AAHS Home  |  2021 Virtual Portal  |  Past & Future Meetings
Countdown to AAHS : 34 Days  
American Association for Hand Surgery

Back to 2022 Abstracts


PROMIS Pain Interference and Physical Function Scores Predict Subsequent Visits in the Hand Clinic After Conservative Management of Carpometacarpal Thumb Arthritis
Amy Phan, BS1, Thais Calderon, MD1 and Warren C Hammert, MD2, (1)University of Rochester, Rochester, NY, (2)Department of Orthopaedics, University of Rochester, Rochester, NY

Introduction: As healthcare moves toward value-based medicine, it is essential to establish if the Patient Reported Outcomes Measurement Information System (PROMIS), a general questionnaire, is sensitive enough to detect change after treatment for common hand conditions. We sought to determine if PROMIS domains are sensitive enough to detect improvement after conservative treatments for carpometacarpal (CMC) thumb arthritis including (1) corticosteroid injection or (2) splinting/hand therapy.
Materials and Methods: This is a retrospective study analyzing three groups with CMC thumb arthritis: 88 patients who received splinting/hand therapy who returned to clinic at 6 weeks, 70 patients with steroid injection and 6-week follow up, and 50 patients who received splinting/hand therapy, but did not have another appointment for their thumb arthritis. PROMIS Physical Function (PF), Pain Interference (PI), Depression, and Upper Extremity (UE) were collected at each visit. We used chi-squared and one-way ANOVA tests to compare demographic variables. A one-way ANOVA was used to compare differences in baseline scores between each cohort, and paired t-tests were used to compare 6-week follow-up scores to baseline.
Results: Within the returning splinting/hand therapy, non-returning splinting/hand therapy, and steroid injection groups, the mean age was 60.1 to 61.8 years old, 72% to 80.7% were female, and 91.4% to 96% were Caucasian. At baseline, non-returning splinting/hand therapy patients had higher mean PF (p=0.11, p=0.01) and UE (p=0.058, p=0.054) scores and lower PI (p=0.053, p=0.001) scores in comparison to the returning cohort who received the same treatments and to the steroid injection cohort (Table 2). There were no significant differences in PROMIS PF (p=0.81), PI (p=0.22), Depression (p=0.36), or UE (p=0.44) scores for patients who returned after 6-weeks of treatment with splinting/hand therapy. Moreover, at 6-weeks post-injection, PROMIS PF (p=0.36) and UE (p=0.37) scores marginally increased, while PI (p=0.04) and Depression (p=0.005) scores decreased with statistical significance.
Conclusions: Patients with CMC thumb arthritis who return after receiving splinting/hand therapy have lower baseline PF and UE scores and higher PI scores at baseline than those who do not return. Longitudinal PROMIS scores may undervalue the effectiveness of splinting/hand therapy for CMC thumb arthritis due to the selection bias of more severe patients returning to hand clinic. For patients who receive steroid injection for CMC thumb arthritis, PI scores can be used primarily to monitor for improvement.


Back to 2022 Abstracts