title: Influence of Priming on Patient-Reported Outcome Measures: A Randomized Controlled Trial.
abstract: BACKGROUND
  Patient-reported outcome measures (PROMs) are influenced by psychosocial factors, but it is unknown whether we can influence PROM scores by modifying the mindset of the patient.
  
  
  OBJECTIVE
  We assessed whether priming affects scores on PROMs.
  
  
  METHODS
  In all, 168 patients with musculoskeletal illness participated in this double-blinded, randomized, controlled, parallel study between July 2014 and October 2014 in a level I trauma center. Inclusion criteria were patients aged 18 years or older with English fluency and literacy and the ability to provide informed consent. Priming was performed by means of the Pain Catastrophizing Scale (PCS). The patients were randomized (1:1:1) into 3 groups: intervention group I was negatively primed with the original PCS; intervention group II was positively primed with a positively phrased PCS group; and control group III was not primed. Assessments were performed using PROMs on the domain of physical function, depression, and pain. Bivariate and multivariable regression analyses were conducted.
  
  
  RESULTS
  The intervention and control groups were well balanced in demographic and condition-specific characteristics. The positive PCS was independently associated with higher PROM scores in the physical function domain (Patient-Reported Outcome Measurement Information System Upper Extremity Function: coefficient = 4.7, partial R(2) = 0.042; CI: 1.2-8.2; p < 0.010).
  
  
  CONCLUSIONS
  Patients primed with a positively phrased version of the PCS reported less functional disability as compared with patients who were either negatively primed or not primed at all. This suggests that by influencing the mindset, PROMs can be influenced, resulting in better outcome if positively primed.
  
  
  METHODS
  Level 1 therapeutic study.
  
  
  BACKGROUND
  NCT02209259.
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA.
authors.forename: Femke M A P
authors.initials: FM
authors.lastname: Claessen
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA.
authors.forename: Jos J
authors.initials: JJ
authors.lastname: Mellema
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA.
authors.forename: Nicky
authors.initials: N
authors.lastname: Stoop
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA.
authors.forename: Bart
authors.initials: B
authors.lastname: Lubberts
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA.
authors.forename: David
authors.initials: D
authors.lastname: Ring
authors.affiliation: Department of Orthopaedic Surgery and Joint Research Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. Electronic address: r.w.poolman@olvg.nl.
authors.forename: Rudolf W
authors.initials: RW
authors.lastname: Poolman
mesh_terms: D000328:Adult; D000368:Aged; D001134:Arm Injuries / Q000503:physiopathology / Q000523:psychology; D002349:Carpal Tunnel Syndrome / Q000503:physiopathology* / Q000523:psychology; D058443:Catastrophization; D003863:Depression / Q000523:psychology*; D004311:Double-Blind Method; D005260:Female; D006230:Hand Injuries / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology* / Q000523:psychology; D010147:Pain Measurement; D000071066:Patient Reported Outcome Measures; D060865:Repetition Priming; D011795:Surveys and Questionnaires; D052582:Trigger Finger Disorder / Q000503:physiopathology* / Q000523:psychology