Discrimination Ability of PROMIS Pediatric Domains compared to SRS-22r and Legacy PROMs in Juvenile and Adolescent Idiopathic Scoliosis.

STUDY DESIGN Comparative cohort study. OBJECTIVE To compare patient reported outcome measures (PROMs) in children and adolescents with varying extent of spinal deformity. SUMMARY OF BACKGROUND DATA Several PROMs have been proposed to help assess health-related quality-of-life (HRQoL) in pediatric spinal deformity surgery and research, but it is unclear which are sensitive to deformity severity. METHODS Pediatric patients diagnosed with spinal asymmetry or juvenile/adolescent idiopathic scoliosis completed the Patient-Reported Outcomes Management Information System (PROMIS) Pediatric Computer Adaptive Test Bank (Domains: Mobility, Pain Interference, Physical Activity, Physical Stress Experiences, Psychological Stress Experiences), SRS-22r, HSS Pedi-FABS activity scale, and Trunk Appearance Perception Scale. Patients were grouped as spinal asymmetry, mild deformity, and substantial deformity by major Cobb angle measuring less than 10°, between 10° and 40°, and greater than 40° respectively. One-way ANOVA with a Tukey post-hoc correction was used to determine score differences between groups. RESULTS Final analyses included 206 patients, of which 135 (66%) were female. The mean age was 13.0 ± 2.2 years, the mean major Cobb angle was 20.1 ± 14.1° (range: 0-74.2°). Compared to both spinal asymmetry and mild deformity patients, patients with substantial deformity reported worse outcomes, including lower function, more pain, and decreased psychological health by legacy PROMs and PROMIS. PROMIS Physical Activity and Psychological Stress Experiences did not capture any significant differences between all groups. There were no significant differences in outcomes between the spinal asymmetry and mild deformity groups for all PROMs measured. CONCLUSIONS Patients with substantial spinal deformity reported lower activity and function, more pain, and greater physical and psychological stress compared to patients without clinical spinal deformity by legacy PROMs and several PROMIS domains. As PROMIS Physical Activity and Psychological Stress Experiences did not capture these differences, these PROMs may measure different constructs than the legacy PROMs as they relate to spinal curvature and may be less relevant to measure HRQoL in this population. LEVEL OF EVIDENCE 3.