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A Nassr - One of the best experts on this subject based on the ideXlab platform.
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wednesday september 26 2018 9 00 am 10 00 am best papers 2 do cervical spine surgery patients Recall their preoperative status a cohort study of Recall Bias in patient reported outcomes
The Spine Journal, 2018Co-Authors: Ilyas S Aleem, Bradford L Currier, Paul M Huddleston, John M Rhee, Mohamad Bydon, Brett A Freedman, Mhd Tayseer Shamaa, A NassrAbstract:BACKGROUND CONTEXT Surgery for cervical degenerative myelopathy or radiculopathy focuses on addressing pain and disability while improving the patients’ quality of life. Although patient-reported outcomes (PROs) are being widely adopted, their ability to be interpreted may be limited by the accuracy of a patient's ability to Recall preintervention impairment. PURPOSE Recall Bias has been previously investigated in multiple orthopedic and lumbar spine studies, but Recall accuracy in cervical spine patients remains unknown. We sought to characterize the accuracy of patient Recall as a function of time on validated outcomes after cervical spine surgery. STUDY DESIGN/SETTING Retrospective review of prospectively collected outcomes. PATIENT SAMPLE Consecutive series of patients undergoing cervical spine surgery for myelopathy or radiculopathy. OUTCOME MEASURES Numeric pain scale, neck disability index. METHODS We analyzed a consecutive series of patients undergoing cervical spine surgery for degenerative myelopathy or radiculopathy at a single institution. Using standardized questionnaires, we recorded preoperative neck and arm numeric pain scores (NPS), neck disability indices (NDI) and 36-Item Short Form Health Survey (SF-36). Patients were asked to Recall their preoperative status through a standardized phone call script and were subsequently stratified based on the timing of their Recall into short-term ( 1 year) follow-up sub-groups. Actual and Recalled scores were compared using McNemar's or paired t tests, and relations were quantified using Pearson correlation coefficients. Characteristics between the subgroups were compared using Wilcoxon rank sum tests, t-tests, chi-square tests, or Fisher's exact tests as appropriate. RESULTS Seventy-three patients with a mean age of 58.2 years (range 22 to 83 years) were included, with 34 and 39 patients in the short-term and long-term follow-up subgroups patients respectively. The mean period of Recall from surgery was 4.6 months and 22.2 months for the short-term and long-term follow-up subgroups respectively. Compared to the preoperative scores, patients showed significant improvement in neck NPS (mean difference [MD]=−2.9, 95% CI −3.5 to −2.3), arm NPS (MD −3.4, 95% CI −4.0 to −2.8), and NDI (MD −12.4%, 95% CI −16.9 to −7.9). Patient recollection of preoperative status was more severe than actual for neck NPS (MD +1.5, p CONCLUSIONS Relying on retrospectively Recalled data for outcome assessment does not provide an accurate measure of preoperative status. Prospective collection of PROs remains the gold standard to measure outcomes following cervical spine surgery. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.
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do cervical spine surgery patients Recall their preoperative status a cohort study of Recall Bias in patient reported outcomes
Journal of Spinal Disorders & Techniques, 2018Co-Authors: Ilyas S Aleem, Bradford L Currier, Michael J Yaszemski, Heidi Poppendeck, Paul M Huddleston, Jason C Eck, John M Rhee, Mohamad Bydon, Brett A Freedman, A NassrAbstract:STUDY DESIGN This is a prospective cohort study. OBJECTIVE To characterize the accuracy of patient recollection of preoperative symptoms after cervical spine surgery. SUMMARY OF BACKGROUND DATA Recall Bias is a well-known source of systematic error. The accuracy of patient Recall after cervical spine surgery remains unknown. METHODS Consecutive patients undergoing cervical spine surgery for myelopathy or radiculopathy were enrolled. Neck and arm numeric pain scores and Neck Disability Indices were recorded preoperatively. Patients were asked to Recall their preoperative status at either short (<1 y) or long-term (≥1 y) follow-up. Actual and Recalled scores were compared using paired t tests and relations were quantified using the Pearson correlation coefficients. Multivariable linear regression was used to identify factors impacting recollection. RESULTS In total, 73 patients with a mean age of 58.2 years were included. Compared with their preoperative scores, patients showed significant improvement in neck pain [mean difference (MD)=-2.9; 95% confidence intervals (CIs), -3.5 to -2.3], arm pain (MD, -3.4; 95% CI, -4.0 to -2.8), and disability (MD, -12.4%; 95% CI, -16.9 to -7.9). Patient recollection of preoperative status was significantly more severe than actual for neck pain (MD, +1.5; 95% CI, 0.8-2.2), arm pain (MD, +2.3; 95% CI, 1.6-3.0), and disability (MD, +5.8%; 95% CI, 2.4-9.2). Moderate correlation between actual and Recalled scores with regard to neck (r=0.41), arm (r=0.50) pain, and disability (r=0.67) was seen. This was maintained across age, sex, and time between date of surgery and recollection. Over 30% of patients switched their predominant symptom from neck-to-arm pain or vice versa on Recall of their preoperative symptoms. CONCLUSIONS Relying on patient recollection does not provide an accurate measure of preoperative status after cervical spine surgery. Prospective and not retrospective collection of patient-reported outcomes remain the gold standard to measure and interpret outcomes after cervical spine surgery. Recall Bias has the potential to affect patient satisfaction and requires further study.
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do lumbar decompression and fusion patients Recall their preoperative status a cohort study of Recall Bias in patient reported outcomes
Spine, 2017Co-Authors: Ilyas S Aleem, M Zarrabian, Bradford L Currier, Jason C Eck, John M Rhee, Jonathan S Duncan, Amin Mohamed Ahmed, Michelle J Clarke, A NassrAbstract:STUDY DESIGN Prospective cohort study. OBJECTIVE To characterize the accuracy of patient recollection of preoperative symptoms after lumbar spine surgery. SUMMARY OF BACKGROUND DATA Although patient-reported outcomes have become important in the evaluation of spine surgery patients, the accuracy of patient Recall remains unknown. METHODS Patients undergoing lumbar decompression with or without fusion were enrolled. Back and leg Numeric Pain Scores and Oswestry Disability Indices were recorded preoperatively. Patients were asked to Recall their preoperative status at a minimum of 1 year after surgery. Actual and Recalled scores were compared using paired t tests and relations were quantified using Pearson correlation coefficients. Multivariable linear regression was used to identify factors that affected recollection. RESULTS Sixty-two patients with a mean age of 66.1 years were included. Compared to their preoperative scores, patients showed significant improvement in back pain (mean difference [MD] = -3.2, 95% CI -4.0 to -2.4), leg pain (MD -3.3, 95% CI -4.3 to -2.2), and disability (MD -25.0%, 95% CI -28.7 to -19.6). Patient recollection of preoperative status was significantly more severe than actual for back pain (MD +2.3, 95% CI 1.5-3.2), leg pain (MD +1.8, 95% CI 0.9-2.7), and disability (MD +9.6%, 95% CI 5.6-14.0). No significant correlation between actual and Recalled scores with regards to back (r = 0.18) or leg (r = 0.24) pain and only moderate correlation with disability (r = 0.44) were seen. This was maintained across age, sex, and time between date of surgery and recollection. More than 40% of patients switched their predominant symptom from back pain to leg pain or leg pain to back pain on Recall. CONCLUSION Relying on patient recollection does not provide an accurate measure of preoperative status after lumbar spine surgery. Recall Bias indicates the importance of obtaining true baseline scores and patient-reported outcomes prospectively and not retrospectively. LEVEL OF EVIDENCE 2.
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do lumbar decompression and fusion patients Recall their pre operative status Recall Bias in patient reported outcomes
Journal of Bone and Joint Surgery-british Volume, 2016Co-Authors: M Zarrabian, I Aleem, J Duncan, A Ahmed, J Eck, J Rhee, B Currier, A NassrAbstract:Although patient-reported outcomes (PROs) have become increasingly important in the evaluation of spine surgery patients, interpretability may be limited by a patient9s ability to Recall pre-intervention impairment. The accuracy of patient Recall of preoperative back pain, leg pain, and disability after spine surgery remains unknown. We sought to characterise the accuracy of patient Recall of preoperative symptoms in a cohort of lumbar spine surgery patients. We analysed consecutive patients undergoing lumbar decompression or decompression and fusion for lumbar radiculopathy by a single surgeon over a four-year period. Using standardised questionnaires, we recorded back and leg numeric pain scores (NPS) and Oswestry Disability Indices (ODI) preoperatively and asked patients to Recall their preoperative status at a minimum of one-year following surgery. We then statistically compared and characterised patient Recall of their pre-operative status and their actual pre-operative status. Patients with incomplete follow up or diagnoses other than degenerative lumbar stenosis were excluded. Sixty-seven patients with a mean age of 66.1 years (55% female) were included in the final analysis. All cases were either posterior or combined anterior/ posterior procedures. Mean levels of surgery was 1.7 and 93.8% of all cases were instrumented. Mean duration of preoperative symptoms was 44.5 months (3.7 years). Preoperative vs postoperative PROs improved with regards to NPS back (5.2 vs 2.2, p= to 2 point difference), exceeding the minimal clinical important difference (MCID) for NPS. This pattern was maintained across age, gender, and duration of preoperative symptoms. We also observed cases of symptom minimisation Recall Bias, and cases in which back and leg pain predominance were switched in severity during Recall Bias. Significant Recall Bias of preoperative symptoms exists in patients undergoing spine surgery, potentially limiting accurate assessment and interpretation of PROs. An understanding of PROs and their limitations is essential to assess treatment efficacy of spinal procedures.
Ilyas S Aleem - One of the best experts on this subject based on the ideXlab platform.
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wednesday september 26 2018 9 00 am 10 00 am best papers 2 do cervical spine surgery patients Recall their preoperative status a cohort study of Recall Bias in patient reported outcomes
The Spine Journal, 2018Co-Authors: Ilyas S Aleem, Bradford L Currier, Paul M Huddleston, John M Rhee, Mohamad Bydon, Brett A Freedman, Mhd Tayseer Shamaa, A NassrAbstract:BACKGROUND CONTEXT Surgery for cervical degenerative myelopathy or radiculopathy focuses on addressing pain and disability while improving the patients’ quality of life. Although patient-reported outcomes (PROs) are being widely adopted, their ability to be interpreted may be limited by the accuracy of a patient's ability to Recall preintervention impairment. PURPOSE Recall Bias has been previously investigated in multiple orthopedic and lumbar spine studies, but Recall accuracy in cervical spine patients remains unknown. We sought to characterize the accuracy of patient Recall as a function of time on validated outcomes after cervical spine surgery. STUDY DESIGN/SETTING Retrospective review of prospectively collected outcomes. PATIENT SAMPLE Consecutive series of patients undergoing cervical spine surgery for myelopathy or radiculopathy. OUTCOME MEASURES Numeric pain scale, neck disability index. METHODS We analyzed a consecutive series of patients undergoing cervical spine surgery for degenerative myelopathy or radiculopathy at a single institution. Using standardized questionnaires, we recorded preoperative neck and arm numeric pain scores (NPS), neck disability indices (NDI) and 36-Item Short Form Health Survey (SF-36). Patients were asked to Recall their preoperative status through a standardized phone call script and were subsequently stratified based on the timing of their Recall into short-term ( 1 year) follow-up sub-groups. Actual and Recalled scores were compared using McNemar's or paired t tests, and relations were quantified using Pearson correlation coefficients. Characteristics between the subgroups were compared using Wilcoxon rank sum tests, t-tests, chi-square tests, or Fisher's exact tests as appropriate. RESULTS Seventy-three patients with a mean age of 58.2 years (range 22 to 83 years) were included, with 34 and 39 patients in the short-term and long-term follow-up subgroups patients respectively. The mean period of Recall from surgery was 4.6 months and 22.2 months for the short-term and long-term follow-up subgroups respectively. Compared to the preoperative scores, patients showed significant improvement in neck NPS (mean difference [MD]=−2.9, 95% CI −3.5 to −2.3), arm NPS (MD −3.4, 95% CI −4.0 to −2.8), and NDI (MD −12.4%, 95% CI −16.9 to −7.9). Patient recollection of preoperative status was more severe than actual for neck NPS (MD +1.5, p CONCLUSIONS Relying on retrospectively Recalled data for outcome assessment does not provide an accurate measure of preoperative status. Prospective collection of PROs remains the gold standard to measure outcomes following cervical spine surgery. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.
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do cervical spine surgery patients Recall their preoperative status a cohort study of Recall Bias in patient reported outcomes
Journal of Spinal Disorders & Techniques, 2018Co-Authors: Ilyas S Aleem, Bradford L Currier, Michael J Yaszemski, Heidi Poppendeck, Paul M Huddleston, Jason C Eck, John M Rhee, Mohamad Bydon, Brett A Freedman, A NassrAbstract:STUDY DESIGN This is a prospective cohort study. OBJECTIVE To characterize the accuracy of patient recollection of preoperative symptoms after cervical spine surgery. SUMMARY OF BACKGROUND DATA Recall Bias is a well-known source of systematic error. The accuracy of patient Recall after cervical spine surgery remains unknown. METHODS Consecutive patients undergoing cervical spine surgery for myelopathy or radiculopathy were enrolled. Neck and arm numeric pain scores and Neck Disability Indices were recorded preoperatively. Patients were asked to Recall their preoperative status at either short (<1 y) or long-term (≥1 y) follow-up. Actual and Recalled scores were compared using paired t tests and relations were quantified using the Pearson correlation coefficients. Multivariable linear regression was used to identify factors impacting recollection. RESULTS In total, 73 patients with a mean age of 58.2 years were included. Compared with their preoperative scores, patients showed significant improvement in neck pain [mean difference (MD)=-2.9; 95% confidence intervals (CIs), -3.5 to -2.3], arm pain (MD, -3.4; 95% CI, -4.0 to -2.8), and disability (MD, -12.4%; 95% CI, -16.9 to -7.9). Patient recollection of preoperative status was significantly more severe than actual for neck pain (MD, +1.5; 95% CI, 0.8-2.2), arm pain (MD, +2.3; 95% CI, 1.6-3.0), and disability (MD, +5.8%; 95% CI, 2.4-9.2). Moderate correlation between actual and Recalled scores with regard to neck (r=0.41), arm (r=0.50) pain, and disability (r=0.67) was seen. This was maintained across age, sex, and time between date of surgery and recollection. Over 30% of patients switched their predominant symptom from neck-to-arm pain or vice versa on Recall of their preoperative symptoms. CONCLUSIONS Relying on patient recollection does not provide an accurate measure of preoperative status after cervical spine surgery. Prospective and not retrospective collection of patient-reported outcomes remain the gold standard to measure and interpret outcomes after cervical spine surgery. Recall Bias has the potential to affect patient satisfaction and requires further study.
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do lumbar decompression and fusion patients Recall their preoperative status a cohort study of Recall Bias in patient reported outcomes
Spine, 2017Co-Authors: Ilyas S Aleem, M Zarrabian, Bradford L Currier, Jason C Eck, John M Rhee, Jonathan S Duncan, Amin Mohamed Ahmed, Michelle J Clarke, A NassrAbstract:STUDY DESIGN Prospective cohort study. OBJECTIVE To characterize the accuracy of patient recollection of preoperative symptoms after lumbar spine surgery. SUMMARY OF BACKGROUND DATA Although patient-reported outcomes have become important in the evaluation of spine surgery patients, the accuracy of patient Recall remains unknown. METHODS Patients undergoing lumbar decompression with or without fusion were enrolled. Back and leg Numeric Pain Scores and Oswestry Disability Indices were recorded preoperatively. Patients were asked to Recall their preoperative status at a minimum of 1 year after surgery. Actual and Recalled scores were compared using paired t tests and relations were quantified using Pearson correlation coefficients. Multivariable linear regression was used to identify factors that affected recollection. RESULTS Sixty-two patients with a mean age of 66.1 years were included. Compared to their preoperative scores, patients showed significant improvement in back pain (mean difference [MD] = -3.2, 95% CI -4.0 to -2.4), leg pain (MD -3.3, 95% CI -4.3 to -2.2), and disability (MD -25.0%, 95% CI -28.7 to -19.6). Patient recollection of preoperative status was significantly more severe than actual for back pain (MD +2.3, 95% CI 1.5-3.2), leg pain (MD +1.8, 95% CI 0.9-2.7), and disability (MD +9.6%, 95% CI 5.6-14.0). No significant correlation between actual and Recalled scores with regards to back (r = 0.18) or leg (r = 0.24) pain and only moderate correlation with disability (r = 0.44) were seen. This was maintained across age, sex, and time between date of surgery and recollection. More than 40% of patients switched their predominant symptom from back pain to leg pain or leg pain to back pain on Recall. CONCLUSION Relying on patient recollection does not provide an accurate measure of preoperative status after lumbar spine surgery. Recall Bias indicates the importance of obtaining true baseline scores and patient-reported outcomes prospectively and not retrospectively. LEVEL OF EVIDENCE 2.
Bradford L Currier - One of the best experts on this subject based on the ideXlab platform.
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wednesday september 26 2018 9 00 am 10 00 am best papers 2 do cervical spine surgery patients Recall their preoperative status a cohort study of Recall Bias in patient reported outcomes
The Spine Journal, 2018Co-Authors: Ilyas S Aleem, Bradford L Currier, Paul M Huddleston, John M Rhee, Mohamad Bydon, Brett A Freedman, Mhd Tayseer Shamaa, A NassrAbstract:BACKGROUND CONTEXT Surgery for cervical degenerative myelopathy or radiculopathy focuses on addressing pain and disability while improving the patients’ quality of life. Although patient-reported outcomes (PROs) are being widely adopted, their ability to be interpreted may be limited by the accuracy of a patient's ability to Recall preintervention impairment. PURPOSE Recall Bias has been previously investigated in multiple orthopedic and lumbar spine studies, but Recall accuracy in cervical spine patients remains unknown. We sought to characterize the accuracy of patient Recall as a function of time on validated outcomes after cervical spine surgery. STUDY DESIGN/SETTING Retrospective review of prospectively collected outcomes. PATIENT SAMPLE Consecutive series of patients undergoing cervical spine surgery for myelopathy or radiculopathy. OUTCOME MEASURES Numeric pain scale, neck disability index. METHODS We analyzed a consecutive series of patients undergoing cervical spine surgery for degenerative myelopathy or radiculopathy at a single institution. Using standardized questionnaires, we recorded preoperative neck and arm numeric pain scores (NPS), neck disability indices (NDI) and 36-Item Short Form Health Survey (SF-36). Patients were asked to Recall their preoperative status through a standardized phone call script and were subsequently stratified based on the timing of their Recall into short-term ( 1 year) follow-up sub-groups. Actual and Recalled scores were compared using McNemar's or paired t tests, and relations were quantified using Pearson correlation coefficients. Characteristics between the subgroups were compared using Wilcoxon rank sum tests, t-tests, chi-square tests, or Fisher's exact tests as appropriate. RESULTS Seventy-three patients with a mean age of 58.2 years (range 22 to 83 years) were included, with 34 and 39 patients in the short-term and long-term follow-up subgroups patients respectively. The mean period of Recall from surgery was 4.6 months and 22.2 months for the short-term and long-term follow-up subgroups respectively. Compared to the preoperative scores, patients showed significant improvement in neck NPS (mean difference [MD]=−2.9, 95% CI −3.5 to −2.3), arm NPS (MD −3.4, 95% CI −4.0 to −2.8), and NDI (MD −12.4%, 95% CI −16.9 to −7.9). Patient recollection of preoperative status was more severe than actual for neck NPS (MD +1.5, p CONCLUSIONS Relying on retrospectively Recalled data for outcome assessment does not provide an accurate measure of preoperative status. Prospective collection of PROs remains the gold standard to measure outcomes following cervical spine surgery. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.
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do cervical spine surgery patients Recall their preoperative status a cohort study of Recall Bias in patient reported outcomes
Journal of Spinal Disorders & Techniques, 2018Co-Authors: Ilyas S Aleem, Bradford L Currier, Michael J Yaszemski, Heidi Poppendeck, Paul M Huddleston, Jason C Eck, John M Rhee, Mohamad Bydon, Brett A Freedman, A NassrAbstract:STUDY DESIGN This is a prospective cohort study. OBJECTIVE To characterize the accuracy of patient recollection of preoperative symptoms after cervical spine surgery. SUMMARY OF BACKGROUND DATA Recall Bias is a well-known source of systematic error. The accuracy of patient Recall after cervical spine surgery remains unknown. METHODS Consecutive patients undergoing cervical spine surgery for myelopathy or radiculopathy were enrolled. Neck and arm numeric pain scores and Neck Disability Indices were recorded preoperatively. Patients were asked to Recall their preoperative status at either short (<1 y) or long-term (≥1 y) follow-up. Actual and Recalled scores were compared using paired t tests and relations were quantified using the Pearson correlation coefficients. Multivariable linear regression was used to identify factors impacting recollection. RESULTS In total, 73 patients with a mean age of 58.2 years were included. Compared with their preoperative scores, patients showed significant improvement in neck pain [mean difference (MD)=-2.9; 95% confidence intervals (CIs), -3.5 to -2.3], arm pain (MD, -3.4; 95% CI, -4.0 to -2.8), and disability (MD, -12.4%; 95% CI, -16.9 to -7.9). Patient recollection of preoperative status was significantly more severe than actual for neck pain (MD, +1.5; 95% CI, 0.8-2.2), arm pain (MD, +2.3; 95% CI, 1.6-3.0), and disability (MD, +5.8%; 95% CI, 2.4-9.2). Moderate correlation between actual and Recalled scores with regard to neck (r=0.41), arm (r=0.50) pain, and disability (r=0.67) was seen. This was maintained across age, sex, and time between date of surgery and recollection. Over 30% of patients switched their predominant symptom from neck-to-arm pain or vice versa on Recall of their preoperative symptoms. CONCLUSIONS Relying on patient recollection does not provide an accurate measure of preoperative status after cervical spine surgery. Prospective and not retrospective collection of patient-reported outcomes remain the gold standard to measure and interpret outcomes after cervical spine surgery. Recall Bias has the potential to affect patient satisfaction and requires further study.
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do lumbar decompression and fusion patients Recall their preoperative status a cohort study of Recall Bias in patient reported outcomes
Spine, 2017Co-Authors: Ilyas S Aleem, M Zarrabian, Bradford L Currier, Jason C Eck, John M Rhee, Jonathan S Duncan, Amin Mohamed Ahmed, Michelle J Clarke, A NassrAbstract:STUDY DESIGN Prospective cohort study. OBJECTIVE To characterize the accuracy of patient recollection of preoperative symptoms after lumbar spine surgery. SUMMARY OF BACKGROUND DATA Although patient-reported outcomes have become important in the evaluation of spine surgery patients, the accuracy of patient Recall remains unknown. METHODS Patients undergoing lumbar decompression with or without fusion were enrolled. Back and leg Numeric Pain Scores and Oswestry Disability Indices were recorded preoperatively. Patients were asked to Recall their preoperative status at a minimum of 1 year after surgery. Actual and Recalled scores were compared using paired t tests and relations were quantified using Pearson correlation coefficients. Multivariable linear regression was used to identify factors that affected recollection. RESULTS Sixty-two patients with a mean age of 66.1 years were included. Compared to their preoperative scores, patients showed significant improvement in back pain (mean difference [MD] = -3.2, 95% CI -4.0 to -2.4), leg pain (MD -3.3, 95% CI -4.3 to -2.2), and disability (MD -25.0%, 95% CI -28.7 to -19.6). Patient recollection of preoperative status was significantly more severe than actual for back pain (MD +2.3, 95% CI 1.5-3.2), leg pain (MD +1.8, 95% CI 0.9-2.7), and disability (MD +9.6%, 95% CI 5.6-14.0). No significant correlation between actual and Recalled scores with regards to back (r = 0.18) or leg (r = 0.24) pain and only moderate correlation with disability (r = 0.44) were seen. This was maintained across age, sex, and time between date of surgery and recollection. More than 40% of patients switched their predominant symptom from back pain to leg pain or leg pain to back pain on Recall. CONCLUSION Relying on patient recollection does not provide an accurate measure of preoperative status after lumbar spine surgery. Recall Bias indicates the importance of obtaining true baseline scores and patient-reported outcomes prospectively and not retrospectively. LEVEL OF EVIDENCE 2.
John M Rhee - One of the best experts on this subject based on the ideXlab platform.
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wednesday september 26 2018 9 00 am 10 00 am best papers 2 do cervical spine surgery patients Recall their preoperative status a cohort study of Recall Bias in patient reported outcomes
The Spine Journal, 2018Co-Authors: Ilyas S Aleem, Bradford L Currier, Paul M Huddleston, John M Rhee, Mohamad Bydon, Brett A Freedman, Mhd Tayseer Shamaa, A NassrAbstract:BACKGROUND CONTEXT Surgery for cervical degenerative myelopathy or radiculopathy focuses on addressing pain and disability while improving the patients’ quality of life. Although patient-reported outcomes (PROs) are being widely adopted, their ability to be interpreted may be limited by the accuracy of a patient's ability to Recall preintervention impairment. PURPOSE Recall Bias has been previously investigated in multiple orthopedic and lumbar spine studies, but Recall accuracy in cervical spine patients remains unknown. We sought to characterize the accuracy of patient Recall as a function of time on validated outcomes after cervical spine surgery. STUDY DESIGN/SETTING Retrospective review of prospectively collected outcomes. PATIENT SAMPLE Consecutive series of patients undergoing cervical spine surgery for myelopathy or radiculopathy. OUTCOME MEASURES Numeric pain scale, neck disability index. METHODS We analyzed a consecutive series of patients undergoing cervical spine surgery for degenerative myelopathy or radiculopathy at a single institution. Using standardized questionnaires, we recorded preoperative neck and arm numeric pain scores (NPS), neck disability indices (NDI) and 36-Item Short Form Health Survey (SF-36). Patients were asked to Recall their preoperative status through a standardized phone call script and were subsequently stratified based on the timing of their Recall into short-term ( 1 year) follow-up sub-groups. Actual and Recalled scores were compared using McNemar's or paired t tests, and relations were quantified using Pearson correlation coefficients. Characteristics between the subgroups were compared using Wilcoxon rank sum tests, t-tests, chi-square tests, or Fisher's exact tests as appropriate. RESULTS Seventy-three patients with a mean age of 58.2 years (range 22 to 83 years) were included, with 34 and 39 patients in the short-term and long-term follow-up subgroups patients respectively. The mean period of Recall from surgery was 4.6 months and 22.2 months for the short-term and long-term follow-up subgroups respectively. Compared to the preoperative scores, patients showed significant improvement in neck NPS (mean difference [MD]=−2.9, 95% CI −3.5 to −2.3), arm NPS (MD −3.4, 95% CI −4.0 to −2.8), and NDI (MD −12.4%, 95% CI −16.9 to −7.9). Patient recollection of preoperative status was more severe than actual for neck NPS (MD +1.5, p CONCLUSIONS Relying on retrospectively Recalled data for outcome assessment does not provide an accurate measure of preoperative status. Prospective collection of PROs remains the gold standard to measure outcomes following cervical spine surgery. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.
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do cervical spine surgery patients Recall their preoperative status a cohort study of Recall Bias in patient reported outcomes
Journal of Spinal Disorders & Techniques, 2018Co-Authors: Ilyas S Aleem, Bradford L Currier, Michael J Yaszemski, Heidi Poppendeck, Paul M Huddleston, Jason C Eck, John M Rhee, Mohamad Bydon, Brett A Freedman, A NassrAbstract:STUDY DESIGN This is a prospective cohort study. OBJECTIVE To characterize the accuracy of patient recollection of preoperative symptoms after cervical spine surgery. SUMMARY OF BACKGROUND DATA Recall Bias is a well-known source of systematic error. The accuracy of patient Recall after cervical spine surgery remains unknown. METHODS Consecutive patients undergoing cervical spine surgery for myelopathy or radiculopathy were enrolled. Neck and arm numeric pain scores and Neck Disability Indices were recorded preoperatively. Patients were asked to Recall their preoperative status at either short (<1 y) or long-term (≥1 y) follow-up. Actual and Recalled scores were compared using paired t tests and relations were quantified using the Pearson correlation coefficients. Multivariable linear regression was used to identify factors impacting recollection. RESULTS In total, 73 patients with a mean age of 58.2 years were included. Compared with their preoperative scores, patients showed significant improvement in neck pain [mean difference (MD)=-2.9; 95% confidence intervals (CIs), -3.5 to -2.3], arm pain (MD, -3.4; 95% CI, -4.0 to -2.8), and disability (MD, -12.4%; 95% CI, -16.9 to -7.9). Patient recollection of preoperative status was significantly more severe than actual for neck pain (MD, +1.5; 95% CI, 0.8-2.2), arm pain (MD, +2.3; 95% CI, 1.6-3.0), and disability (MD, +5.8%; 95% CI, 2.4-9.2). Moderate correlation between actual and Recalled scores with regard to neck (r=0.41), arm (r=0.50) pain, and disability (r=0.67) was seen. This was maintained across age, sex, and time between date of surgery and recollection. Over 30% of patients switched their predominant symptom from neck-to-arm pain or vice versa on Recall of their preoperative symptoms. CONCLUSIONS Relying on patient recollection does not provide an accurate measure of preoperative status after cervical spine surgery. Prospective and not retrospective collection of patient-reported outcomes remain the gold standard to measure and interpret outcomes after cervical spine surgery. Recall Bias has the potential to affect patient satisfaction and requires further study.
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do lumbar decompression and fusion patients Recall their preoperative status a cohort study of Recall Bias in patient reported outcomes
Spine, 2017Co-Authors: Ilyas S Aleem, M Zarrabian, Bradford L Currier, Jason C Eck, John M Rhee, Jonathan S Duncan, Amin Mohamed Ahmed, Michelle J Clarke, A NassrAbstract:STUDY DESIGN Prospective cohort study. OBJECTIVE To characterize the accuracy of patient recollection of preoperative symptoms after lumbar spine surgery. SUMMARY OF BACKGROUND DATA Although patient-reported outcomes have become important in the evaluation of spine surgery patients, the accuracy of patient Recall remains unknown. METHODS Patients undergoing lumbar decompression with or without fusion were enrolled. Back and leg Numeric Pain Scores and Oswestry Disability Indices were recorded preoperatively. Patients were asked to Recall their preoperative status at a minimum of 1 year after surgery. Actual and Recalled scores were compared using paired t tests and relations were quantified using Pearson correlation coefficients. Multivariable linear regression was used to identify factors that affected recollection. RESULTS Sixty-two patients with a mean age of 66.1 years were included. Compared to their preoperative scores, patients showed significant improvement in back pain (mean difference [MD] = -3.2, 95% CI -4.0 to -2.4), leg pain (MD -3.3, 95% CI -4.3 to -2.2), and disability (MD -25.0%, 95% CI -28.7 to -19.6). Patient recollection of preoperative status was significantly more severe than actual for back pain (MD +2.3, 95% CI 1.5-3.2), leg pain (MD +1.8, 95% CI 0.9-2.7), and disability (MD +9.6%, 95% CI 5.6-14.0). No significant correlation between actual and Recalled scores with regards to back (r = 0.18) or leg (r = 0.24) pain and only moderate correlation with disability (r = 0.44) were seen. This was maintained across age, sex, and time between date of surgery and recollection. More than 40% of patients switched their predominant symptom from back pain to leg pain or leg pain to back pain on Recall. CONCLUSION Relying on patient recollection does not provide an accurate measure of preoperative status after lumbar spine surgery. Recall Bias indicates the importance of obtaining true baseline scores and patient-reported outcomes prospectively and not retrospectively. LEVEL OF EVIDENCE 2.
Terrence Peter Haines - One of the best experts on this subject based on the ideXlab platform.
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response shift Recall Bias and their effect on measuring change in health related quality of life amongst older hospital patients
Health and Quality of Life Outcomes, 2010Co-Authors: Steven M Mcphail, Terrence Peter HainesAbstract:Background Assessments of change in subjective patient reported outcomes such as health-related quality of life (HRQoL) are a key component of many clinical and research evaluations. However, conventional longitudinal evaluation of change may not agree with patient perceived change if patients' understanding of the subjective construct under evaluation changes over time (response shift) or if patients' have inaccurate recollection (Recall Bias). This study examined whether older adults' perception of change is in agreement with conventional longitudinal evaluation of change in their HRQoL over the duration of their hospital stay. It also investigated this level of agreement after adjusting patient perceived change for Recall Bias that patients may have experienced.
