{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T04:18:18Z","timestamp":1787717898241,"version":"build-2784847793"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100018936","name":"Universit\u00e4tsklinikum Heidelberg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100018936","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Spine J"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Between lumbar decompression and the first follow-up visit (~\u20096 weeks post-op), the day-to-day course of recovery is not routinely captured in detail. We tested whether a single-item, smartphone well-being ePROM (\u201cHow are you today?\u201d, 0\u2013100 VAS; higher\u2009=\u2009better), sent every 2\u20133 days, could be deployed in routine care, what level of endpoint completion was achieved, whether it showed preliminary convergent validity when measured at the same visit as clinic PROMs (ODI, PHQ-9), and whether serial responses could illustrate postoperative recovery trajectories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Consecutive patients with degenerative lumbar disease completed a digital baseline survey (Feb 1\u2013Aug 31, 2025;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009429). Patients with an operative indication for lumbar disc herniation or spinal canal stenosis who underwent lumbar decompression entered postoperative high-frequency well-being monitoring for 6 weeks. Patients were not included in the digital follow-up pathway when web-based participation was not feasible in routine care. The pathway generated electronic health record-accessible submissions but did not include automated alert thresholds or a mandated alert-to-action protocol.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 183 operated patients invited to postoperative monitoring, 70\/183 (38.3%) contributed an evaluable clinic ODI at ~\u20096 weeks, 68\/183 (37.2%) had a same-day PHQ-9, and 48\/183 (26.2%) were endpoint-complete for both visit-day measures; this low endpoint-completion rate represents a major implementation barrier. In the pair-level timing dataset, same-day well-being versus reverse-coded ODI (100\u2009\u2212\u2009ODI; higher\u2009=\u2009less disability) showed moderate concordance (\u03c1\u2009=\u20090.54, 95% CI 0.37\u20130.68;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009107 pairs), with similar moderate estimates at short lags (\u2264\u20092 days \u03c1\u2009\u2248\u20090.46; \u22644 days \u03c1\u2009\u2248\u20090.42), while longer-lag estimates were exploratory and non-monotonic. On the visit day, well-being related inversely to depressive burden (PHQ-9 \u03c1 = \u22120.25;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200968). In a joint model using raw ODI and PHQ-9, higher disability and higher depressive burden were associated with lower concurrent well-being (standardized \u03b2: \u22120.35 for ODI; \u22120.20 for PHQ-9), although explained variance was limited (adjusted R\u00b2 = 0.151).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Routine-care deployment was technically possible, and time-aligned measures showed preliminary convergent validity, but endpoint completion was low (26.2%) and prevents any claim of broad feasibility or universal scalability. The ePROM should be considered a hypothesis-generating trajectory signal that requires equity safeguards and prospective closed-loop alert-to-action testing before implementation as a clinical decision tool.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00586-026-10322-7","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T03:20:16Z","timestamp":1787714416000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond one-time PROMs: high-frequency single-item mobile ePROM tracking of postoperative recovery in spine surgery\u2014a prospective feasibility study"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3842-0783","authenticated-orcid":false,"given":"Pavlina","family":"Lenga","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Fleige","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max Christian","family":"Blumenstock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2716-5425","authenticated-orcid":false,"given":"Matthias","family":"Ganzinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2065-6464","authenticated-orcid":false,"given":"Sebastian","family":"Ille","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4050-1531","authenticated-orcid":false,"given":"Sandro M.","family":"Krieg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9740-0788","authenticated-orcid":false,"given":"Martin","family":"Dugas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"10322_CR1","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/S0140-6736(21)00733-9","volume":"398","author":"NN Knezevic","year":"2021","unstructured":"Knezevic NN, Candido KD, Vlaeyen JWS et al (2021) Low back pain. Lancet 398:78\u201392. https:\/\/doi.org\/10.1016\/S0140-6736(21)00733-9","journal-title":"Lancet"},{"key":"10322_CR2","doi-asserted-by":"publisher","first-page":"699","DOI":"10.36076\/ppj.2009\/12\/699","volume":"12","author":"L Manchikanti","year":"2009","unstructured":"Manchikanti L, Boswell MV, Singh V et al (2009) Comprehensive evidence-based guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician 12:699\u2013802","journal-title":"Pain Physician"},{"key":"10322_CR3","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-025-09254-5","author":"JH Geere","year":"2025","unstructured":"Geere JH, Hunter PR, Marjoram T, Cook AJ, Rai AS (2025) Loss to follow-up after lumbar decompressive surgery: effect of collection method and perioperative factors on patient-reported outcome measures. Eur Spine J. https:\/\/doi.org\/10.1007\/s00586-025-09254-5","journal-title":"Eur Spine J"},{"key":"10322_CR4","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","volume":"16","author":"K Kroenke","year":"2001","unstructured":"Kroenke K, Spitzer RL, Williams JB (2001) The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16:606\u2013613. https:\/\/doi.org\/10.1046\/j.1525-1497.2001.016009606.x","journal-title":"J Gen Intern Med"},{"key":"10322_CR5","unstructured":"The PHQ-9: validity of a brief depression severity measure. PubMed. Accessed June 12 (2025) https:\/\/pubmed.ncbi.nlm.nih.gov\/11556941\/"},{"key":"10322_CR6","unstructured":"NHS England Digital. Patient Reported Outcome Measures (PROMs). Accessed September 15 (2025) https:\/\/digital.nhs.uk\/data-and-information\/data-tools-and-services\/data-services\/patient-reported-outcome-measures-proms"},{"key":"10322_CR7","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1016\/j.jpain.2018.01.006","volume":"19","author":"M May","year":"2018","unstructured":"May M, Junghaenel DU, Ono M et al (2018) Ecological momentary assessment methodology in chronic pain research: a systematic review. J Pain 19:699\u2013716. https:\/\/doi.org\/10.1016\/j.jpain.2018.01.006","journal-title":"J Pain"},{"key":"10322_CR8","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1016\/j.jpain.2010.07.001","volume":"12","author":"S Schneider","year":"2011","unstructured":"Schneider S, Stone AA, Schwartz JE, Broderick JE (2011) Peak and end effects in patients\u2019 daily recall of pain and fatigue: a within-subjects analysis. J Pain 12:228\u2013235. https:\/\/doi.org\/10.1016\/j.jpain.2010.07.001","journal-title":"J Pain"},{"key":"10322_CR9","doi-asserted-by":"publisher","first-page":"101005","DOI":"10.1016\/j.lanepe.2024.101005","volume":"44","author":"MA Franzoi","year":"2024","unstructured":"Franzoi MA, Ferreira AR, Lemaire A et al (2024) Implementation of a remote symptom monitoring pathway in oncology care: analysis of real-world experience across 33 cancer centres in France and Belgium. Lancet Reg Health Eur 44:101005. https:\/\/doi.org\/10.1016\/j.lanepe.2024.101005","journal-title":"Lancet Reg Health Eur"},{"key":"10322_CR10","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1038\/s41746-021-00525-1","volume":"4","author":"SR Knight","year":"2021","unstructured":"Knight SR, Ng N, Tsanas A et al (2021) Mobile devices and wearable technology for measuring patient outcomes after surgery: a systematic review. NPJ Digit Med 4:157. https:\/\/doi.org\/10.1038\/s41746-021-00525-1","journal-title":"NPJ Digit Med"},{"key":"10322_CR11","doi-asserted-by":"publisher","first-page":"e295","DOI":"10.1016\/S2589-7500(23)00026-2","volume":"5","author":"KA McLean","year":"2023","unstructured":"McLean KA, Knight SR, Diehl TM et al (2023) Readiness for implementation of novel digital health interventions for postoperative monitoring: a systematic review and clinical innovation network analysis. Lancet Digit Health 5:e295\u2013e315. https:\/\/doi.org\/10.1016\/S2589-7500(23)00026-2","journal-title":"Lancet Digit Health"},{"key":"10322_CR12","doi-asserted-by":"publisher","first-page":"e137","DOI":"10.1016\/j.asmr.2022.11.004","volume":"5","author":"MD Smith","year":"2023","unstructured":"Smith MD, Madden RN, Proffitt MJ, Hartzler RU (2023) Compliance with electronic patient-reported outcome measure system data collection is 51% two years after shoulder arthroscopy. Arthrosc Sports Med Rehabil 5:e137\u2013e142. https:\/\/doi.org\/10.1016\/j.asmr.2022.11.004","journal-title":"Arthrosc Sports Med Rehabil"},{"key":"10322_CR13","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1227\/neu.0000000000002245","volume":"92","author":"JK Greenberg","year":"2023","unstructured":"Greenberg JK, Frumkin MR, Javeed S et al (2023) Feasibility and acceptability of a preoperative multimodal mobile health assessment in spine surgery candidates. Neurosurgery 92:538\u2013546. https:\/\/doi.org\/10.1227\/neu.0000000000002245","journal-title":"Neurosurgery"},{"key":"10322_CR14","doi-asserted-by":"publisher","first-page":"100588","DOI":"10.1016\/j.inpm.2025.100588","volume":"4","author":"AR Stephens","year":"2025","unstructured":"Stephens AR, Bender NR, El-Hassan R, Patel RK (2025) Evidence of non-response bias in patient-reported outcome measurement information system surveys. Interv Pain Med 4:100588. https:\/\/doi.org\/10.1016\/j.inpm.2025.100588","journal-title":"Interv Pain Med"},{"key":"10322_CR15","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1093\/ehjqcco\/qcad069","volume":"10","author":"MZH Kolk","year":"2024","unstructured":"Kolk MZH, Frodi DM, Langford J et al (2024) Behavioural digital biomarkers enable real-time monitoring of patient-reported outcomes: a substudy of the multicentre, prospective observational SafeHeart study. Eur Heart J Qual Care Clin Outcomes 10:531\u2013542. https:\/\/doi.org\/10.1093\/ehjqcco\/qcad069","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"key":"10322_CR16","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2025.04.022","author":"D Shin","year":"2025","unstructured":"Shin D, Meade S, Scariano G et al (2025) Improving equitable collection and analysis of PROMIS global health data over time following spine surgery: characterizing survey nonresponse and missing data. Spine J. https:\/\/doi.org\/10.1016\/j.spinee.2025.04.022","journal-title":"Spine J"},{"key":"10322_CR17","doi-asserted-by":"publisher","first-page":"796","DOI":"10.3171\/2021.2.SPINE202181","volume":"35","author":"A Boaro","year":"2021","unstructured":"Boaro A, Leung J, Reeder HT et al (2021) Smartphone GPS signatures of patients undergoing spine surgery correlate with mobility and current gold standard outcome measures. J Neurosurg Spine 35:796\u2013806. https:\/\/doi.org\/10.3171\/2021.2.SPINE202181","journal-title":"J Neurosurg Spine"},{"key":"10322_CR18","doi-asserted-by":"publisher","first-page":"427","DOI":"10.3171\/2023.5.SPINE23336","volume":"39","author":"D Chauhan","year":"2023","unstructured":"Chauhan D, Ahmad HS, Subtirelu R et al (2023) Defining the minimal clinically important difference in smartphone-based mobility after spine surgery: correlation of survey questionnaire to mobility data. J Neurosurg Spine 39:427\u2013437. https:\/\/doi.org\/10.3171\/2023.5.SPINE23336","journal-title":"J Neurosurg Spine"},{"key":"10322_CR19","doi-asserted-by":"publisher","first-page":"4939","DOI":"10.1038\/s41598-020-61893-4","volume":"10","author":"MN Stienen","year":"2020","unstructured":"Stienen MN, Rezaii PG, Ho AL et al (2020) Objective activity tracking in spine surgery: a prospective feasibility study with a low-cost consumer-grade wearable accelerometer. Sci Rep 10:4939. https:\/\/doi.org\/10.1038\/s41598-020-61893-4","journal-title":"Sci Rep"},{"key":"10322_CR20","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1016\/j.spinee.2007.11.006","volume":"8","author":"AG Copay","year":"2008","unstructured":"Copay AG, Glassman SD, Subach BR, Berven S, Schuler TC, Carreon LY (2008) Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales. Spine J 8:968\u2013974. https:\/\/doi.org\/10.1016\/j.spinee.2007.11.006","journal-title":"Spine J"}],"container-title":["European Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-026-10322-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00586-026-10322-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-026-10322-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T03:20:19Z","timestamp":1787714419000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00586-026-10322-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,26]]},"references-count":20,"alternative-id":["10322"],"URL":"https:\/\/doi.org\/10.1007\/s00586-026-10322-7","relation":{},"ISSN":["0940-6719","1432-0932"],"issn-type":[{"value":"0940-6719","type":"print"},{"value":"1432-0932","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,26]]},"assertion":[{"value":"10 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 August 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 August 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Clinical use of MyEDC, including routine postoperative high-frequency ePROM monitoring, was approved by the local ethics committee (approval no. S\u2011607\/2023). Secondary scientific analysis of the routine-care registry data was approved under S\u2011096\/2025.","order":2,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"No individual person\u2019s data were included in this study.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Analysis of these routinely collected clinical data was covered under the institutional neurosurgical registry ethics approval (Local Ethics Committee; approval number: S-096\/2025), and thus separate informed consent for scientific evaluation was not required.","order":4,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}}]}}