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Patient-Reported Outcomes Measurement Information System (PROMIS)-Physical Function Assessments
Please visit this website for more information about the instrument:
Supplemental: Stroke
Short Description of Instrument
The Patient Reported Outcomes Measurement Information System (PROMIS) Version 1.0 contains 12 calibrated item banks with Likert style items (e.g., anger, anxiety, depression, fatigue (Cella et al., 2010; Garcia et al., 2007), pain (Amtmann et al., 2010), physical function, satisfaction with social activities and roles, sleep/wake disturbance (Bruni et al., 1996, 1994; Spruyt & Gozal 2011), and global health (Cella et al., 2010; Hays et al., 2009)). It is part of the NIH goal to develop systems to support NIH-funded research supported by all of its institutes and centers. PROMIS measures cover physical, mental, and social health and can be used across chronic conditions.
The instrument is domain-focused (domains listed above) rather than specific to a particular disease; however, a disease-customized measurement approach can be utilized by choosing the PROMIS measures most relevant to the specific disease. See: PROMIS Domain Framework for pediatric and adult domains.
This assessment measures patient-reported outcomes related to physical function.
Because many persons with a chronic disease will have more than one chronic condition and cannot distinguish the fraction of a problem attributable to each one, physical function items attempt to quantitate the sum of these effects, leaving the teasing out of relative contributions to the analysis stage. Physical function is conceptually multidimensional, with four related subdomains: mobility (lower extremity function), dexterity (upper extremity function), axial (neck and back function), and ability to carry out instrumental activities of daily living (IADL).
On average, respondents will answer five questions per minute, suggesting, for example, that a computerized adaptive test (CAT) administration of all nine banks with an average of five items per bank will take about ten minutes to complete.
No licensing or royalty fees for English and Spanish PROMIS measures used in individual research, clinical practice, educational assessment or other application. Translations in other languages have a distribution fee. Permission is required for commercial use or integration into proprietary technology; see Terms and Conditions of Use for details.
Adults (ages 18+), pediatric self-report (ages 8-17) and
parents serving as proxy reporters for their child (youth ages 5-17).
Item bank and short forms are available in Dutch, English and French. Short forms are also available in additional languages; see PROMIS Translations for details.
Other Important Notes:
There are two general options to consider when selecting a PROMIS instrument for your study: CAT or static short forms. Within these two general options are several specific considerations to guide your optimal selection. In all cases, when you create an assessment from a PROMIS bank, a score will be produced on the same common (Theta) metric which has been converted to a T-distribution based on the United States general population. The choice you make for assessment in your study should be driven by your relative interests in precision, brevity, item content, and flexibility/portability.
Comments/Special Instructions
Scoring and Psychometric Properties
Each item is rated by the difficulty the patient has experienced in completing each item in a 5-point Likert scale. A score of 1 is rated the lowest (an inability to complete the item) and a score of 5 is rated the highest (no difficulty experienced at all). Once the assessment is complete, summative scores are generated.
T scores for most items.
In all cases, a high score means more of domain. For example, higher scores on the fatigue measures indicate poorer health whereas higher scores on physical functioning measure indicate better health.
Standardization Population: For most domains, T-scores relate to the US General Population. See PROMIS Calibrations Testing for further details regarding sample for specific ages and domains.
Scoring Manuals is available at: PROMIS Physical Function Scoring Manual.
Psychometric Properties
Validation is ongoing. The physical function item bank has demonstrated reliability, precision and construct validity as it is correlated with legacy instruments: Health Assessment Questionnaire (r=-0.80) and SF-36 (r=-0.88). It is also correlated with the 10 item short form (r=0.96) (Cella et al. 2010).The psychometric properties of this scale were evaluated in general and chronic disease populations (Rose et al. 2014) and in a six chronic health conditions (Schalet et al., 2016). This scale was found to have excellent internal consistency and minimal ceiling effect in a study of ischemic stroke patients by Katzan et al. (2016). The minimally important difference range in ischemic and hemorrhagic stroke patients was determined to be 2.5 to 6.5 T-score points (Lapin et al., 2018).
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.
Bruni O, Ottaviano S, Guidetti V, Romoli M, Innocenzi M, Cortesi F, Giannotti F. The Sleep Disturbance Scale for Children (SDSC) construction and validation of an instrument to evaluate sleep disturbances in childhood and adolescence. J Sleep Res. 1996;5(4):251–261.
Bruni O, Romoli M., Innocenzi M, Giannotti F, Cortesi F and Ottaviano S. Prevalenza dei disturbi del sonno in eth scolare. In: Di Perri R., Raffaele M., Silvestri R. and Smirne S. (Eds) 11 Sonno in ltaliu 1994. Poletto Ed., Milano, 1994 163–171.
Cella D, Riley W, Stone A, Rothrock N, Reeve B, Yount S, Amtmann D, Bode R, Buysse D, Choi S, Cook K, Devellis R, DeWalt D, Fries JF, Gershon R, Hahn EA, Lai JS, Pilkonis P, Revicki D, Rose M, Weinfurt K, Hays R; PROMIS Cooperative Group. The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005-2008. J Clin Epidemiol. 2010 Nov;63(11):1179-1194.
Cella D, Yount S, Rothrock N, Gershon R, Cook K, Reeve B, Ader D, Fries JF, Bruce BRM: The patient reported outcomes measurement information system (PROMIS): progress of an NIH roadmap cooperative group during its first two years.  Med Care 2007, 45:S3-S11.
Garcia SF, Cella D, Clauser SB, Flynn KE, Lad T, Lai JS, Reeve BB, Smith AW, Stone AA, Weinfurt K. Standardizing patient-reported outcomes assessment in cancer clinical trials: a patient-reported outcomes measurement information system initiative. J Clin Oncol. 2007;25(32):5106–5112.
Hays RD, Revicki DA, Feeny D, Fayers P, Spritzer KL, Cella D. Using Linear Equating to Map PROMIS(®) Global Health Items and the PROMIS-29 V2.0 Profile Measure to the Health Utilities Index Mark 3. Pharmacoeconomics. 2016;34(10):1015-1022.
Katzan IL, Fan Y, Uchino K, Griffith SD. The PROMIS physical function scale: A promising scale for use in patients with ischemic stroke. Neurology. 2016;86(19):1801-1807.
Lapin B, Thompson NR, Schuster A, Katzan IL. Clinical Utility of
Patient-Reported Outcome Measurement Information System Domain Scales. Circ Cardiovasc Qual Outcomes. 2019;12(1):e004753.
Rose M, Bjorner JB, Gandek B, Bruce B, Fries JF, Ware JE Jr. The PROMIS Physical Function item bank was calibrated to a standardized metric and shown to improve measurement efficiency. J Clin Epidemiol. 2014;67(5):516–526.
Schalet BD, Hays RD, Jensen SE, Beaumont JL, Fries JF, Cella D. Validity of PROMIS physical function measured in diverse clinical samples. J Clin Epidemiol. 2016 May;73:112-118.
Spruyt K, Gozal D. Pediatric sleep questionnaires as diagnostic or epidemiological tools: a review of currently available instruments. Sleep Med Rev. 2011;15(1):19–32.