Comparing the Primary Concerns of Injured Collegiate-Athletes to the Content of Patient-Reported Outcome Measures

Abstract Context: Patient-reported outcome measures(PROMs) have been endorsed for providing patient-centered care. However, PROMs must represent their target populations. Objective: Identify the primary concerns of collegiate-athletes experiencing injury and compare those to the content of established PROMs. Design: Cross-Sectional Setting: Collegiate athletic training facilities Patients or Other Participants: Collegiate athletes experiencing injury(n=149). Main Outcome Measures: Open-ended response to the Measure Yourself Medical Outcome Profile(MYMOP-2) were used to identify primary concerns, which were linked to International Classification of Functioning, Disability and Health(ICF) taxonomy codes. Items of the Patient-Reported Outcomes Measurement Information System(PROMIS®), modified Disablement of the Physically Active Scale(mDPAS), Lower Extremity Functional Scale(LEFS), Knee injury and Osteoarthritis Outcome Score(KOOS), International Knee Documentation Committee Subjective Knee Form(IKDC), the Foot and Ankle Ability Measure (FAAM), Disablement of the Arm, Shoulder, and Hand(DASH), Functional Arm Scale for Throwers(FAST), and Kerlan-Jobe Orthopaedic Clinic questionnaire(KJOC) were linked to ICF codes. Chi-square single-sample goodness-of-fit tests examined if 70% of content was shared between PROM and participant-generated codes. Results: Participant-generated concerns were primarily related to sport-participation(16%) and pain(23%). Chi-square tests showed that the LEFS and FAAM presented significant content differences with common participant-generated lower extremity responses at all levels. The PROMIS®, DASH, mDPAS, KOOS, IKDC, FAST, and KJOC did not have significant content differences for level 2 codes; however, significant differences were present for level 3 analyses except for the KOOS and IKDC.(p<0.001). All measures except the IKDC contained significant superfluous content(p<0.05). Conclusions: The presence of significant content differences supports clinician perceived barriers regarding relevance of established PROMs. However, the IKDC was observed to be a relevant and efficient PROM for evaluating the primary concerns of collegiate-athletes experiencing lower extremity injury. Clinicians should consider utilizing patient-generated measures to support coverage of patient-specific concerns in care.