In general, PROMIS items should not be modified unless there is data that supports that modification. This data would include input from patients showing problems with the original item and reduction in that error with a modified item. For example, sometimes, researchers are concerned that an item won’t function well as-is with a specific population. One strategy would be to evaluate the original item and a proposed modified item using cognitive interviews with the target patient population. Demonstrate that patients misinterpret or are unable to answer the item. Demonstrate that the proposed modified item reduces or eliminates that error.

If the researcher would like for this modification to be adopted into the PROMIS measure, it would then be necessary to test the modified, experimental PROMIS item and original item in the same assessment with a larger sample. Data analyses should include evaluating the experimental item’s performance (e.g., testing for differential item functioning, responsiveness, correlations with other variables). As noted by Dr. Hays, calibrating the new item on the PROMIS metric is ideal. The PROMIS Health Organization is very interested in supporting improvements to PROMIS measures. If you feel a modification improves the interpretability or performance of an item, please contact HealthMeasures so that this improvement can be integrated into the measure.

Whether an item was modified for use in your own study or you want the modification to be adopted by PROMIS, describe the modification in any presentations or publications. Identify it as a modified item.

The HealthMeasures Terms of Use states the following, "User agrees not to adapt, alter, amend, abridge, modify, condense, make derivative works, or translate HealthMeasures Instruments without prior written permission from the Provider. In cases where permission is granted, User will be expected to evaluate the impact of approved modifications."

In other words, users of HealthMeasures instruments, of which PROMIS is a part, are not allowed to modify PROMIS items without written permission to do so, and we require you to study how your changes compare to the original instrument. To acquire permission to modify a PROMIS item, email help@healthmeasures.net.

To learn more, you can find our Terms of Use at www.healthmeasures.net/images/PROMIS/Ter...opyright_Notices.pdf.

Can I modify a PROMIS item? What's involved?