--- title: "Implement pt-reported outcomes system-orthopedic practice. | Sutter Health" description: "Using tablets to administer computerized adaptive tests and enter the data in EMR for later retrieval was effective technique to collect pt-reported outcomes." url: "https://www.sutterhealth.org/research/publications/implement-pt-reported-outcomes-system-orthopedic-practice-1055312399" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Implement pt-reported outcomes system-orthopedic practice. # Implementation of patient-reported outcomes measurement information system data collection in a private orthopedic surgery practice. Haskell A & Kim T. _Foot Ankle Int. 1071100717753967. doi: 10.1177/1071100717753967. \[Epub ahead of print\]_ 2018-01-01 ## Abstract BACKGROUND: The authors describe a method of collecting patient-reported outcomes (PROs) using computerized adaptive tests (CATs) in a high-volume orthopedic surgery practice with limited resources and no research coordinator. METHODS: Patient-Reported Outcomes Measurement Information System CATs were collected prospectively for all clinic patients using a tablet and recorded in the electronic medical record. Scores were compared with validated national norms using single-variable t tests. Linear regression was used to assess age effects. Preoperative and postoperative pain scales were compared using paired t tests. RESULTS: In total, 4,524 CATs were administered during 10,719 visits (42%), reaching 70% as more tablets were introduced. Completing the CATs required 157 seconds. Older patients took more time than younger ones ( P < .05). Compared with normalized t scores of 50 ± 10 for the US population, pain intensity was 48.0 (95% confidence interval \[CI\], 47.8-48.2), pain interference 58.9 (95% CI, 58.6-59.1), physical function 40.1 (95% CI, 39.9-40.3), global physical health 43.4 (95% CI, 41.9-44.9), and global mental health 41.1 (95% CI, 40.89-41.4) ( P < .05 for all). Age had a small effect on all domains ( P < .05). Approximately 20 patients would be required to demonstrate a 15% change for a 2-tailed, paired study with α = 0.05 and 80% power. After surgery, pain intensity improved from 51.9 ± 8.2 to 44.1 ± 8.5, pain interference improved from 62.5 ± 6.9 to 55.7 ± 8.4, and physical function improved from 37.3 ± 8.9 to 41.5 ± 7.9 ( P < .05 for all). CONCLUSIONS: Using tablets to administer CATs and entering the data in the electronic medical record for later retrieval was an effective technique to collect PROs. An adequate number of tablets are needed for acceptable completion rates. Modest sample size requirements for comparative studies highlight the potential of these tools and techniques. LEVEL OF EVIDENCE: Level II, Prospective Comparative Study. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/29366343) ![Andrew Haskell, M.D.](https://dyn.mktgcdn.com/p/e19Z0QwiEJVIawTe_Uey_VlyYexupaSsdn87lO6XoJk/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Andrew Haskell, M.D. Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/andrew-haskell-md-1049681101) ## Research topics - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Medical Informatics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Medical+Informatics%5C%22%22) - [Musculoskeletal Disorders](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Musculoskeletal+Disorders%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Patterns of health care utilization for low back pain.](https://www.sutterhealth.org/research/publications/health-care-utilization-in-low-back-pain-1055312713) Stewart WF, Yan X, Boscarino JA, Maeng DD, Mardekian J, Sanchez RJ, Von Korff MR. J Pain Res. 8:523-35. doi: 10.2147/JPR.S83599. eCollection 2015. 2015 Aug 12 - Publication ### [Patient characteristics and healthcare utilization of a chronic pain population within an integrated healthcare system.](https://www.sutterhealth.org/research/publications/pt-characteristics-healthcare-use-chronic-pain-1055312340) Romanelli RJ, Shah SN, Ikeda L, Lynch B, Craig TL, Cappelleri JC, Jukes T, Ishisaka D. Am J Manag Care. 23(2):e50-e56. 2017 Feb 01 - Publication ### [Opioid prescribing for chronic pain in a community-based healthcare system.](https://www.sutterhealth.org/research/publications/opiod-prescribing-chronic-pain-community-health-1055312298) Romanelli RJ, Ikeda LI, Lynch B, Craig T, Cappelleri JC, Jukes T, Ishisaka DY. Am J Manag Care. 23(5):e138-e145. 2017 May 01 - Publication ### [Primary care physician practice styles and quality, cost, and productivity.](https://www.sutterhealth.org/research/publications/pcp-practice-styles-and-quality-cost-productivity-1055312774) Luft HS, Liang SY, Eaton LJ, Chung S. Am J Manag Care. 26(4):e127-e134. doi: 10.37765/ajmc.2020.42840. 2020 Apr 01 - Publication ### [Implementation of departmental quality strategies is positively associated with clinical practice: results of a multicenter study in 73 hospitals in 7 European countries.](https://www.sutterhealth.org/research/publications/quality-strategies-assoc-clinical-practrace-1055312466) Sunol R, Wagner C, Arah OA, Kristensen S, Pfaff H, Klazinga N, Thompson CA, Wang A, DerSarkissian M, Bartels P, Michel P, Groene O; DUQuE Project Consortium. PLoS One. 10(11):e0141157. doi: 10.1371/journal.pone.0141157. 2015 Nov 20 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/implement-pt-reported-outcomes-system-orthopedic-practice-1055312399#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Implement pt-reported outcomes system-orthopedic practice."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/implement-pt-reported-outcomes-system-orthopedic-practice-1055312399#medicalscholarlyarticle","name":"Implementation of patient-reported outcomes measurement information system data collection in a private orthopedic surgery practice.","headline":"Implement pt-reported outcomes system-orthopedic practice.","abstract":"BACKGROUND: The authors describe a method of collecting patient-reported outcomes (PROs) using computerized adaptive tests (CATs) in a high-volume orthopedic surgery practice with limited resources and no research coordinator. METHODS: Patient-Reported Outcomes Measurement Information System CATs were collected prospectively for all clinic patients using a tablet and recorded in the electronic medical record. Scores were compared with validated national norms using single-variable t tests. Linear regression was used to assess age effects. Preoperative and postoperative pain scales were compared using paired t tests. RESULTS: In total, 4,524 CATs were administered during 10,719 visits (42%), reaching 70% as more tablets were introduced. Completing the CATs required 157 seconds. Older patients took more time than younger ones ( P \u003c .05). Compared with normalized t scores of 50 ± 10 for the US population, pain intensity was 48.0 (95% confidence interval [CI], 47.8-48.2), pain interference 58.9 (95% CI, 58.6-59.1), physical function 40.1 (95% CI, 39.9-40.3), global physical health 43.4 (95% CI, 41.9-44.9), and global mental health 41.1 (95% CI, 40.89-41.4) ( P \u003c .05 for all). Age had a small effect on all domains ( P \u003c .05). Approximately 20 patients would be required to demonstrate a 15% change for a 2-tailed, paired study with α = 0.05 and 80% power. After surgery, pain intensity improved from 51.9 ± 8.2 to 44.1 ± 8.5, pain interference improved from 62.5 ± 6.9 to 55.7 ± 8.4, and physical function improved from 37.3 ± 8.9 to 41.5 ± 7.9 ( P \u003c .05 for all). CONCLUSIONS: Using tablets to administer CATs and entering the data in the electronic medical record for later retrieval was an effective technique to collect PROs. An adequate number of tablets are needed for acceptable completion rates. Modest sample size requirements for comparative studies highlight the potential of these tools and techniques. 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