Patient-Reported Outcome Measures: The Promise of PROMIS

Orthopaedic research has evolved during the 20 years since I started medical school. Of all the technological advances, perhaps one of the most important changes has been the renewed focus on our patients and their own interpretations of their care. This is evident when we look at the metrics by which we define success or failure. The stereotyped measure of orthopaedic success was the postoperative radiograph. Our literature is replete with manuscripts that looked no further than that outcome. We have moved beyond that and now routinely expect quality research to include patient-reported outcome measures (PROMs). The first generation of measures, frequently called legacy measures, were an improvement but have been limited by several factors. In this issue of JAAOS, Brodke et al1 identify these limitations well. In total, these legacy measures are prone to significant error, create inefficiencies in clinical practice, and leave our patients dissatisfied. The Patient-Reported Outcomes Measurement Information System (PROMIS) represents over a decade of research into the fundamental properties of patient outcome measures and is our best path forward for capturing high-quality, meaningful information for our patients. The integration with computer adaptive testing brings PROMIS into clinical reality by providing an efficient and patient-friendly interface. PROMIS will be the new standard of patient-reported outcome measures and should be incorporated into orthopaedic research moving forward. How we measure success will continue to evolve, but patients’ perspective on their care should remain at the center of our discussions.