Associations between clinical diagnostic criteria and pretreatment patient-reported outcomes measures in a prospective observational cohort of patients.

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Presentation transcript:

Associations between clinical diagnostic criteria and pretreatment patient-reported outcomes measures in a prospective observational cohort of patients with neurogenic thoracic outlet syndrome Joshua Balderman, MD, Katherine Holzem, BS, Beverly J. Field, PhD, Michael M. Bottros, MD, Ahmmad A. Abuirqeba, BA, Chandu Vemuri, MD, Robert W. Thompson, MD Journal of Vascular Surgery Volume 66, Issue 2, Pages 533-544.e2 (August 2017) DOI: 10.1016/j.jvs.2017.03.419 Copyright © 2017 The Authors Terms and Conditions

Fig 1 Demographic data for 183 patients referred for evaluation of thoracic outlet syndrome (TOS) over a 6-month period. A, The pie chart shows the proportion of patients with a clinical diagnosis of neurogenic TOS (NTOS) compared with arterial TOS (ATOS), venous TOS (VTOS), and other non-TOS diagnoses. B, The pie chart shows the proportion of NTOS patients with a history of injury. C, Histogram illustrates the age distribution of NTOS patients: mean ± standard error, 37.1 ± 1.1 years; median, 37.3 years (range, 12-66 years). D, Histogram demonstrates the duration of symptoms for NTOS patients before referral. Journal of Vascular Surgery 2017 66, 533-544.e2DOI: (10.1016/j.jvs.2017.03.419) Copyright © 2017 The Authors Terms and Conditions

Fig 2 Proportion of neurogenic thoracic outlet syndrome (NTOS) patients exhibiting positive findings for each of 14 clinical diagnostic criteria (CDC). Diagnostic criteria developed by the Consortium for Research and Education on Thoracic Outlet Syndrome (CORE-TOS), as described in Thompson RW, Development of consensus-based diagnostic criteria for NTOS, in Illig KA, Thompson RW, Freischlag JA, Donahue DM, Jordan SE, Edgelow PI, editors. Thoracic Outlet Syndrome, London: Springer; 2013. pp.143-155. Journal of Vascular Surgery 2017 66, 533-544.e2DOI: (10.1016/j.jvs.2017.03.419) Copyright © 2017 The Authors Terms and Conditions

Fig 3 Box-and-whisker plots for seven different patient-reported outcome measures (PROMs) in neurogenic thoracic outlet syndrome (NTOS) patients, covering five domains: functional disability, quality of life (QOL), pain, depression, and pain catastrophizing. The top and bottom borders of the boxes represent the 25th and 75th percentiles of the distribution, the middle line shows the median, the solid diamond demonstrates the mean, the whiskers represent two standard deviations above and below the mean, and individual outliers are shown as open circles. BPI, Brief Pain Inventory; CBSQ, Cervical-Brachial Symptom Questionnaire; SF-12, 12-Item Short Form Health Survey; SDS, Self-Rating Depression Scale; PCS, Pain Catastrophizing Scale; QuickDASH, 11-item version of the Disabilities of the Arm, Shoulder and Hand. Journal of Vascular Surgery 2017 66, 533-544.e2DOI: (10.1016/j.jvs.2017.03.419) Copyright © 2017 The Authors Terms and Conditions

Fig 4 Scatter plots illustrate linear regression correlation analyses for associations between various patient-reported outcome measures (PROMs) in neurogenic thoracic outlet syndrome (NTOS patients): (A) Cervical-Brachial Symptom Questionnaire (CBSQ), (B) Brief Pain Inventory (BPI), (C) McGill Pain Score, and (D) the 12-Item Short Form Health Survey (SF-12) with the 11-item version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH); (E) McGill Pain Score with the CBSQ; (F) BPI and (G) NTOS Index with the McGill Pain Score; and (H) SF-12 with the Self-Rated Depression Scale (SDS). The R2 and P values obtained by Pearson correlation analyses are displayed on each panel. Journal of Vascular Surgery 2017 66, 533-544.e2DOI: (10.1016/j.jvs.2017.03.419) Copyright © 2017 The Authors Terms and Conditions

Fig 5 Relationships between pain catastrophizing and the number of positive clinical diagnostic criteria (CDC), duration of elevated arm stress test (EAST), and functional disability measured by the 11-item version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) in neurogenic thoracic outlet syndrome (NTOS) patients. Scatter plots illustrate linear regression correlation analyses for associations with low (<30) and elevated (≥30) Pain Catastrophizing Scale (PCS) scores and the number of (A) positive clinical diagnosis criteria (CDC), (C) elevated arm stress test (EAST), and (E) 11-item version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH), with P values and R2 values obtained by Pearson correlation analyses displayed on each panel. Bar graphs illustrate comparisons between patients with low (<30) and elevated (≥30) PCS scores for (B) CDC, (D) EAST, and (F) QuickDASH, representing the mean ± standard error (P values shown from two-tailed t-tests). Journal of Vascular Surgery 2017 66, 533-544.e2DOI: (10.1016/j.jvs.2017.03.419) Copyright © 2017 The Authors Terms and Conditions

Supplementary Fig 1 (online only) Scatter plots illustrate liner regression correlation analyses for associations with the number of clinical diagnostic criteria (CDC) in neurogenic thoracic outlet syndrome (NTOS) patients. A, Duration of elevated arm stress test (EAST). Various patient-reported outcome measures (PROMs): (B) McGill Pain Score, (C) NTOS index, (D) Self-Rating Depression Scale (SDS), (E) physical component of the 12-Item Short Form Health Survey (SF-12), and (F) the Pain Catastrophizing Scale (PCS) score. The P values and R2 values obtained by Pearson correlation analyses are displayed on each panel. Journal of Vascular Surgery 2017 66, 533-544.e2DOI: (10.1016/j.jvs.2017.03.419) Copyright © 2017 The Authors Terms and Conditions

Supplementary Fig 2 (online only) Scatter plots illustrate liner regression correlation analyses for associations between various patient reported outcome measures (PROMs) in neurogenic thoracic outlet syndrome (NTOS) patients and the elevated arm stress test (EAST). The R2 and P values obtained by Pearson correlation analyses are displayed on each panel. A, McGill Pain Score, (B) NTOS index, (C) Self-Rating Depression Scale (SDS), and (D) the physical component of the 12-Item Short Form Health Survey (SF-12). Journal of Vascular Surgery 2017 66, 533-544.e2DOI: (10.1016/j.jvs.2017.03.419) Copyright © 2017 The Authors Terms and Conditions