Does loss to follow-up lead to an overestimation of treatment success? Findings from a spine surgery registry of over 15,000 patients

Purpose Patient-reported outcome measures (PROMs) are integral to the assessment of treatment success, but loss to follow-up (attrition) may lead to bias in the results reported. We sought to evaluate the extent, nature and implications of attrition in a long-established, single-centre spine registry. Methods The registry contained the data of 15,264 consecutive spine surgery patients. PROMs included the Core Outcome Measures Index (COMI) and a rating of the Global Treatment Outcome (GTO) and Satisfaction with Care. Baseline characteristics associated with returning a 12-month PROM (= “responder”) were analysed (logistic regression). The 3-month outcomes of 12-month responders versus 12-month non-responders were compared (ANOVA and Chi-square). Results In total, 14,758/15,264 (97%) patients (60 ± 17y; 46% men) had consented to the use of their registry data for research. Preoperative, 3-month post-operative and 12-month post-operative PROMs were returned by 91, 90 and 86%, respectively. Factors associated with being a 12-month responder included: greater age, born in the country of the study, no private/semi-private insurance, better baseline status (lower COMI score), fewer previous surgeries, less comorbidity and no perioperative medical complications. 12-month non-responders had shown significantly worse outcomes in their 3-month PROMs than had 12-month responders (respectively, 66% vs 80% good GTO (“treatment helped/helped a lot”); 77% vs 88% satisfied/very satisfied; and 49% vs 63% achieved MCIC on COMI). Conclusion Although attrition in this cohort was relatively low, 12-month non-responders displayed distinctive characteristics and their early outcomes were significantly worse than those of 12-month responders. If loss to follow-up is not addressed, treatment success will likely be overestimated, with erroneously optimistic results being reported..

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:32

Enthalten in:

European spine journal - 32(2023), 3 vom: 29. Jan., Seite 813-823

Sprache:

Englisch

Beteiligte Personen:

Mannion, Anne F. [VerfasserIn]
Fekete, Tamás F. [VerfasserIn]
O’Riordan, Dave [VerfasserIn]
Loibl, Markus [VerfasserIn]
Kleinstück, Frank S. [VerfasserIn]
Porchet, François [VerfasserIn]
Reitmeir, Raluca [VerfasserIn]
Jeszenszky, Dezsö [VerfasserIn]
Haschtmann, Daniel [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

Themen:

Attrition
Bias
Loss to follow-up
Outcome
Registries

RVK:

RVK Klassifikation

Anmerkungen:

© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

doi:

10.1007/s00586-023-07541-7

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2134342714

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