Articlehybrid2013

Item Response Theory, Computerized Adaptive Testing, and PROMIS: Assessment of Physical Function

James F. Fries · James P. Witter · Matthias Rose · David F Cella · Dinesh Khanna · Esi Morgan DeWitt

198 citations0/0 files storedThe Journal of Rheumatology

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Psychometric Methodologies and Testing Health Systems, Economic Evaluations, Quality of Life Psychological Testing and Assessment

Abstract

OBJECTIVE: Patient-reported outcome (PRO) questionnaires record health information directly from research participants because observers may not accurately represent the patient perspective. Patient-reported Outcomes Measurement Information System (PROMIS) is a US National Institutes of Health cooperative group charged with bringing PRO to a new level of precision and standardization across diseases by item development and use of item response theory (IRT). METHODS: With IRT methods, improved items are calibrated on an underlying concept to form an item bank for a "domain" such as physical function (PF). The most informative items can be combined to construct efficient "instruments" such as 10-item or 20-item PF static forms. Each item is calibrated on the basis of the probability that a given person will respond at a given level, and the ability of the item to discriminate people from one another. Tailored forms may cover any desired level of the domain being measured. Computerized adaptive testing (CAT) selects the best items to sharpen the estimate of a person's functional ability, based on prior responses to earlier questions. PROMIS item banks have been improved with experience from several thousand items, and are calibrated on over 21,000 respondents. RESULTS: In areas tested to date, PROMIS PF instruments are superior or equal to Health Assessment Questionnaire and Medical Outcome Study Short Form-36 Survey legacy instruments in clarity, translatability, patient importance, reliability, and sensitivity to change. CONCLUSION: Precise measures, such as PROMIS, efficiently incorporate patient self-report of health into research, potentially reducing research cost by lowering sample size requirements. The advent of routine IRT applications has the potential to transform PRO measurement.

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1996A 12-Item Short-Form Health Survey 2010The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005–2008 1980Measurement of patient outcome in arthritis 2007The Patient-Reported Outcomes Measurement Information System (PROMIS)2008Evaluation of a preliminary physical function item bank supported the expected advantages of the Patient-Reported Outcomes Measurement Information System (PROMIS)2009Progress in Assessing Physical Function in Arthritis: PROMIS Short Forms and Computerized Adaptive Testing

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