title: The Orthopaedic Foot and Ankle Outcomes Research (OFAR) network: feasibility of a multicenter network for patient outcomes assessment in foot and ankle.
abstract: BACKGROUND
  There is an increasing need for orthopaedic practitioners to measure and collect patient-reported outcomes data. In an effort to better understand outcomes from operative treatment, the American Orthopaedic Foot & Ankle Society (AOFAS) established the Orthopaedic Foot and Ankle Outcomes Research (OFAR) Network, a national consortium of foot and ankle orthopaedic surgeons. We hypothesized that the OFAR Network could successfully collect, aggregate, and report patient-reported outcome (PRO) data using the National Institutes of Health (NIH) Patient Reported Outcomes Measurement Information System (PROMIS).
  
  
  METHODS
  Ten sites enrolled consecutive patients undergoing elective surgery for 1 of 6 foot/ankle disorders. Outcome instruments were collected preoperatively and at 6 months postoperatively using the PROMIS online system: Foot and Ankle Ability Measure (FAAM), Foot Function Index (FFI), and PROMIS physical function (PF) and pain computerized adaptive tests (CAT). During the 3-month period, 328 patients were enrolled; 249 (76%) had completed preoperative patient-reported outcomes data and procedure-specific data. Of these, 140 (56%) also completed 6-month postoperative patient- reported outcomes data.
  
  
  RESULTS
  Ankle arthritis and flatfoot demonstrated consistently worse preoperative scores. Five of 6 disorders showed significant improvement at 6 months on PF CAT and FAAM, 4 of 6 showed improvement on pain interference CAT, and no disorders showed improvement on FFI. Ankle arthritis and flatfoot demonstrated the greatest magnitude of change on most patient-reported outcomes scales.
  
  
  CONCLUSIONS
  We were able to enroll large numbers of patients in a short enrollment period for this preliminary study. Data were easily aggregated and analyzed. Substantial loss of follow-up data indicates a critical area requiring further effort. The AOFAS OFAR Network is undergoing expansion with goals to ultimately facilitate large, prospective multicenter studies and optimize the quality and interpretation of available outcome instruments for the foot and ankle population.
  
  
  METHODS
  Level II, prospective comparative study.
authors.affiliation: Stanford University, Redwood City, CA, USA kjhunt@stanford.edu.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Hunt
authors.affiliation: Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Ian
authors.initials: I
authors.lastname: Alexander
authors.affiliation: University of Rochester, NY, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Baumhauer
authors.affiliation: Baylor/UT Southwestern, Dallas, TX, USA.
authors.forename: James
authors.initials: J
authors.lastname: Brodsky
authors.affiliation: Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Chiodo
authors.affiliation: University of Toronto, Canada.
authors.forename: Timothy
authors.initials: T
authors.lastname: Daniels
authors.affiliation: Orthocarolina, Charlotte, NC, USA.
authors.forename: W Hodges
authors.initials: WH
authors.lastname: Davis
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Jon
authors.initials: J
authors.lastname: Deland
authors.affiliation: Hospital for Special Surgery, New York, NY, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Ellis
authors.affiliation: University of Utah, Salt Lake City, UT, USA.
authors.forename: Man
authors.initials: M
authors.lastname: Hung
authors.affiliation: Campbell Clinic, Memphis, TN, USA.
authors.forename: Susan N
authors.initials: SN
authors.lastname: Ishikawa
authors.affiliation: University of Arizona, Tucson, AZ, USA.
authors.forename: L Daniel
authors.initials: LD
authors.lastname: Latt
authors.affiliation: University of Iowa, Iowa City, IA, USA.
authors.forename: Phinit
authors.initials: P
authors.lastname: Phisitkul
authors.affiliation: UCLA, Los Angeles, CA, USA.
authors.forename: Nelson Fong
authors.initials: NF
authors.lastname: SooHoo
authors.affiliation: Stanford University, Redwood City, CA, USA.
authors.forename: Arthur
authors.initials: A
authors.lastname: Yang
authors.affiliation: University of Utah, Salt Lake City, UT, USA.
authors.forename: Charles L
authors.initials: CL
authors.lastname: Saltzman
mesh_terms: D000842:Ankle / Q000601:surgery*; D057186:Comparative Effectiveness Research; D003625:Data Collection; D005240:Feasibility Studies; D005260:Female; D005528:Foot / Q000601:surgery*; D005530:Foot Deformities / Q000601:surgery; D006801:Humans; D007592:Joint Diseases / Q000601:surgery; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011446:Prospective Studies; D012955:Societies, Medical; D014481:United States
keywords: PRO; PROMIS; ankle arthritis; computer adaptive testing; patient-reported outcomes