The Relationship Among 3 Generic Patient-Reported Outcome Instruments in Patients With Lower Extremity Health Conditions

Abstract

Context Generic patient-reported outcome (PRO) instruments are designed to capture health-related quality-of-life outcomes and to determine treatment effectiveness from the patient's perspective. Multiple generic PROs are used in clinical practice, and an investigation of the psychometric properties of these instruments in a high-functioning, physically active population is important for the future use of these instruments. Objective To determine the relationship among 3 generic PROs: the modified Disablement in the Physically Active (mDPA) Scale, the Patient-Reported Outcome Measurement Information System Physical Function (PROMIS-PF), and the Short Form 12 (SF-12) in physically active patients seeking treatment for a lower extremity health condition. Design Cross-sectional study. Setting Athletic training clinical facility, physical therapy clinic. Patients or Other Participants One hundred patients seeking rehabilitation services for a lower extremity health condition. Main Outcome Measure(s) All patients completed a demographic questionnaire and the 3 generic PROs at 1 time point during their rehabilitation: the mDPA-Total, mDPA-physical summary component (mDPA-PSC), mDPA-mental summary component (mDPA-MSC), the PROMIS-PF, and SF-12 mental component summary (SF-MCS) and physical component summary (SF-PCS). Separate Spearman rank (r) correlations were performed to assess the strength of the relationship among PRO instruments. The floor and ceiling effects were also examined. Results A strong relationship was present between the SF-12 PCS and the mDPA-Total (r = −0.65), the mDPA-PSC (r = −0.64), and the PROMIS-PF (r = 0.65). Significant moderate relationships were identified between the mDPA-MSC and the SF-12 PCS (r = −0.43) and MCS (r = −0.53). Weak relationships were noted between the mDPA-Total and SF-12 MCS (r = −0.21) and the SF-12 MCS and mDPA-PSC (r = −0.10) and PROMIS-PF (r = 0.20). Conclusions The PROMIS-PF and mDPA had good convergent and divergent validity. Clinicians treating physically active patients should consider these instruments for use in clinical practice. Future researchers should examine additional psychometric properties of these instruments in physically active patients.

Validation of PROMIS-29 domain scores among adult burn survivors: A National Institute on Disability, Independent Living, and Rehabilitation Research Burn Model System Study

“…For DIF analyses, a minimum of 200 subjects per group has been recommended. 38 In this study, we examined DIF with respect to age (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54), or 55+ years), sex, education (high school graduate or above, no high school diploma), race (White, non-White), ethnicity (Hispanic, non-Hispanic), and TBSA burned (0-19%, ≥20%). Differential item functioning analyses were conducted using ordinal logistic regression models with the lordif program in R (R Core Team 2016).…”

Development and initial validation of the Orthotic Patient-Reported Outcomes—Mobility (OPRO-M): An item bank for evaluating mobility of people who use lower-limb orthoses

“…These included the PROMIS-PF 20-item short form [10], OPUS-LEFS [12], and LEFS [15]. PROMIS-PF has been shown to have evidence of validity when tested with LLO users [25] and evidence of validity and/or reliability when tested with people diagnosed with a variety of health conditions that affect the lower extremities [26][27][28][29]. OPUS-LEFS has been shown to have excellent internal consistency when tested with a mixed sample of orthosis and prosthesis users [12].…”

Development of a candidate item bank for measuring mobility of lower limb orthosis users

“…The Patient‐Reported Outcome Measure Information System – Physical Function (PROMIS‐PF), is an IRT‐based item bank with a generic population focus 24 . PROMIS‐PF has been psychometrically evaluated with several clinical populations that often include LLO users, including people with lower extremity health conditions, 25 spine disorders, 26 ischemic stroke, 27 and multiple sclerosis 28 . Weber et al 29 tested PROMIS‐PF in a sample of 98 LLO users and reported initial evidence of known groups construct validity.…”