Correlation of the Single Assessment Numerical Evaluation to Legacy Patient-reported Outcomes in Lumbar Fusion

Introduction: Effective PROM collection, comparison, and usage is a highly relevant topic in orthopedic surgery, particularly regarding recent collection requirements. Maintaining compliance while minimizing patient survey burden is essential for patient engagement and data quality, both of which are critical in research and practice. The objective of this study is to assess the correlation and reliability of the single assessment numeric evaluation (SANE) to legacy patient-reported outcome measures (PROMs) in lumbar fusion patients, to determine whether it may serve as a simple supplemental validation tool alongside established instruments. Methods: A retrospective review of 146 lumbar fusion patients at a single institution who completed the SANE score as well as legacy PROMs Patient-Reported Outcomes Measurement Information System (PROMIS-10) and Oswestry Disability Index (ODI) at preoperative as well as 3, 6, and 12 months postoperative was conducted. The PROMIS-10 was divided into 2 subcomponents: mental component score (MCS) and physical component score (PCS). Floor and ceiling rates, Spearman’s correlation (ρ), minimal clinically important difference (MCID), and Bland-Altman plots were calculated and generated to assess the correlation between the SANE score and the legacy PROMs. χ 2 tests and the Student t tests were used for categorical and continuous data, respectively. Confidence intervals for Bland-Altman plots were calculated with a 95% CI. P values were considered significant if P <0.05. Results: All PROMs improved statistically from baseline at 12 months postoperative. The correlations with respect to the SANE score at 12 months postoperative were: PROMIS-10 PCS (ρ=0.61) and ODI (ρ=−0.64), PROMIS-10 MCS (ρ=0.46). No floor or ceiling effects were observed. The MCID pass rates were: PROMIS-10 PCS 62, PROMIS-10 MCS 38, SANE 64, and ODI 71%. Conclusions: The SANE score was found to have a moderate correlation with both the region-specific ODI and the holistic PROMIS-10 PCS postoperatively. Researchers and practitioners should consider the addition of the SANE score into spine PROM collections due to the questionnaire’s ability to assess and describe pertinent patient information efficiently.