Eur Spine J. 2025 Aug 30. doi: 10.1007/s00586-025-09254-5. Online ahead of print.
ABSTRACT
PURPOSE: To identify collection methods and perioperative factors linked to 12-month patient-reported outcome measure (PROM) response rate and evaluate the effect of loss to follow-up on PROM results.
METHODS: The study included 2588 elective lumbar decompressive surgery without spinal fusion during 2008-2023. The primary PROM was the Oswestry Disability Index (ODI). The independent effect of PROM collection methods and perioperative factors on 12-month ODI response was examined. The effect of loss to follow-up on 12-month PROM responder results was evaluated with modelled 12-month PROM and with observed 3-month PROM in a group with last ODI response at 3-months. The response rate to 6-month electronic-only collection was evaluated in patients who advocated to also receive electronic questionnaires.
RESULTS: Proportionally, 70.8% (1832/2588) were 12-month ODI responders, 19.4% (501/2588) provided a last ODI response at 3-months, and 9.9% (255/2588) were ODI non-responders. The PROM collection method linked to the highest 12-month ODI response rate was two attempts each by electronic and postal questionnaire. Important perioperative factors for lower 12-month ODI response were younger age, smoker, ASA grade, physical comorbidities, male, and anxiety/depression. Twelve-month responder PROM results were unchanged (≤ 1% of metric) by the addition of missing values from modelled PROM or last ODI response at 3-months. The 6-month ODI response rate to electronic-only questionnaire was 48% (467/969).
CONCLUSION: Combined electronic and postal PROM collection achieved a 78% response rate. Populations at risk of underrepresentation in spinal register 12-month results were identified. Twelve-month PROM results are not significantly affected by 29% missing data.
PMID:40884548 | DOI:10.1007/s00586-025-09254-5
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