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Andrew B. Harris, Floreana Kebaish, Lee H. Riley III, Khaled M. Kebaish and Richard L. Skolasky

lacked preoperative PAM scores, were excluded, and an additional 381 patients, who lacked complete 1-year follow-up data, were also excluded. Measurement of Patient Activation The Patient Activation Measure (PAM) is a questionnaire composed of 13 questions designed to determine how “engaged and active” patients are in their own healthcare. The questionnaire was developed initially by Hibbard and colleagues in 2004, 12 and it assesses the degree to which patients believe that taking an active role is important, have the confidence and knowledge to take action, have the