Percent of Normal: A Pragmatic Patient-Reported Outcome Measure for the Orthopaedic Trauma Clinic.

OBJECTIVES The purpose of this study was to compare a single numerical patient-reported outcome measure (PROM) to general health and injury-specific PROMs. DESIGN Retrospective cohort. SETTING Urban level one trauma center. PATIENTS/PARTICIPANTS 175 patients with 34 humerus, 54 pelvis, 31 acetabular, and 56 ankle fractures. MAIN OUTCOME MEASUREMENTS Patients were administered three PROMs: the 12-item short-form (SF-12), an injury-specific PROM (QuickDASH - humerus; Majeed Pelvic Outcome Score (Majeed) - pelvis; modified Merle d'Aubigne score (Merle) - acetabular; Foot and Ankle Disability Index (FADI) - ankle), and the Percent of Normal (PON) PROM, a single numerical PROM, which asked, "How would you rate yourself, if 100% is back to normal?" Floor/ceiling effect, convergent validity, and responsiveness of PROMs were assessed. RESULTS None of the PROMs demonstrated a floor effect. The Merle was the only PROM with a ceiling effect (19%). The PON had a strong correlation with the QuickDASH (r=0.78) and Majeed (r=0.78), a moderate association with the SF-12 physical component score (PCS)(r=0.63), Merle (r=0.67), and FADI (r=0.55), and a weak association with the SF-12 mental component score (MCS)(r=0.22). The regression coefficient for change in PROM over time, a measure of responsiveness, was greater for the PON, compared to the SF-12 PCS/MCS, Majeed, Merle, and FADI, but not the QuickDASH. CONCLUSION The PON is a pragmatic PROM that can be easily administered in clinic by the physician to quickly assess and manage a variety of fractures, avoiding the disadvantages of non-relative general or region-specific PROMs. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.