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PROMIS Pain Interference Short Form
Availability
Publicly Available from the PROMIS website:
Classification
Supplemental: Huntington's Disease (HD), Multiple Sclerosis(MS)
 
Exploratory: Myalgic encephalomyelitis/Chronic fatigue syndrome (ME/CFS)
Short Description of Instrument
Construct measured: Self-reported consequences of pain on relevant aspects of one’s life.
Generic vs. disease specific: Generic.
Means of administration: Short forms or computerized adaptive testing (CAT).
Intended respondent: Patient or parent proxy for children ages 5-17.
# of items: 41 (total), 4, 6 or 8 (short form).
# of subscales and names of sub-scales: N/A.
# of items per sub-scale: N/A.
Comments/Special Instructions
Background: The PROMIS Pain Interference instruments (adult and child) measure the self-reported consequences of pain on relevant aspects of one’s life. This includes the extent to which pain hinders engagement with social, cognitive, emotional, physical, and recreational activities. Pain interference also incorporates items probing sleep and enjoyment in life, though the item bank only contains one sleep item. The pain interference short form is generic rather than disease-specific. It assesses pain interference over the past seven days. PROMIS Pediatric Pain Interference instruments are available for adults (ages 18+), for children (ages 8-17) and parent proxy serving as proxy reporters for their child (youth ages 5-17).
Scoring
All PROMIS instruments including the Pain Interference short form item banks is scored using item-level calibrations. The most accurate way to score the instrument is to utilize scoring tools within Assessment Center or API that look at responses to each item for each participant. Data collected in either of these platforms will automatically score in this way. We refer to this as “response pattern scoring.” For adults, each question has five response options ranging in value from one to five (for pediatrics and parent proxy it is 0 to 4). To find the total raw score for a short form with all questions answered, sum the values of the response to each question. For example, for the six-item form, the lowest possible raw score is 6; the highest possible raw score is 30. A higher PROMIS T-score represents more of the concept being measured. For negatively-worded concepts like pain interference, a T-score of 60 is one SD worse than average. By comparison, a pain interference T-score of 40 is one SD better than average.
Rationale/Justification
Strengths/ Weaknesses: The strength of the six-item version 1.0 instrument lies in its focus on item content and its ability to assess the full range of pain interference measured by the pain interference item bank. When selecting a short form, the main difference is instrument length. Reliability and precision of short forms within a domain are highly similar. Longer short forms generally offer greater correlation (strength of relationship) with the full item bank, as well as greater precision.
 
If you are working with a sample in which you expect large variability in a domain and you want to include the full range of item content from that domain, you would probably prefer this six-item version 1.0 short form. On the other hand, if you are hoping to capture secondary outcomes data, but have little room for additional measures, you would probably prefer a very brief (four-item) profile short form.
 
These PROMIS measures use standardized scores centered on a reference population. Both general population and a clinical population were used to norm the Pain behavior item bank; They are easily accessible with Multiple data collection tools: Paper NIH Toolbox iPad App Assessment Center API (includes RedCap) Assessment Center PROMIS iPad App.
 
This tool does not differentiate between interference caused by pain and interference caused by other ME/CFS symptoms, especially post-exertional malaise (PEM). Because of this, it is recommended that other instruments to measure pain and PEM be used in conjunction with the PROMIS Pain Interference Short Form.
 
Psychometric Properties: For scores in the T-score range 50-80, the reliability was equivalent to 0.96 to 0.99. Patterns of correlations with other health outcomes supported the construct validity of the item bank. The scores discriminated among persons with different numbers of chronic conditions, disabling conditions, levels of self-reported health, and pain intensity (p < 0.0001).
 
Administration: There are two administration options for assessing pain interference: short forms and computerized adaptive testing (CAT). With the short form (4, 6, or 8 item banks), participants are instructed to answer all items (i.e., questions or statements) presented. With CAT, participant responses guide the computer’s choice of subsequent items from the full item bank (41 items in total). Although items differ across respondents taking CAT, scores are comparable across participants. Some administrators may prefer to ask the same question of all respondents or of the same respondent over time, to enable a more direct comparability across people or time. Whether one uses a short form or CAT, the score metric is Item Response Theory (IRT), a family of statistical models that link individual questions to a presumed underlying trait or concept of pain interference represented by all items in the item bank.
References
Amtmann D, Cook KF, Jensen MP, Chen WH, Choi S, Revicki D, Cella D, Rothrock N, Keefe F, Callahan L, Lai JS. Development of a PROMIS item bank to measure pain interference. Pain. 2010;150(1):173–182.
 
Kim J, Chung H, Amtmann D, Revicki DA, Cook KF. Measurement invariance of the PROMIS pain interference item bank across community and clinical samples. Qual Life Res. 2013;22(3):501–507.
Recommended Instrument for
HD, MS and ME/CFS
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