Linking Measures

Getting Scores on the Same Metric

The PROsetta Stone® project developed mathematical links between legacy measures and PROMIS® or Neuro-QoL™ scores (see Schalet et al., 2021). This work takes a major step toward establishing the relationships between instruments that measure similar concepts.

PROsetta Stone linking applies and compares multiple methodologies to place the scores of two measures on the same metric. The result is a cross-walk table that associates each possible score on a "legacy" measure to a T-score of the comparable PROMIS instrument. For example, as shown on the left in Helpful Resources , the summed SF-36 Physical Function Scores have been linked to PROMIS Physical Function T-scores. A person using the SF-36 would calculate a physical function summed score, then use the table to find the equivalent score on PROMIS Physical Function.

The PROsetta Stone team has published results on depression, anxiety, physical function, pain, fatigue, and global health. Linked measures include FACT/FACIT, GAD-7, HOOS/KOOS, ODI, PHQ-9, SF-36, and many others. More information on methodology and related publications are on the PROsetta Stone project website.

Depression Linking Tables 

PROsetta Stone linking tables can be used to translate thresholds from one measure to the PROMIS metric. For example, several depression measures have thresholds for mild, moderate, and severe symptomatology. With PROsetta, thresholds across measures can be compared.

PROsetta depression cross walk

Choi, S.W., Schalet, B., Cook, K.F., & Cella, D. (2014). Establishing a Common Metric for Depressive Symptoms: Linking the BDI-II, CES-D, and PHQ-9 to PROMIS Depression. Psychological Assessment, 26(2), 513-527.

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Linking Adult and Pediatric PROMIS Measures

As children mature into adulthood it has been difficult to compare scores from PROMIS pediatric measures (ages 8-17) to PROMIS adult measures (ages 18+). Linking methodology was applied to create algorithms to convert pediatric v2.0 scores to the adult metric and vice versa for depressive symptoms, anxiety, anger, physical function (mobility and upper extremity), fatigue, and pain interference. Apply the formula below with the appropriate values in the following tables. For example, a PROMIS pediatric anxiety score of 55 = a PROMIS adult anxiety score of 57.63 because 20.23 + (0.68*55) = 57.63

β0 + (β1 x [PROMIS score])


PROMIS Pediatric v2.0 to Adult Score Conversion

Domain β0 β1
Depressive Symptoms 11.47 0.78
Anxiety 20.23 0.68
Anger 15.91 0.74
Mobility 11.29 0.83
Upper Extremity 16.71 0.60
Fatigue 21.00 0.58
Pain Interference 22.34 0.62


PROMIS Adult to Pediatric v2.0 Score Conversion

Domain β0 β1
Depression -5.75 1.11
Anxiety -12.36 1.16
Anger -9.67 1.13
Mobility -7.95 1.08
Upper Extremity -16.72 1.40
Fatigue -16.72 1.32
Pain Interference -16.53 1.24


  • A zip file containing an application to transform physical health scores for web-based applications is here (under PROMIS Research, find Tulsky, Kisala, Boulton et al (2019) Qual Life Res, and click “linking_application”)
  • Emotional health domains are summarized in Reeve et al 2016. Learn more>>
  • Physical health domains are summarized in Tulsky et al 2018. Learn more>>

R Package for Linking

A PROsetta Stone R package is available for linking patient-reported outcome measures. See Choi et al, 2021.

What are some applications of linking?

Linking results, such as those obtained from PROsetta Stone, can inform data aggregation efforts. For example:

  • Linking studies may support longitudinal studies. It may be necessary for longitudinal researchers to change measures over time, either due to researcher preference or because a scale is no longer age-appropriate (e.g. an adolescent scale is no longer valid in young adulthood). Results from a linking sub-study can enable such a switch.
  • Linking may also reduce error in meta-analyses. Meta-analysts attempt to aggregate of results across studies, clinics, or nations using different measures on an interpretable common metric.
  • The comparison of scores via linking can be further applied in quality improvement initiatives, where clinicians or hospitals are evaluated and compared relative to their peers.

Need to link multiple measures? Experienced HealthMeasures psychometricians and analysts are available to consult or collaborate on linking studies. To learn more, contact us.

Watch this 2-minute video for information about comparing the scores of PROMIS measures to scores from other measures.



Last updated on 5/24/2024