title: Patient-Reported Outcome Instruments in Pediatric Deformity Surgery: A Bibliometric Analysis.
abstract: METHODS
  Bibliometric analysis.
  
  
  OBJECTIVE
  To identify patient-reported outcomes instruments (PROIs) used in pediatric deformity surgery research over the past decade and their frequency and usage trends.
  
  
  BACKGROUND
  The emphasis on PROIs is increasing along with the demand for evidence-based medicine and cost-effectiveness research. Therefore, investigators and PROI consensus writers should be aware of the PROIs used in pediatric deformity and usage trends.
  
  
  METHODS
  Five top orthopedics journals were reviewed from 2004 to 2013 for clinical studies of surgical intervention in pediatric deformity that report PROIs. Publication year, level of evidence (LOE), and PROIs were reported for each article. Mean and range scores for the most frequently used PROIs were analyzed at 2-year follow-up.
  
  
  RESULTS
  A total of 79 studies using PROIs were published in the pediatric deformity literature over the period studied. The researchers identified 21 named PROIs and 6 additional custom questionnaires. The Scoliosis Research Society (SRS)-22 was the most frequently used instrument (32.9%), followed by the SRS-24 (29.1%), Oswestry disability index (17.7%), visual analog scale (12.7%), SRS-30 (10.1%), and Short Form-36 (6.3%). Level of evidence III was most common (39.2%) and 1 LOE I study was identified. Mean preoperative and postoperative SRS instrument scores were 4.0 (95% confidence interval, 3.8-4.1) and 4.5 (95% confidence interval, 4.4-4.6), respectively, in SRS-22r equivalents. No studies met the criteria for mean and range calculation for the other top instruments.
  
  
  CONCLUSIONS
  Scoliosis Research Society instruments are used in 74.7% of pediatric deformity studies reporting PROIs. Therefore, there is a consensus that SRS instruments should be used in pediatric deformity outcome studies; yet, consistent use of the most up-to-date version, the SRS-22r, is still needed. General health questionnaires are currently underused in pediatric deformity research. Version reporting and use of the latest versions of PROIs need to be improved in future studies.
authors.affiliation: Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Holt S
authors.initials: HS
authors.lastname: Cutler
authors.affiliation: Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Javier Z
authors.initials: JZ
authors.lastname: Guzman
authors.affiliation: Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: James
authors.initials: J
authors.lastname: Connolly
authors.affiliation: Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Motasem
authors.initials: M
authors.lastname: Al Maaieh
authors.affiliation: Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Abigail K
authors.initials: AK
authors.lastname: Allen
authors.affiliation: Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: samuel.cho@mountsinai.org.
authors.forename: Samuel K
authors.initials: SK
authors.lastname: Cho
keywords: Patient-reported outcomes; Pediatric spinal deformity; Quality of life; SRS questionnaire