OBJECTIVE To address the relative influence of psychological factors on variation in PROMIS PF CAT and ODI scores. DESIGN Cross-sectional. SETTING We enrolled patients with low back pain, presenting to clinicians specializing in the treatment of spine conditions in a large urban area. PARTICIPANTS One hundred sixteen new and return English speaking patients. MAIN OUTCOME MEASURES The PROMIS Physical Function (PF) Computer Adaptive Test (CAT) and the Oswestry Low Back Pain Disability Index (ODI) . METHODS Patients completed the Pain Catastrophizing Scale short form (PCS-4), Patient Health Questionnaire short form (PHQ-2), Pain Self-Efficacy Questionnaire short form (PSEQ-2), PROMIS PF CAT, and ODI on a secure tablet. RESULTS The 95% confidence interval (CI) for the amount of variation in PROMIS PF CAT scores (95% CI 0.06 to 0.31) accounted for by psychological measures overlapped with the 95% CI for the amount of variation in ODI scores (CI 0.26 to 0.53). PROMIS PF CAT had a strong correlation with ODI on (r -0.69; P <0.001). Greater PROMIS PF CAT scores were independently associated with fewer symptoms of depression (β -1.6, 95% CI -2.7 to -0.58, P=0.003). Higher ODI scores were independently associated with more catastrophic thinking (β 1.2; 95% CI 0.60 to 1.88; P < 0.001), and less self-efficacy (β -2.4; 95% CI -3.2 to -1.5; P <0.001). PSEQ-2 accounted for the largest proportion of variation in ODI. PHQ-2 accounted for the largest proportion of variation in PROMIS PF CAT. Psychological measures explained more variation in ODI (semipartial R2 0.48 for psychological measures; adjusted R2 full model 0.49) than in PROMIS PF CAT (semipartial R2 0.17 for psychological measures; adjusted R2 full model 0.31). CONCLUSIONS The ODI and PROMIS PF CAT are comparably sensitive to psychological factors in patients with persistent lower back pain. Given that the PROMIS PF CAT is more efficient to administer, clinicians might consider using PROMIS PF CAT when assessing physical limitations in patients with persistent lower back pain.

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是时候用 PROMIS 物理功能计算机自适应测试代替 Oswestry 指数了吗？

目的 解决心理因素对 PROMIS PF CAT 和 ODI 分数变化的相对影响。设计横截面。设置 我们招募了腰痛患者，将其介绍给大城市地区专门治疗脊柱疾病的临床医生。参与者 116 名新的和返回的说英语的患者。主要结果测量 PROMIS 身体机能 (PF) 计算机适应性测试 (CAT) 和 Oswestry 腰痛残疾指数 (ODI)。方法 患者在安全的平板电脑上完成疼痛灾难化量表简表 (PCS-4)、患者健康问卷简表 (PHQ-2)、疼痛自我效能问卷简表 (PSEQ-2)、PROMIS PF CAT 和 ODI。结果 PROMIS PF CAT 评分变异量的 95% 置信区间 (CI)（95% CI 0.06 至 0. 31) 通过心理测量与 ODI 分数变化量的 95% CI 重叠 (CI 0.26 至 0.53) 来解释。PROMIS PF CAT 与 ODI 有很强的相关性 (r -0.69; P <0.001)。较高的 PROMIS PF CAT 评分与较少的抑郁症状独立相关（β -1.6，95% CI -2.7 至 -0.58，P=0.003）。较高的 ODI 分数与更多的灾难性思维独立相关（β 1.2；95% CI 0.60 至 1.88；P < 0.001）和较低的自我效能感（β -2.4；95% CI -3.2 至 -1.5；P <0.001）。PSEQ-2 占 ODI 变异的最大比例。PHQ-2 占 PROMIS PF CAT 变异的最大比例。与 PROMIS PF CAT（半部分 R2 0.49）相比，心理测量解释了更多的 ODI 变化（心理测量的半部分 R2 0.48；调整后的 R2 完整模型 0.49）。17 心理措施；调整后的 R2 完整模型 0.31）。结论 ODI 和 PROMIS PF CAT 对持续性腰痛患者的心理因素比较敏感。鉴于 PROMIS PF CAT 的管理效率更高，临床医生在评估持续腰痛患者的身体限制时可能会考虑使用 PROMIS PF CAT。