Meaningful Change for PROMIS®

Estimates for the magnitude of change that corresponds to “important” change are published.

         Finally, you should keep in mind that most MID estimates are an average across the range of scores. It may be that people require more or less change to consider it meaningful depending on where they started. [KFC1] 

 [KFC1]Kozlowski AJ, Cella D, Nitsch KP, Heinemann AW. Evaluating Individual Change

With the Quality of Life in Neurological Disorders (Neuro-QoL) Short Forms. Arch

Phys Med Rehabil. 2016 Apr;97(4):650-4.e8. doi: 10.1016/j.apmr.2015.12.010.

PubMed PMID: 26740062; PubMed Central PMCID: PMC4994512.


Watch this 3-minute video about meaningful change in PROMIS scores.

Many terms for change (e.g., clinically important change, minimally important change, minimally perceptible change) are used. Specific estimates for minimally important differences (MIDs) are below. We report which administrations of a measure (e.g., 7-item form, CAT) were used to derive the MID estimates. This does not imply that there are different estimates for different forms.



  • Change of 2.5-4.5 points (used 17 item short form) Yost
  • Change of 3.0-5.0 points (used 7 item short form) Yost

Based on Neuro-QoL™ short form, which shares metric with PROMIS Kozlowski:

  • Lower Quartile: Change of 4.7-12.2 points 
  • Middle Half: Change of 4.7 – 5.1 points 
  • Upper Quartile: Change of 5.0-11.3 points 
Pain Interference
  • Change of 3.5-5.5 points (used CAT with back pain samples) Amtmann
  • Change of 2-3 points (used short forms with chronic pain samples) Chen
  • Change of 3.5-4.5 points (used short forms with stroke sample) Chen
  • Change of 2.35-2.4 points (used short form with knee OA sample) Lee
  • Change of 4.0-6.0 points (used 10 item short form with cancer sample) Yost
Physical Function
  • Change of 2 points (used 20 item short form with RA sample) Hays 
  • Change of 1.9-2.2 points (used short form with knee OA sample) Lee
  • Change of 4-6 points (used 10 item short form with cancer sample) Yost
  • In a 2018 analysis with patients undergoing total joint replacement, different methods of calculating a meaningful change produced a range of estimates for multiple measures including the PROMIS Physical Function CAT. See Hung et al (2018).
Gastrointestinal Symptoms 
  • Belly Pain: Change of 6 points Khanna
  • Constipation: Change of 5-6 points Khanna
  • Diarrhea: Change of 5-6 points Khanna
  • Gas and Bloating: Change of 6 points Khanna
  • Reflux: Change of 1 point for worsening, 5 points for improvement Khanna
 Emotional Well-Being
  • Anxiety: Change of 3.0-5.5 points (used CAT with chronic pain sample) Swanholm
  • Anxiety: Change of 2.3-3.4 points (used short form with knee OA sample) Lee
  • Anxiety: Change of 3.0-4.5 points (used 9 item short form with cancer sample)  Yost
  • Depression: Change of 3.5-5.5 points (used CAT with chronic pain sample) Swanholm
  • Depression: Change of 3.0-3.1 points (used short form with knee OA sample) Lee 
  • Depression: Change of 3.0-4.5 points (used 10 item short form with cancer sample) Yost



  • Depression: Change of 2-3 points Thissen
  • Pain Interference: Change of 2-3 points Thissen
  • Fatigue: Change of 2-3 points Thissen
  • Mobility: Change of 2-3 points Thissen
  • Morgan and colleagues found that estimates of MIDs varied by domain, the severity of symptom/dysfunction, and by who was making the judgement (pediatric patient, parent, or clinician).