PROMIS^® Score Cut Points

Score cut points assign descriptive words (e.g., moderate) to a score range (e.g., 60-70). This makes interpreting a score more intuitive and actionable. They are available for PROMIS measures.

Adult Measures

See score cut points for adult respondents (ages 18+). Learn more>>

Pediatric and Parent Proxy Measures

See score cut points for self-report pediatric respondents (ages 8-17) and parent proxy report measures for children (ages 5-17). Learn more>>

Early Childhood Parent-Report Measures

See score cut points for parent-report measures for children (ages 1-5). Learn more>>

How to Use Score Cut Point Figures

• Identify your respondent (adult, pediatric, parent proxy, or early childhood parent report).
• Identify your measure’s domain (e.g., Depression, Fatigue, Physical Function).
• Select the correct figure for your measure and respondent.

Example

In the figure below, scores less than or equal to 55 T-score points are described as “within normal limits”. Scores between 55 and 60 are described as “mild” whereas scores 60-70 are labeled “moderate” and scores above 70 are labeled “severe.” The figure also shows that the general population has a mean of 50 and standard deviation of 10. Therefore, if a patient has a score of 60, I know that the patient is one standard deviation worse than the general population average and on the border between mild and moderate.

Variation in Terminology and Cut Points

PROMIS domains use different terms to describe score ranges. For example, some domains use mild/moderate/severe whereas others use very high to very low. Cut points also vary. Each domain has a score cut point figure that shows the indicated terms and cut points. These can be applied to short forms and computer adaptive tests for a given domain.
 

Methods

PROMIS scientists used norm-based methods to select score cut points. This means they reviewed the distribution of scores from a large sample. This helped their understanding of the range of scores typically collected in the general population. Next, they evaluated if 0.5, 1.0, and 2.0 standard deviations were reasonable thresholds to use across domains. This was done by looking at the percentage of participants from large scale testing that would fit in each category.

For PROMIS Global, an anchor-based approach was used. The five-category Global01 item (rated from excellent to poor) was used as an anchor item to estimate the scores of PROMIS Global physical health at each level of physical health. Global02 was used to estimate PROMIS Global mental health scores at each level of mental health.

Standard Setting Using Bookmarking

Another approach to selecting score cut points is with bookmarking. Researchers have adopted a method applied in educational testing to identify thresholds for levels of academic outcomes (e.g., math proficiency levels). This method, called Bookmarking, has been used to establish thresholds for severity levels (e.g., no problems, mild problems, moderate problems, severe problems) in multiple patient populations. Learn more>>

Severity thresholds exist for:

• PROMIS Pain Interference, Fatigue, Anxiety, and Depression (Cella et al 2014) in cancer
• PROMIS Physical Function, Cognitive Function, and Sleep Disturbance (Rothrock et al 2019) in cancer
• PROMIS Pain Interference and Fatigue (Bingham et al 2021) in rheumatoid arthritis
• PROMIS Physical Function, Pain Interference, Sleep Disturbance, and Depression (Nagaraja et al 2018) in rheumatic conditions
• PROMIS Pediatric Mobility, Upper Extremity Function, Pain Interference, and Fatigue (Morgan et al 2017) in juvenile idiopathic arthritis
• PROMIS Pediatric Anxiety, Depressive Symptoms, Fatigue, and Mobility (Mann et al 2020) in juvenile idiopathic arthritis and childhood-onset systemic lupus erythematosus

Other Methods

Researchers have dichotomized responses to items and then used patterns of responses to determine no/mild, moderate, and severe score cut-points.

• PROMIS Pediatric Pain Interference and Pain Behavior (Singh & Panepinto 2019) in children with sickle cell disease.

Last updated on 7/2/2025