Outcome Scores in Wrist Injuries....Are They Right?

Description

In this presentation, Andrew Duckworth summarizes critical insights regarding patient-reported outcome measures (PROMs) in the context of recent research on orthopedic trials. He emphasizes the challenges and limitations of existing outcome scores, particularly in light of their applicability to various patient demographics, including the elderly. Duckworth reviews notable studies, such as the AIM and PROFHER trials, which illustrate that despite significant differences in complication rates following different treatment methods, the PROMs often yield no significant outcome differences, suggesting that these score systems might not adequately capture the nuances of patient recovery experiences.



He highlights specific considerations that affect the validity of PROMs, like the age appropriateness of scores like the DASH and PRWE, the context of elective versus trauma surgeries, and issues such as ceiling and floor effects. Importantly, Duckworth points out that many patients may report satisfactory PROMs yet still feel their recovery is incomplete, indicating a disconnect between quantifiable outcomes and patient perceptions.



Furthermore, Duckworth stresses the need for evolving PROMs that can better accommodate patient variability and accurately reflect their recovery journeys. He advocates for the potential adoption of advanced adaptive scoring methods like PROMIS to address these issues and improve outcome assessments in future clinical trials, ultimately aiming to enhance patient care and treatment efficacy.

DOI: 10.1302/3114-250994

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