Evaluation of the Patient-Reported Outcomes Measurement Information System Upper Extremity Computer Adaptive Test

Beckmann, James T.; Hung, Man; Voss, Maren Wright; Crum, Anthony B; Bounsanga, Jerry; Tyser, Andrew R.

doi:10.1016/j.jhsa.2016.04.025

Cited by 83 publications

(58 citation statements)

References 21 publications

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“…Since the test has been made available, the Upper Extremity CAT has been shown to be both reliable and consistent. Our data indicated a strong correlation between Upper Extremity and Physical Function scores, a finding that confirms published correlations ranging from 0.48 to 0.77 3,11,14 However, when administering both the Upper Extremity CAT and Physical Function CAT to patients with upper extremity conditions, they indicate differential levels of absolute impairment. In our population of over 5000 patients, Upper Extremity scores consistently indicated greater disability but, in a non-uniform manner with the discrepancy increasing with better overall physical function.…”

Section: Discussionsupporting

confidence: 89%

“…Doring et al found that the average PROMIS Upper Extremity scores indicated greater disability than general Physical Function scores in patients with symptomatic upper extremities 3 . That study, and several others 5,13 , reported no ceiling effect to the Upper Extremity CAT, however Beckman et al reported that 10.8% of their population reached the maximum score which would compromise the surgeon’s ability to appropriately demonstrate treatment value 14 . Hung et al also reported a ceiling effect without identification of a specific maximal score but reported the Upper Extremity CAT to be adequately reliable with good fit 15 .…”

Section: Introductionmentioning

confidence: 71%

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Performance of Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE) Versus Physical Function (PF) Computer Adaptive Tests (CATs) in Upper Extremity Clinics

Beleckas

Padovano

Guattery

et al. 2017

The Journal of Hand Surgery

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Purpose To examine the performance of the PROMIS Upper Extremity Function CAT relative to the PROMIS Physical Function CAT in patients seeking specialty care for upper extremity conditions. Methods This observational trial analyzed prospectively collected PROMIS Upper Extremity and Physical Function CAT scores from 5202 adult patients with 10344 outpatient clinic visits presenting to a tertiary orthopaedic clinic. Pearson’s correlation coefficient was utilized to evaluate the association between initial Physical Function and Upper Extremity scores, as well as the association between changes in Physical Function and Upper Extremity scores between visits. Differences in scores between populations presenting with hand conditions versus shoulder and elbow conditions were evaluated via Student’s t test, as were differences in scores between new and return patient visits. Results PROMIS Upper Extremity CAT scores were strongly correlated with PROMIS Physical Function CAT scores. However, patients averaged 8 points lower scoring on Upper Extremity CAT testing compared to Physical Function CAT scores. The Upper Extremity CAT demonstrated a ceiling effect at a score of 56 that impacted 7% of patients with a secondary ceiling at 50. Change in Physical Function and Upper Extremity scores between visits were moderately correlated with a mean difference of less than 1 point. Patients presenting for hand conditions achieved better Physical Function and Upper Extremity scores than patients presenting for shoulder and elbow conditions. Conclusions The PROMIS Upper Extremity module appears responsive to changes over time. However, the current Upper Extremity CAT has a ceiling score of 56 which does not allow for improvement of scores 0.6 SD higher than the presumptive normative population mean of 50. Although a specific assessment of upper extremity function is desirable, continued refinement of the PROMIS Upper Extremity CAT is required to better assess patients with higher levels of function.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 71%

Performance of Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE) Versus Physical Function (PF) Computer Adaptive Tests (CATs) in Upper Extremity Clinics

Beleckas

Padovano

Guattery

et al. 2017

The Journal of Hand Surgery

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“…An additional point of agreement between the current study and prior publications is the significant correlation between measures of physical function (qDASH, PROMIS PF CAT, and PROMIS UE CAT) among patients presenting to a hand surgery clinic. 5,8,9,13 …”

Section: Discussionmentioning

confidence: 99%

“…5,8,9 While some studies did not observe floor or ceiling effects for the PF CAT 5 and UE CAT 9 , others have demonstrated ceiling effects of 1.3% and 10.8%, respectively. 8 …”

Section: Introductionmentioning

confidence: 96%

“…6,7 In contrast to fixed-length scale metrics, PROMIS computer adaptive testing (CAT) is based upon probability-based computer algorithms utilizing item response theory to minimize question burden while maintaining high levels of measurement precision. 7,8 Psychometric characteristics of the PROMIS Physical Function (PF) and Physical Function Upper Extremity (UE) CATs have been described specifically in the context of hand and upper extremity patients, and both correlate strongly with the DASH and quickDASH. 5,8,9 While some studies did not observe floor or ceiling effects for the PF CAT 5 and UE CAT 9 , others have demonstrated ceiling effects of 1.3% and 10.8%, respectively.…”

Section: Introductionmentioning

confidence: 99%

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Association of Physical Function, Anxiety, and Pain Interference in Nonshoulder Upper Extremity Patients Using the PROMIS Platform

Kazmers

Hung

Rane

et al. 2017

The Journal of Hand Surgery

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Purpose The relationship between psychosocial factors and self-reported physical function among hand and upper extremity patients is complex. The Patient-Reported Outcomes Measurement Information System (PROMIS) platform has attempted to create a variety of specifically-targeted metrics which can be administered using computer adaptive testing (CAT). Three metrics measuring self-reported physical function (herein referred to in combination as “functional” metrics) include the PROMIS Physical Function (PF) CAT, PROMIS Upper Extremity (UE) CAT, and the quick-Dash (qDASH). Two metrics assessing psychosocial factors include the PROMIS Anxiety and Pain Interference (PI) CATs (“non-functional” metrics). This study evaluates whether the functional metrics were correlated with non-functional metrics. Methods The five questionnaires were administered prospectively on a tablet computer to all consecutive adult patients presenting to outpatient hand and upper extremity (non-shoulder) clinic at a tertiary academic medical center from 1/1/2014 – 11/1/2014. For patients with multiple visits during the study period, only the first was included. Data were evaluated retrospectively to assess the relationship between functional and non-functional measures, with Pearson correlation coefficients to understand the relationship between continuous variables, and one-way ANOVAs to examine for differences in outcome measures across demographic groups. Multivariable linear regression analyses were performed to determine factors predicting functional disability. Results We included 1299 patients: mean age was 46.8 years, 53% were female, and 23% were unemployed or on disability. The PROMIS PF CAT, PROMIS UE CAT, and qDASH scores were all significantly correlated with PROMIS Anxiety CAT (Pearson correlation coefficients −0.46, −0.48, and 0.53, respectively) and PROMIS PI CAT (−0.60, −0.65, and 0.76, respectively) scores. Multivariable regression analyses demonstrated that increased PROMIS Anxiety and Pain Interference CAT scores each independently and adversely influenced PROMIS PF CAT, PROMIS UE CAT, and qDASH scores. Conclusions Increasing levels of patient anxiety and pain interference are independently associated with decreased patient-reported upper extremity function. Clinical Relevance Statement This study provides further support of the biopsychosocial model by highlighting that increased anxiety is associated with decreased self-reported function using the PROMIS platform.

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Translation, cross-cultural and construct validity of the Dutch–Flemish PROMIS® upper extremity item bank v2.0

et al. 2020

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Evaluation of the Patient-Reported Outcomes Measurement Information System Upper Extremity Computer Adaptive Test

Cited by 83 publications

References 21 publications

Performance of Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE) Versus Physical Function (PF) Computer Adaptive Tests (CATs) in Upper Extremity Clinics

Performance of Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE) Versus Physical Function (PF) Computer Adaptive Tests (CATs) in Upper Extremity Clinics

Association of Physical Function, Anxiety, and Pain Interference in Nonshoulder Upper Extremity Patients Using the PROMIS Platform

Translation, cross-cultural and construct validity of the Dutch–Flemish PROMIS® upper extremity item bank v2.0

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