Using Patient-Reported Outcome Measurement Information System Computer Adaptive Testing Domains to Investigate the Impact of Obesity on Physical Function, Pain Interference, and Mental Health in Sports Medicine Patients

Background: While obesity has become an increasingly prevalent health concern in the United States, little emphasis has been placed on utilizing patient reported outcome measures (PROM) to investigate its impact on life from the patients'perspective. The purpose of the study was to determine the association between patients' body mass index (BMI) and three Patient-Reported Outcome Measurement Information System (PROMIS) computer adaptive test scores: upper extremity physical function (UE) or lower extremity physical function (PF), pain interference (PI), and depression (D). Methods: Patients were recruited from two sports medicine orthopedic surgery clinics. PROMIS questionnaires were administered to patients arriving for their first visit. Patients were stratified into BMI groupings according to the National Institute of Health standards. Patients' BMI, sex, race, ethnicity, and injury were determined retroactively. Data were analyzed using a Pearson correlation and a least significant difference post hoc test. Results: A total of 833 patients completed the set of PROMIS questionnaires that were retrospectively analyzed. BMI was found to have a correlation with PROMIS-UE (R=-0.111, P<0.05), PROMIS-PF (R=-0.174, P<0.01), PROMIS-PI (R=0.224, P<0.01), and PROMIS-D (R=0.092, P<0.05). Obese patients also portrayed the worst PROMIS-UE, PROMIS-PI, and PROMIS-PF. Conclusion: We found BMI to correlate with each PROMIS domain: negatively with PROMIS-UE, PROMIS-PF, PROMIS-D, and positively with PROMIS-PI. Additionally, overweight and obese BMI patients portrayed worse physical function and pain interference scores than their healthy group counterparts.