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Quality of Life Research
Published in: Quality of Life Research 9/2018

01-09-2018

Anxiety in the orthopedic patient: using PROMIS to assess mental health

Authors: Casey M. Beleckas, Heidi Prather, Jason Guattery, Melissa Wright, Michael Kelly, Ryan P. Calfee

Published in: Quality of Life Research | Issue 9/2018

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Abstract

Purpose

This study explored the performance of the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety assessment relative to the Depression assessment in orthopedic patients, the relationship between Anxiety with self-reported Physical Function and Pain Interference, and to determine if Anxiety levels varied according to the location of orthopedic conditions.

Methods

This cross-sectional evaluation analyzed 14,962 consecutive adult new-patient visits to a tertiary orthopedic practice between 4/1/2016 and 12/31/2016. All patients completed PROMIS Anxiety, Depression, Physical Function, and Pain Interference computer adaptive tests (CATs) as routine clinical intake. Patients were grouped by the orthopedic service providing care and categorized as either affected with Anxiety if scoring > 62 based on linkage to the Generalized Anxiety Disorder-7 survey. Spearman correlations between the PROMIS scores were calculated. Bivariate statistics assessed differences in Anxiety and Depression scores between patients of different orthopedic services.

Results

20% of patients scored above the threshold to be considered affected by Anxiety. PROMIS Anxiety scores demonstrated a stronger correlation than Depression scores with Physical Function and Pain Interference scores. Patients with spine conditions reported the highest median Anxiety scores and were more likely to exceed the Anxiety threshold than patients presenting to sports or upper extremity surgeons.

Conclusions

One in five new orthopedic patients reports Anxiety levels that may warrant intervention. This rate is heightened in patients needing spine care. Patient-reported Physical Function more strongly correlates with PROMIS Anxiety than Depression suggesting that the Anxiety CAT is a valuable addition to assess mental health among orthopedic patients.

Level of Evidence

Diagnostic level III.
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Metadata
Title
Anxiety in the orthopedic patient: using PROMIS to assess mental health
Authors
Casey M. Beleckas
Heidi Prather
Jason Guattery
Melissa Wright
Michael Kelly
Ryan P. Calfee
Publication date
01-09-2018
Publisher
Springer International Publishing
Published in
Quality of Life Research / Issue 9/2018
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-018-1867-7

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