Scoliosis Research Society-22r and Ceiling Effects: Limited Capabilities for Precision-Medicine with Adolescent Idiopathic Scoliosis.
Journal
Spine
ISSN: 1528-1159
Titre abrégé: Spine (Phila Pa 1976)
Pays: United States
ID NLM: 7610646
Informations de publication
Date de publication:
19 Mar 2024
19 Mar 2024
Historique:
received:
20
12
2023
accepted:
11
03
2024
medline:
19
3
2024
pubmed:
19
3
2024
entrez:
19
3
2024
Statut:
aheadofprint
Résumé
Retrospective registry analysis. To examine predictions of individual Scoliosis Research Society-22r (SRS-22r) questions one year after surgery for adolescent idiopathic scoliosis (AIS). A precision-medicine approach to AIS surgery will inform patients of the likelihood of achieving particular results from surgery, specifically individual responses to the SRS-22r questionnaire. A multi-center AIS registry was queried for surgical AIS patients treated between 2002-2020. Preoperative data collected included standard demographic data, deformity descriptive data, and SRS-22r scores. Postoperative 1yr SRS-22r scores were modeled using ordinal logistic regression. . The highest probability was the most likely response. Model performance was examined by c-statistics, where c>.8 was considered excellent. Ceiling effects were measured by the proportion of patients reporting "5" to each question. 3251 patients contributed data to the study; mean age 14.4 (±2.2) yrs, female 2631 (81%), major thoracic coronal curve 53°, mean lumbar 41°. C-statistic values ranged from .6 (poor) to .8 (excellent) evidence of varied predictive capabilities. Q17 ("days off work/school", c = .84, ceiling achieved 75%) and Q15 ("financial difficulties", c = .86, ceiling achieved 82%) had the greatest predictive capabilities while Q11 ("pain medication", c=.73, ceiling achieved 67%), Q10 ("appearance", c=.72, ceiling achieved 35%), and Q19 ("attractive", c=.69, ceiling achieved 37%) performed poorly. Prediction of individual SRS-22r item responses perhaps most germane to AIS treatment was poor. Prediction of less relevant outcomes, where ceiling effects are present, was greater as the models chose "5" for all responses. These ceiling effects may limit discrimination and hamper efforts at personalized outcome predictions. 3.
Sections du résumé
STUDY DESIGN
METHODS
Retrospective registry analysis.
OBJECTIVE
OBJECTIVE
To examine predictions of individual Scoliosis Research Society-22r (SRS-22r) questions one year after surgery for adolescent idiopathic scoliosis (AIS).
SUMMARY OF BACKGROUND DATA
BACKGROUND
A precision-medicine approach to AIS surgery will inform patients of the likelihood of achieving particular results from surgery, specifically individual responses to the SRS-22r questionnaire.
METHODS
METHODS
A multi-center AIS registry was queried for surgical AIS patients treated between 2002-2020. Preoperative data collected included standard demographic data, deformity descriptive data, and SRS-22r scores. Postoperative 1yr SRS-22r scores were modeled using ordinal logistic regression. . The highest probability was the most likely response. Model performance was examined by c-statistics, where c>.8 was considered excellent. Ceiling effects were measured by the proportion of patients reporting "5" to each question.
RESULTS
RESULTS
3251 patients contributed data to the study; mean age 14.4 (±2.2) yrs, female 2631 (81%), major thoracic coronal curve 53°, mean lumbar 41°. C-statistic values ranged from .6 (poor) to .8 (excellent) evidence of varied predictive capabilities. Q17 ("days off work/school", c = .84, ceiling achieved 75%) and Q15 ("financial difficulties", c = .86, ceiling achieved 82%) had the greatest predictive capabilities while Q11 ("pain medication", c=.73, ceiling achieved 67%), Q10 ("appearance", c=.72, ceiling achieved 35%), and Q19 ("attractive", c=.69, ceiling achieved 37%) performed poorly.
CONCLUSION
CONCLUSIONS
Prediction of individual SRS-22r item responses perhaps most germane to AIS treatment was poor. Prediction of less relevant outcomes, where ceiling effects are present, was greater as the models chose "5" for all responses. These ceiling effects may limit discrimination and hamper efforts at personalized outcome predictions.
LEVEL OF EVIDENCE
METHODS
3.
Identifiants
pubmed: 38501486
doi: 10.1097/BRS.0000000000004993
pii: 00007632-990000000-00620
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Investigateurs
Aaron Buckland
(A)
Amer Samdani
(A)
Amit Jain
(A)
Baron Lonner
(B)
Benjamin Roye
(B)
Burt Yaszay
(B)
Chris Reilly
(C)
Daniel Hedequist
(D)
Daniel Sucato
(D)
David Clements
(D)
Firoz Miyanji
(F)
Harry Shufflebarger
(H)
Jack Flynn
(J)
John Asghar
(J)
Jean Marc Mac Thiong
(JM)
Joshua Pahys
(J)
Juergen Harms
(J)
Keith Bachmann
(K)
Lawrence Lenke
(L)
Lori Karol
(L)
Mark Abel
(M)
Mark Erickson
(M)
Michael Glotzbecker
(M)
Michael Kelly
(M)
Michael Vitale
(M)
Michelle Marks
(M)
Munish Gupta
(M)
Nicholas Fletcher
(N)
Noelle Larson
(N)
Patrick Cahill
(P)
Paul Sponseller
(P)
Peter Gabos
(P)
Peter Newton
(P)
Peter Sturm
(P)
Randal Betz
(R)
Stefan Parent
(S)
Stephen George
(S)
Steven Hwang
(S)
Suken Shah
(S)
Sumeet Garg
(S)
Tom Errico
(T)
Vidyadhar Upasani
(V)
Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of Interest Disclosure: This study was supported in part by grants to the Setting Scoliosis Straight Foundation in support of Harms Study Group research from DePuy Synthes Spine, EOS imaging, Stryker Spine, Medtronic, NuVasive, Zimmer Biomet and the Food and Drug Administration.