Abstract
BackgroundSelf-reported health-related quality of life is an important population health outcome, often assessed using a single question about self-rated health (SRH). The Patient Reported Outcomes Measurement Information System (PROMIS) is a new set of measures constructed using item response theory, so each item contains information about an underlying construct. This study’s objective is to assess the association between SRH and PROMIS scores and social determinants of health (SDoH) to evaluate the use of PROMIS for measuring population health.MethodsA cross sectional survey of 4142 US adults included demographics, 7 PROMIS domains with 2 items each, the PROMIS-preference (PROPr) score, self-rated health (SRH), 30 social determinants of health (SDoH), and 12 chronic medical conditions. SDoH and chronic condition impact estimates were created by regressing the outcome (PROMIS domain, PROPr, or SRH) on demographics and SDoH or a single chronic condition. Linear regression was used for PROMIS domains and PROPr; ordinal logistic regression was used for SRH.ResultsBoth SRH and PROPr detected statistically significant differences for 11 of 12 chronic conditions. Of the 30 SDoH, 19 statistically significant differences were found by SRH and 26 statistically significant differences by PROPr. The SDoH with statistically significant differences included those addressing education, income, financial insecurity, and social support. The number of statistically significant differences found for SDoH varies by individual PROMIS domains from 13 for Sleep Disturbance to 25 for Physical Function.ConclusionsSRH is a simple single question that provides information about health-related quality of life. The 14 item PROMIS measure used in this study detects more differences in health-related quality of life for social determinants of health than SRH. This manuscript illustrates the relative costs and benefits of each approach to measuring health-related quality of life.
Highlights
Self-reported health-related quality of life is an important population health outcome, often assessed using a single question about self-rated health (SRH)
Linear regression was used for Patient Reported Outcomes Measurement Information System (PROMIS) domains and PROPr as the PROMIS domains were Item Response Theory (IRT) scored and utility measures are considered cardinal scales; ordinal logistic regression was used for SRH
IRT-calibrated questions can give a substantial amount of information about the construct they are measuring; this study uses just 2 questions per health-related quality of life (HRQoL) domain and shows sensitivity to a variety of social determinants of health (SDoH)
Summary
Self-reported health-related quality of life is an important population health outcome, often assessed using a single question about self-rated health (SRH). There are a wide variety of indicators used to measure and monitor population health including mortality, disease prevalence, disability, and injury rates. These measures are critical, they do not capture health as perceived by the individuals within a population [1, 2]. Measures of health-related quality of life (HRQoL). Hanmer Health Qual Life Outcomes (2021) 19:221 provide a standardized survey-based approach to assess population health [3]. [5] This item provides a general perception of health that reflects both objective health conditions and the individual’s values for different aspects of HRQoL. Multiple studies have found this question to be predictive of health care utilization and mortality [6,7,8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
