Psychometric properties of NIH PROMIS® instruments in bariatric surgery candidates.

Abstract

Objective: Ascertain the psychometric properties of the Patient-Reported Outcomes Measurement Information System® (PROMIS®) Depression (PROMIS-D®) and Anxiety (PROMIS-A®) Short Forms in a sample of presurgical bariatric patients. Method: This retrospective chart review included 259 patients who completed a presurgical psychological evaluation comprising a semistructured interview and self-report measures. Other data used included demographics, psychiatric diagnoses, and initial psychological clearance for surgery (yes/no). Reliability of the PROMIS-D® and PROMIS-A® instruments was assessed using Cronbach’s alpha, interitem correlations, and item-total correlations. Convergent, predictive, and concurrent validity were assessed using various methods (correlations, logistic regressions, and generalized linear models) to determine whether PROMIS® instruments were correlated with similar measures, predicted surgical clearance and psychiatric diagnosis, and whether psychiatric diagnosis status was associated with significantly different PROMIS® scores. Categorical confirmatory factor analyses assessed the factor structure, and multiple-indicator multiple cause models assessed invariance. Results: Patients were predominantly female (78%), white (97%) and middle-aged (M = 43.49, SD = 11.26). Rates of diagnosed anxiety and depression-related disorders were high (17% and 23%). At least 65% of respondents reported “never” or “rarely” experiencing symptoms across both measures, and the mean T scores for the PROMIS-A® and PROMIS-D® were 48.31 (SD = 8.99) and 48.64 (SD = 9.49), respectively. Both measures demonstrated good psychometric properties and were essentially unidimensional. Conclusions: Analyses supported using both PROMIS® measures. Additionally, two subgroups were identified: those who reported virtually no symptoms of anxiety or depression, likely because they want surgical approval, and those not receiving initial psychological clearance for surgery based on PROMIS® self-reported scores indicating distress and clinician-diagnosed psychopathology.

Sexual minority bariatric patients: preliminary examination of eating behaviors, anxiety, and depression

“…-The National Institute of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety SF [27] is a 7-item self-report questionnaire assessing symptoms of anxiety. The NIH PROMIS Anxiety SF has been previously administered among a sample of bariatric patients and has been found to have good psychometric properties [28]. [27] consists of 8 items that assess symptoms of depression.…”

“…[27] consists of 8 items that assess symptoms of depression. Previous research has administered the NIH PROMIS Depression SF to a sample of bariatric patients and found the measure to be reliable and valid [28]. [29] is a 21-item measure of anxiety symptoms in the past week with scores ranging from 0 (not at all) to 3 (severely).…”

“…[29] is a 21-item measure of anxiety symptoms in the past week with scores ranging from 0 (not at all) to 3 (severely). The BAI has previously been used to among bariatric patients [28,30].…”

“…).-The BDI-II [31] consists of 21 items assessing symptoms of depression in the past two weeks based 0 to 3 response scales. The BDI-II has been administered among bariatric patients and has yielded strong psychometric properties [23,28,32].…”

PROMIS®: Standardizing the patient voice in health psychology research and practice.

“…Extending the range of clinical samples in which PROMIS measures have been investigated, Kudel and colleagues (Kudel et al, 2019) studied the psychometric properties of selected PROMIS instruments in bariatric surgery candidates. They administered PROMIS Depression and Anxiety short forms to presurgical bariatric patients and found that both measures demonstrated good reliability, validity, and measurement invariance across race and sex.…”