Development of predictive models for all individual questions of SRS-22R after adult spinal deformity surgery: a step toward individualized medicine

European spine journal

article

Christopher P. Ames¹  Justin S. Smith²  Ferran Pellisé³  Michael Kelly⁴  Jeffrey L. Gum⁵  Ahmet Alanay⁶  Emre Acaroğlu⁷  Francisco Javier Sánchez Pérez-Grueso⁸  Frank S. Kleinstück⁹  Ibrahim Obeid^1,10  Alba Vila-Casademunt^1,11  Christopher I. Shaffrey^1,11  Douglas C. Burton^1,12  Virginie Lafage^1,13  Frank J. Schwab^1,13  Christopher I. Shaffrey²  Shay Bess^1,14  Miquel Serra-Burriel^1,15 

[1] Department of Neurosurgery, University of California San Francisco;Department of Neurosurgery, University of Virginia Medical Center;Spine Surgery Unit, Hospital Vall d’Hebron;Department of Orthopaedic Surgery, Washington University;Norton Leatherman Spine Center;Department of Orthopedics and Traumatology, Acibadem University;Ankara ARTES Spine Center;Spine Surgery Unit, Hospital Universitario La Paz;Spine Center Division, Department of Orthopedics and Neurosurgery;Spine Surgery Unit, Bordeaux University Hospital;Vall d’Hebron Institute of Research (VHIR);Department of Orthopaedic Surgery, University of Kansas Medical Center;Department of Orthopaedic Surgery, Hospital for Special Surgery;Denver International Spine Center, Presbyterian St. Luke’s/Rocky Mountain Hospital for Children;Department of Economics and Business, Center for Research in Health and Economics

关键词: Adult spinal deformity;    Individualized medicine;    Outcomes;    Predictive analytics;    Scoliosis Research Society22R (SRS-22R) questionnaire;    Surgery;   

DOI  :  10.1007/s00586-019-06079-x

来源: Springer

【 摘 要 】

Health-related quality of life (HRQL) instruments are essential in value-driven health care, but patients often have more specific, personal priorities when seeking surgical care. The Scoliosis Research Society-22R (SRS-22R), an HRQL instrument for spinal deformity, provides summary scores spanning several health domains, but these may be difficult for patients to utilize in planning their specific care goals. Our objective was to create preoperative predictive models for responses to individual SRS-22R questions at 1 and 2 years after adult spinal deformity (ASD) surgery to facilitate precision surgical care. Two prospective observational cohorts were queried for ASD patients with SRS-22R data at baseline and 1 and 2 years after surgery. In total, 150 covariates were used in training machine learning models, including demographics, surgical data and perioperative complications. Validation was accomplished via an 80%/20% data split for training and testing, respectively. Goodness of fit was measured using area under receiver operating characteristic (AUROC) curves. In total, 561 patients met inclusion criteria. The AUROC ranged from 56.5 to 86.9%, reflecting successful fits for most questions. SRS-22R questions regarding pain, disability and social and labor function were the most accurately predicted. Models were less sensitive to questions regarding general satisfaction, depression/anxiety and appearance. To the best of our knowledge, this is the first study to explicitly model the prediction of individual answers to the SRS-22R questionnaire at 1 and 2 years after deformity surgery. The ability to predict individual question responses may prove useful in preoperative counseling in the age of individualized medicine. These slides can be retrieved under Electronic Supplementary Material.

【 授权许可】

Unknown