Patient-Reported Outcomes Measurement Information System (PROMIS) Instruments: Reliability and Validity in Veterans Following Orthopedic Surgery

Abstract

The patient-reported outcomes measurement information system (PROMIS) offers standardized assessment measures of clinically relevant patient-reported outcomes. This study evaluated the reliability and validity of select PROMIS measures with U.S. military veterans following orthopedic surgery. Data for the current study were collected as part of a pilot randomized control trial assessing the efficacy of a 1-day Acceptance and Commitment Therapy workshop on persistent postsurgical pain in at-risk veterans undergoing orthopedic surgery. Sixty-seven participants completed surveys 3 months after surgery. Participants completed the following PROMIS instruments: PROMIS Anxiety Short Form 8a, PROMIS Depression Short Form 8b, and PROMIS Pain Interference Short Form 8a. PROMIS measures were compared to the Generalized Anxiety Disorder 7-Item Scale, the Patient Health Questionnaire 9-Item Scale, and the Brief Pain Inventory Pain Interference subscale, respectively. All three PROMIS measures demonstrated excellent internal consistency (Cronbach’s αs ranged from .93 to .96) and each loaded onto a single factor. The PROMIS measures were moderately correlated with their respective comparison measures ( r = .69 to .76). The PROMIS anxiety and PROMIS depression measures were highly correlated to one another ( r = .91). Findings highlight the potential utility of these PROMIS measures in veterans following orthopedic surgery and the overlap between the PROMIS depression and anxiety measures in this sample.

Addiction Medicine Practice-Based Research Network (AMNet): Assessment Tools and Quality Measures

“…Universal rather than diseases specific. Provides a patient perspective on the extent to which pain interferes in activities of daily living Pain-related functioning Good to excellent Internal Consistency (Cronbach’s α ranged from 0.93 to 0.96) strong to very strong construct validity (r = 0.69 to 0.76) with PROMIS Anxiety Short Form and PROMIS Depression Short Form 60 Notes: a Interpretation of ICC values: ICC˂0.5=poor, 0.5≤ICC˂0.75=moderate, 0.75≤ICC˂0.9=good, and ICC≥0.90=excellent. 61 bInterpretation of α values: α˂0.5 = unacceptable; 0.5≤α˂0.6=poor; 0.6≤α˂0.7= questionable; 0.7≤α˂0.8=acceptable; 0.8≤α˂0.9=good; α≥0.9=excellent.…”

Measures of Anxiety in Rheumatic Diseases

“…Internal consistency was found to be 0.92 to 0.97, with test‐retest correlations at 0.82 to 0.83 (104–106). In SLE, good test‐retest agreement was found for the majority of domains, including anxiety (intraclass correlation coefficient [2;1] 0.70; 95% confidence interval 0.51‐0.84) (107).…”

Item Response Theory Analysis: PROMIS® Anxiety Form and Generalized Anxiety Disorder Scale

“…Classical test theory (CTT) is a commonly used measurement framework that assumes the true score cannot be directly observed and can only be assessed indirectly through the observed test score with error (Allen & Yen, 2001). PROMIS ® anxiety measures have been tested using CTT and demonstrated validity and reliability in adult populations with different conditions, including patients with osteoarthritis (Driban et al, 2015; Lee et al, 2017), multiple sclerosis (Marrie et al, 2018), lumbar degenerative disease (Purvis et al, 2018), and orthopedic conditions (Beleckas et al, 2018; Hadlandsmyth et al, 2020). While reliability and validity of different anxiety short forms are highly similar, the longest short form (8a) is recommended for use to achieve the most precise measure and the shortest form (4a) is recommended for use when there is little room for additional measures to capture anxiety as a secondary outcome (National Institute of Health, 2019).…”

“…The GAD-7 showed evidence for unidimensionality and decent fit to IRT models in primary care patients (Jordan et al, 2017). In addition, the GAD-7 has been tested using CCT with established reliability and validity in different adult patient populations using CTT, including patients following coronary artery bypass surgery (Tully & Baker, 2012), orthopedic surgery (Hadlandsmyth et al, 2020), and patients with chronic depression (Toussaint et al, 2020), anxiety, and mood disorders (Rutter & Brown, 2017).…”