Abstract
BackgroundThe Patient-Reported Outcomes Measurement Information System® (PROMIS) includes a Physical Function (PF) item bank and an Upper Extremity (UE) item bank, which is composed of a subset of items from the PF bank. The UE item bank has few items and known ceiling effects. Therefore, this study aimed to expand the item bank to assess a wider range of functioning. With the additional content, other psychometric properties—improved content validity, item bank depth, range of measurement, and score reliability—were also evaluated. We convened an expert panel to review potential items, and then conducted psychometric analyses on both extant and newly-collected data.ResultsExpert focus groups reviewed the PF item bank for items that were “sufficiently” related to upper extremity functioning for inclusion in the expanded UE item bank. The candidate item bank was quantitatively evaluated in a new sample of 600 people. The final items were calibrated in an aggregated dataset (n = 11,635) from two existing datasets, and the newly collected sample. The original UE item bank included 15 items. After expert review and quantitative evaluation, 31 items were added. The combined 46 items were calibrated using item response theory (IRT). Then computer adaptive tests (CATs) were simulated based off of the psychometric results. These indicated that the new UE item bank has an extended measurement range compared to the original version.ConclusionsThe expanded PROMIS UE item bank assesses a wider range of upper extremity functioning compared to the initial UE item bank. However, ceiling effects remain a concern for unimpaired groups. The new UE item bank is recommended for individuals with known or suspected upper extremity limitations.
Highlights
The Patient-Reported Outcomes Measurement Information System® (PROMIS) includes a Physical Function (PF) item bank and an Upper Extremity (UE) item bank, which is composed of a subset of items from the PF bank
While a comprehensive review of the dimensionality of physical functioning is beyond the scope of this paper, recognition that upper extremity may be unique is of utmost importance, especially when evaluating clinical patients
The adult PROMIS PF item bank was found to be sufficiently unidimensional when translated, though the upper extremity items were less correlated with a convergent validity measure and the remainder of the PF item bank [18]
Summary
The Patient-Reported Outcomes Measurement Information System® (PROMIS) includes a Physical Function (PF) item bank and an Upper Extremity (UE) item bank, which is composed of a subset of items from the PF bank. Physical function is one of the most important health outcomes when evaluating quality of life. It is a primary outcome for multiple musculoskeletal conditions [1], has been recommended as a target for drug development research in cancer [2], is strongly related to pain [3], and is a primary reason for disability applications [4]. While a comprehensive review of the dimensionality of physical functioning is beyond the scope of this paper, recognition that upper extremity may be unique is of utmost importance, especially when evaluating clinical patients. The adult PROMIS PF item bank was found to be sufficiently unidimensional when translated, though the upper extremity items were less correlated with a convergent validity measure and the remainder of the PF item bank [18]
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