The Maryland Orthopaedic Registry (MOR): Design and baseline characteristics of a prospective registry

BackgroundUtilization of patient-reported outcome tools allows a more accurate assessment of the efficacy of treatment, which is critical to comparative effectiveness research.ObjectivesThe Maryland Orthopaedic Registry (MOR) was established to assess post-surgical outcomes related to patients' pain, functional status, met expectations, and satisfaction using an electronic data collection system. Secondary aims of the registry include assessment of patient expectations of treatment, activity level, and general health status.MethodsAdult patients enrolled in this prospective observational study completed self-report measures assessing pre-operative pain, function, treatment expectations, and activity levels during the perioperative period. MOR utilizes the Patient-Reported Outcomes Measurement Information System (PROMIS®)'computer adaptive testing for physical function, pain interference, fatigue, social satisfaction, anxiety, and depression. Perioperative data is extracted from the medical record.Results300 patients (40% of eligible) have been enrolled into the initial cohort. Most patients (94.1%) were aged 18-65, and 57% were male. Fifty-seven percent of enrollees were White, 33% Black, and 4% Asian. PROMIS physical function and social satisfaction were both more than half a standard deviation below the population mean. Participants reported PROMIS anxiety scores that were half a standard deviation above the population mean and pain interference scores that were more than a standard deviation above the mean. Physical function scores were significantly worse among participants with lower extremity orthopaedic issues, but scores on other measures were similar between participants undergoing lower or upper extremity surgery.ConclusionsMOR provides a comprehensive assessment of patients undergoing orthopaedic surgery. The utilization of electronic clinical assessment tools as well as computer adaptive testing allows for time-efficient data collection. The diverse population is a particular strength of MOR.