PROMIS

The Patient-Reported Outcomes Measurement Information System (PROMIS®) includes measures of physical, mental, and social health for adults and children.

What is the difference between PROMIS Global and the PROMIS-29 Profile?

More
3 years 6 months ago #877

Bido et al. failed to recognize the distinction.

Poor Scientific Quality of Bido et al. article in the Journal of Shoulder and Elbow Surgery
Ron D. Hays, Ph.D.
March 14, 2021

Generic health-related quality of life (HRQoL) measures are useful for comparing different chronic conditions to one another.[3] The PROMIS global health items are an example of a generic measure that yields a “‘bottom-line’’ picture of health.[4] Condition-targeted HRQoL measures assess aspects of HRQoL that are relevant to people with the condition, and have the potential to be more sensitive to differences than generic measures. For example, a study of men treated for localized prostate cancer showed no differences in the generic SF-36 measure by treatment (surgery, radiation, watchful waiting) but prostate-targeted measures of sexual, urinary and bowel function and distress were worse in the radiation and surgery groups.[6]

Bido et al.[1] concluded that the PROMIS Global-10 performed poorly in patients undergoing total shoulder arthroplasty for glenohumeral arthritis compared to legacy measures: the Standardized Shoulder Assessment Form (ASES), Single Assessment Numeric Evaluation (SANE), and the Shoulder Activity Scale (SAS). Bido et al. did not distinguish between changes expected on different types of HRQoL measures. The content of the ASES, SANE and SAS items is slanted toward activities affected by shoulder arthritis. A surgery designed to improve shoulder function should improve performance of these activities. These improvements may result in more positive perceptions of global health. Wilson and Cleary[7] suggested more than 25 years ago directional effects from biological and physiological variables to symptoms, functional status, general health perceptions and overall quality of life. The change in the PROMIS global physical health scale was statistically significant and clinically important (3 T-score points). Because the intervention targeted physical functioning, it is not surprising that the PROMIS global mental health scale change was trivial and not quite statistically significant from baseline to follow-up.

Spearman correlations of the PROMIS global health scale and the condition-targeted legacy measures ranged from 0.31 to 0.5 at the postoperative assessment. Bido et al. used ad-hoc rules of thumb to classify 2 of these 3 correlations as poor, but the article cited to justify this has no relevant information. In contrast, translating the 0.20, 0.50, and 0.80 effect size (d) rules of thumb adopted by the authors to evaluate responsiveness into correlations (r = d /SQRT((d*d) + 4) suggests r = 0.100 as small, 0.243 as medium, and 0.371 as large.

The authors suggest that the PROMIS global health measure is equivalent to the SF-36 and SF-12, but it is more like the Medical Outcomes Study general health perceptions scale. The PROMIS-29 v2.1 instrument[2,5] is is more like the SF-36. Finally, Table 2 shows the PROMIS global health T-score as ranging from 0-100 but these scores do not have a 0-100 possible range.

References
1. Bido J, Sullivan SW, Carr JB, Schairer WW, Nwachukwu BU. PROMIS global-10 performs poorly relative to legacy shoulder instruments in patients undergoing total shoulder arthroplasty for glenohumeral arthritis. Journal of Shoulder and Elbow Surgery. 2020 Nov 18;S1058-2746(20)30893-4. doi: 10.1016/j.jse.2020.10.021.
2. Cella D, Choi SW, Condon DM, Schalet B, Hays RD, Rothrock NE, Yount S, Cook KF, Gershon RC, Amtmann D, DeWalt DA, Pilkonis PA, Stone AA, Weinfurt K, Reeve BB. PROMIS® adult health profiles: Efficient short-form measures of seven health domains. Value Health. 2019;22(5):537-544.
3. Hays RD. Generic versus disease-targeted instruments. In Fayers P, Hays R, editors. Assessing Quality of Life in Clinical Trials: Methods and Practice, 2nd Edition. Oxford: Oxford University Press; 2005. pp. 3-8.
4. Hays RD, Bjorner J, Revicki DA, Spritzer K, Cella D. Development of physical and mental health summary scores from the Patient-Reported Outcomes Measurement Information System (PROMIS) global items. Quality of Life Research. 2009;18:873-80. doi: 10.1007/s11136-009-9496-9.
5. Hays RD, Spritzer KL, Schalet BD, Cella D. PROMIS®-29 v2.0 profile physical and mental health summary scores. Quality of Life Research. 2018;27:1885-1891. doi: 10.1007/s11136-018-1842-3.
6. Litwin M, Hays RD, Fink A, Ganz PA, Leake B, Leach GE, et al. Quality of life outcomes in men treated for localized prostate cancer. Journal of the American Medical Association. 1995;273:129-135. doi: 10.1001/jama.273.2.129.
7. Wilson IB, Cleary PD. Linking Clinical Variables With Health-Related Quality of Life: A Conceptual Model of Patient Outcomes. JAMA. 1995;273(1):59–65. doi:10.1001/jama.1995.03520250075037

Please Log in or Create an account to join the conversation.

More
6 years 7 months ago #542

Both the PROMIS Global scales and PROMIS Profiles provide a multidimensional assessment. They differ in their approach. For adults, PROMIS Global includes 10 items. Four items that reflect different aspects of physical health (e.g., fatigue, physical function, pain) contribute to a Global Physical Health score. Four items that reflect different aspects of mental health (e.g., mood, cognition, social activities/role) contribute to a Global Mental Health score. A change in Global Physical Health may be the result of a change in fatigue, physical function, or other domain of physical health. The scores present a summary of multiple aspects of health.

A PROMIS Profile is a set of short forms from PROMIS item banks and is significantly longer than the global measures (e.g., 10 versus 29 items). The PROMIS-29, for example, includes short forms for anxiety, depression, fatigue, sleep disturbance, pain interference, physical function, and ability to participate in social roles and activities. Each short form produces its own score. It is a comprehensive measure in that it is assessing multiple aspects of mental, physical, and social health. Each short form covers a narrower domain than a global measure. This allows for the evaluation of differences in more specific areas of health (e.g., depression) between groups or over time. Research by Ron Hays and colleagues developed a way to create summary scores similar to what is produced by PROMIS global measures from the PROMIS-29 profile. See another thread in this Forum for more information. www.healthmeasures.net/forum-healthmeasu...multiple-domains#515. If you have sufficient assessment time, the PROMIS-29 Profile offers both the specificity of assessment of multiple unidimensional constructs as well as summary scores and therefore may be more useful than PROMIS Global.

Please Log in or Create an account to join the conversation.

Moderators: HealthMeasures