Abstract

Introduction

Previous studies suggest that a meaningful and easily understood measure of treatment outcome may be the proportion of patients who are in a “patient acceptable symptom state” (PASS). We sought to quantify the score equivalent to PASS for different outcome instruments, in patients with adult spinal deformity (ASD).

Methods

We analysed the following 12-month questionnaire data from the European Spine Study Group (ESSG): Oswestry Disability Index (ODI; 0–100); Numeric Rating Scales (NRS; 0–10) for back/leg pain; Scoliosis Research Society (SRS) questionnaire; and an item “if you had to spend the rest of your life with the symptoms you have now, how would you feel about it?” (5-point scale, dichotomised with top 2 responses “somewhat satisfied/very satisfied” being considered PASS+, everything else PASS−). Receiver operating characteristics (ROC) analyses indicated the cut-off scores equivalent to PASS+.

Results

Out of 1043 patients (599 operative, 444 non-operative; 51 ± 19 years; 84% women), 42% reported being PASS+ at 12 months’ follow-up. The ROC areas under the curve were 0.71–0.84 (highest for SRS subscore), suggesting the questionnaire scores discriminated well between PASS+ and PASS−. The scores corresponding to PASS+ were > 3.5 for the SRS subscore (> 3.3–3.8 for SRS subdomains); ≤ 18 for ODI; and ≤ 3 for NRS pain. There were slight differences in cut-offs for subgroups of age, treatment type, aetiology, baseline symptoms, and sex.

Conclusion

Most interventions for ASD improve patients’ complaints but do not totally eliminate them. Reporting the percentage achieving a score equivalent to an “acceptable state” may represent a more stringent and discerning target for denoting treatment success in ASD.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

中文翻译：

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成人脊柱畸形患者准备好生活在什么水平的症状？对1043名患者的12个月随访数据进行的横断面分析。

摘要

介绍

先前的研究表明，有意义且易于理解的治疗结果衡量标准可能是处于“患者可接受的症状状态”（PASS）的患者比例。我们试图量化成人脊柱畸形（ASD）患者不同结局工具的PASS评分。

方法

我们分析了来自欧洲脊柱研究小组（ESSG）的以下12个月的问卷调查数据：Oswestry残疾指数（ODI； 0-100）；背部/腿部疼痛的数字评分量表（NRS； 0-10）；脊柱侧弯研究学会（SRS）问卷；还有一个项目“如果您必须将余生与现在的症状一起度过，您会如何看待？” （5分制，分为前2个回答“有些满意/非常满意”，认为是PASS +，其他都是PASS-）。接收器工作特性（ROC）分析表明临界值等于PASS +。

结果

在1043例患者中（599例手术，444例非手术； 51±19岁； 84％的女性），其中42％的患者在随访12个月时报告为PASS +。曲线下的ROC区域为0.71-0.84（SRS分数最高），这表明问卷调查得分在PASS +和PASS-之间有很好的区分。对于SRS子分数，与PASS +相对应的分数> 3.5（对于SRS子域，分数> 3.3-3.8）；ODI≤18；NRS疼痛≤3。对于年龄，治疗类型，病因，基线症状和性别等亚组，临界值存在细微差异。

结论

大多数针对ASD的干预措施可以改善患者的不适，但不能完全消除它们。报告达到与“可接受状态”相当的分数的百分比可能代表了更严格和更明确的目标，以表示ASD中的治疗成功。

图形摘要

这些幻灯片可以在电子补充材料下找到。