How Item Banks and Their Application Can Influence Measurement Practice in Rehabilitation Medicine: A PROMIS Fatigue Item Bank Example

Abstract

Objective To illustrate how measurement practices can be advanced using as an example the fatigue item bank (FIB) and its applications (short-forms and computerized adaptive test) that were developed via the NIH Patient Reported Outcomes Measurement Information System (PROMIS) Cooperative Group. Design Psychometric analysis of data collected by an internet survey company using Item Response Theory (IRT) related techniques. Setting A United States general population representative sample collected via internet. Participants 803 respondents used for dimensionality evaluation of the PROMIS FIB and 14,931 respondents used for item calibrations Interventions Not applicable. Main Outcome Measures 112 fatigue items developed by the PROMIS fatigue domain working group, 13-item Functional Assessment of Chronic Illness Therapy-Fatigue, and 4-item SF-36 Vitality scale. Results The PROMIS FIB version 1 which consists of 95 items demonstrated acceptable psychometric properties. Computerized Adaptive Testing (CAT) showed consistently better precision than short-forms. However, all three short-forms showed good precision for the majority of participants, in that more than 95% of sample could be precisely measured with a reliability greater than 0.9. Conclusions Measurement practice can be advanced by using a psychometrically sound measurement tool and its applications. This example shows that CAT and short-forms derived from the PROMIS FIB can reliably estimate fatigue reported by the US general population. Evaluation in clinical populations is warranted before the item bank can be used for clinical trials.

Feasibility and diagnostic accuracy of the Patient‐Reported Outcomes Measurement Information System (PROMIS) item banks for routine surveillance of sleep and fatigue problems in ambulatory cancer care

“…Our findings using ROC analyses for fatigue were different from crosswalk comparisons of FACIT-Fatigue cut scores and PROMIS T-Scores as reported by Lai. 43 For instance, a cut off score on FACIT-Fatigue of 30 is shown to be equivalent to a PROMIS T-score of 57.8, whereas we found optimal sensitivity and specificity at a T-score of 56.6. This finding may be due to the use of the US general population based norms for determining T-scores as other measures have shown norms may differ based on country 62 or due to the non-random nature of our sample.…”

“…The use of ROC has been previously used to test the discriminant power for comparison of outcome measures as expressed in sensitivity and specificity in the osteoporosis and cancer populations and to determine important cutoff scores for use in clinical practice [40][41][42] . Whereas, there have been some cross-walking of the FACIT-Fatigue scores to PROMIS ® T-scores 43 , comparison of legacy measures for insomnia and PROMIS has not been previously examined. In order to facilitate health policy decision-making for use of PROMIS ® CAT in routine surveillance of CRF and insomnia in ambulatory cancer care, we addressed the following research questions in this study: (1) Is it feasible and acceptable for patients to use PROMIS ® CAT for routine surveillance of CRF and insomnia using tablet computers in ambulatory cancer care; and (2) what is the diagnostic accuracy of the PROMIS ® CATS for detecting cases of CRF and sleep disturbance when…”

Stimulating Innovations in the Measurement of Parenting Constructs

“…Alternatively, if the score is not precise enough, more items will be administered. 69,70 For patient-reported outcome measures, the NIH PROMIS Ò initiative has been able to demonstrate that CAT administrations can result in more precise, valid, and reliable scores with fewer items (e.g., 4 to 8 items) administered per construct measured. 68,69,71 CAT administrations can be advantageous for the assessment of parenting because the intent is to administer as few items as possible while maintaining the precision, validity, and reliability of the scores without sacrificing the ability to compare scores across studies.…”

The relationship between physical function and experience of fatigue in patients with chronic obstructive pulmonary disease

“…The multi-dimensional questionnaires include primarily the severity of fatigue but also frequency and duration and/or the consequences/impact of fatigue on different functions in daily life 88 . It is important to distinguish between assessing the symptom itself and the impact of the symptom on different functions 89 . In Figure 2 the different measurable dimensions of fatigue are distinguished.…”