic Florida Professor of Surgery, McGill University, Montreal, Canada
  McGill University
  Weston, Florida, United States

  All relevant financial disclosures have been managed and will be listed below.
  This individual has no relevant relationships with ineligible companies.
• LL

  Lawrence Lee, MD PhD

  Associate Professor of Surgery
  McGill University Health Centre
  Montreal, Quebec, Canada

  Disclosure information not submitted.

Senior Author(s)

• JF

  Julio F. Fiore Jr, PhD

  Assistant Professor
  McGill University
  Montreal, Quebec, Canada

  Disclosure information not submitted.

Purpose/Background: In line with the principles of patient-centered care, postoperative recovery after colorectal surgery should be measured using patient-reported outcome measures. The questionnaire PROMIS-29, derived from the NIH Patient-Reported Outcomes Measurement Information System (PROMIS), measures general aspects of physical and mental health which may relate to surgical recovery. However, evidence regarding the psychometric properties of PROMIS-29 in the context of colorectal surgery remains limited. The aim of this study is to assess the construct validity and responsiveness of PROMIS-29 as a measure of postoperative recovery after colorectal surgery.Methods/Interventions: In this prospective cohort study, adult patients (≥18yo) undergoing elective colorectal resection at two academic hospitals responded to the PROMIS-29 questionnaire preoperatively and at postoperative weeks (POW) 1, 2, 3, and 4. Physical health summary (PHS) score and mental health summary (MHS) score were derived from PROMIS-29 t-scores (standardized mean = 50, standard deviation = 10; higher scores = better health status). Construct validity and responsiveness were addressed according to COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments). Construct validity was evaluated via known-group hypotheses that postoperative PHS and MHS scores are higher in patients (1) with shorter length of stay (LOS ≤4 vs. LOS>4 days); 2) without 30-days postoperative complications (vs. with complications); 3) undergoing laparoscopic surgery (vs. open) and 4) without a new-stoma (vs. with a new stoma). To assess responsiveness, we hypothesized that PHS and MHS scores would be higher (1) preoperatively vs. at POW1; (2) at POW2 vs. POW1; (3) at POW3 vs. POW2; (4) at POW4 vs. POW3. Mean differences in scores were obtained using linear regression. Based on previous literature, differences were considered meaningful if > a minimal important difference of 3 points.Results/Outcomes: Overall, 289 patients were included (59±15 years, 48% female, 78% laparoscopic, 20% new stoma, median hospital stay 3 days [IQR 1-6]). Our psychometric analysis is reported in Table 1. The construct validity of PROMIS-29 PHS scores was limited early after surgery (1 out of 4 hypotheses confirmed on POW1) but improved at later time points (3-4 hypotheses confirmed on POW2-4). Similar results were observed for the construct validity of MHS scores (2 hypotheses confirmed on POW1; 3 hypotheses confirmed on POW2-4). Our findings supported the responsiveness of PROMIS-29 PHS and MHS scores (4 out of 4 hypotheses confirmed).Conclusion/

Discussion: PROMIS-29 PHS and MHS scores are responsive to the expected trajectory of postoperative recovery. Their ability to discriminate between groups expected to have different recovery trajectories was limited early after surgery but improved over time. Our findings support that PROMIS-29 may be suitable for measuring late (> POW2), but not early recovery (< POW1) after colorectal surgery.Table 1. Hypotheses tested for construct validity and responsiveness.Data are mean difference (95% CI) in t-scores. Hypotheses supported by the data are bolded. Construct validity analysis was adjusted by baseline PROMIS-29 scores. POW = postoperative week; LOS = length of stay