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Variability of PROMIS Domains across Hand Conditions
Casey Beleckas, BS; Jason Guattery, MS; Melissa Wright, MD; Ryan P. Calfee, MD, MSc2
Washington University in St. Louis School of Medicine, St Louis, MO

Objective: To determine whether PROMIS Depression, Physical Function, and Pain Interference scores at presentation for hand specialty care varied according to the type of symptomatic condition.

Methods: This cross-sectional evaluation analyzed 2,009 consecutive outpatient clinic visits of adult patients presenting to a tertiary hand clinic for an upper extremity condition from 10/2/2015-12/30/2015. All patients completed electronic PROMIS Depression (higher scores = more depression), Physical Function (higher scores = better function), and Pain Interference (higher scores = more pain) modules at their visit. Kruskal-Wallis Chi-square analyses were performed with post-hoc comparisons using the Mann-Whitney U test for differences in PROMIS scores for each health domain according to diagnosis.

Results: Depression, Physical Function, and Pain Interference scores significantly differed between patient groups according to diagnosis (Depression: p<0.001; Physical Function: p<0.001; Pain Interference: p<0.001). Patients with nerve compression syndromes had the highest Depression (median 49.9) and Pain Interference scores (median 61.5) and the lowest Physical Function scores (median: 42.0), while patients presenting with ganglion cysts had the lowest Depression (45.6) and Pain Interference scores (55.8), and the highest Physical Function scores (50.0) (Table1). Assuming moderate effect size change (0.5) to be clinically relevant, patients with nerve compression syndromes had worse physical function than patients with ganglion cysts, hand fractures, and trigger finger.

Conclusions: PROMIS Depression, Physical Function, and Pain Interference scores vary significantly according to the diagnosis prompting presentation for specialty hand care. While patients presenting with nerve compression syndromes demonstrated PROMIS health domain scores with the most negative implications, further studies including additional validated health measures should be performed to determine if these apparent disparities remain consistent. Table 1. Medians (25-75%) of PROMIS CATs by hand condition

Figure 1. Means of PROMIS Physical Function by hand condition

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