Abstract
BackgroundSelf-reports of health provide useful information about function and well-being that can improve communication between patients and clinicians. Global health items provide summary information that are predictive of health care utilization and mortality. There is a need for parsimonious global health scales for use in large sample surveys. This study evaluates the reliability and validity of brief measures of global physical health and mental health in the Patient Reported Outcomes Measurement and Information System (PROMIS®) project.MethodsA total of 21,133 persons included in the PROMIS development sample: 52% female; 82% White, 9% Black, 9% Hispanic; median age of 50 years. We identified two global physical health items (GPH-2) and two global mental health items (GMH-2) with highest discrimination parameters and compared their reliabilities and construct validity to that of the original 4-item scales (GPH-4 and GMH-4) and a single global health item (Global01).ResultsInternal consistency reliability was 0.73 for the GPH-2 (versus 0.81 for the GPH-4) and 0.81 for the GMH-2 (versus 0.86 for the GMH-4). Marginal reliabilities were 0.55 for Global01, 0.70 for GPH-2, 0.79 for GPH-4, 0.80 for GMH-2, and 0.86 for GMH-4. The product-moment correlation between the GPH-2 and GPH-4 was 0.94 and between GMH-2 and GMH-4 was 0.97. The 2-item and 4-item versions of the scales had similar correlations with PROMIS domain scores, the EQ-5D-3L and comorbidities, but the 4-item scales were more strongly correlated with these measures.ConclusionsAdding a single item to a large cross-sectional population survey can cost as much as $100,000. The 2-item variants of the PROMIS global health scales reduce the cost of use on national surveys by 50%, a substantial cost savings. These briefer scales are also more practical for use in clinical practice. The 2-item versions of the PROMIS global health scales display adequate reliability for group comparisons and their associations with other indicators of health are similar to that of the original 4-item scales. The briefer scales are psychometrically sound and reduce burden of survey administration.
Highlights
Self-reports of health provide useful information about function and well-being that can improve communication between patients and clinicians
Four-item global physical health (GPH-4) and global mental health (GMH-4) scales were developed in PROMIS® that had internal consistency reliability coefficients of 0.79 and 0.86, respectively
This study identifies 2-item variants of the PROMIS global physical and mental health scales (GPH-2 and GMH-2) and compares their psychometric properties to the GPH-4, GMH-4, and the Global01 item
Summary
Self-reports of health provide useful information about function and well-being that can improve communication between patients and clinicians. This study evaluates the reliability and validity of brief measures of global physical health and mental health in the Patient Reported Outcomes Measurement and Information System (PROMIS®) project. The Patient-Reported Outcomes Measurement Information System (PROMIS®) is a National Institutes of Health initiative to develop state-of-the-science measures that assess function and well-being in the physical, mental and social domains of health. PROMIS global health items include global ratings of five primary domains (physical function, fatigue, pain, emotional distress, and social health) as well as perceptions of general. Four-item global physical health (GPH-4) and global mental health (GMH-4) scales were developed in PROMIS® that had internal consistency reliability coefficients of 0.79 and 0.86, respectively. When considering briefer versions of multi-item scales, comparability of scores produced from the shorter measure needs to be demonstrated and tradeoffs carefully considered [7]
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