Abstract
BackgroundAccurate score interpretation is required for the appropriate use of patient-reported outcome measures in clinical practice.ObjectiveTo create and evaluate figures (T-score Maps) to facilitate the interpretation of scores on Patient-Reported Outcome Measurement Information System (PROMIS) measures.MethodsFor 21 PROMIS® short forms, item-level information was used to predict the most probable responses to items for the range of possible scores on each short form. Predicted responses were then “mapped” graphically along the range of possible scores. In a previously conducted longitudinal study, 1594 adult participants with chronic conditions (e.g., multiple sclerosis) responded to four items each of a subset of these PROMIS short forms. Participants’ responses to these items were compared to those predicted by the T-score Maps. Difference scores were calculated between observed and predicted scores, and Spearman correlations were calculated.ResultsWe constructed T-score Maps for 21 PROMIS short forms for adults and pediatric self- and parent-proxy report. For the clinical population, participants’ actual responses were strongly correlated with their predicted responses (r = 0.762 to 0.950). The majority of predicted responses exactly matched observed responses (range 69.5% to 85.3%).ConclusionResults support the validity of the predicted responses used to construct T-score Maps. T-score Maps are ready to be tested as interpretation aids in a variety of applications.
Highlights
Patient-reported outcome (PRO) measures are increasingly integrated into routine clinical practice to inform clinical decision making [1,2,3], monitor or screen for symptoms [4, 5], or meet treatment guidelines [6]
Guidance on score interpretation was identified by experts as a required component of implementation of PROs in clinical practice [7], a recent systematic review found that only 39% of oncology implementations included it [8]
PatientReported Outcome Measurement Information System (PROMIS) measures were constructed with item response theory (IRT) [15, 19]
Summary
Patient-reported outcome (PRO) measures are increasingly integrated into routine clinical practice to inform clinical decision making [1,2,3], monitor or screen for symptoms [4, 5], or meet treatment guidelines [6]. In addition to being psychometrically sound [15], PROMIS item banks were developed to reflect how patients conceptualize important symptoms and functions as they apply in one’s day-to-day life. In developing these measures, investigators used mixed methods with substantial patient input [16]. Investigators used mixed methods with substantial patient input [16] This included identification of important components of a symptom or function to be assessed, as well as reliable and accurate interpretation of the meaning of items across patients [17, 18]. Accurate score interpretation is required for the appropriate use of patient-reported outcome measures in clinical practice
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