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Progress in assessing physical function in arthritis: PROMIS short forms and computerized adaptive testing.

James F Fries¹, David Cella, Matthias Rose

¹Department of Medicine, Stanford University School of Medicine, Palo Alto, CA 94304, USA. jff@stanford.edu

The Journal of Rheumatology

|September 10, 2009

Summary

This summary is machine-generated.

Item response theory (IRT) and computerized adaptive testing (CAT) improve arthritis assessment. The PROMIS CAT demonstrated superior performance over static forms, enhancing physical function and disability measurement in patients with arthritis.

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Area of Science:

Rheumatology and Health Measurement Science
Application of psychometric methods in clinical research

Background:

Assessing physical function and disability in arthritis is crucial for research.
Traditional instruments like the Health Assessment Questionnaire Disability Index (HAQ) have limitations in precision and statistical power.
Item response theory (IRT) and computerized adaptive testing (CAT) offer advanced methods to improve measurement accuracy.

Framework:

Development of a 124-item item bank from an initial 1865 items, incorporating Legacy HAQ and Physical Function-10 items.
Creation of four novel instruments: Patient-Reported Outcomes Measurement Information (PROMIS) HAQ, PROMIS 10, 20-item static forms, and a simulated PROMIS CAT.
Rigorous qualitative and quantitative evaluation involving over 21,000 subjects, including patients with rheumatoid arthritis and osteoarthritis.

Implementation:

Comparison of the developed instruments against the standard HAQ.
Evaluation of online and mailed administration modes for consistency.
Assessment of instrument performance across a wide range of disease severity.

Implications:

The PROMIS HAQ is validated and available, offering improved measurement.
New PROMIS short forms are anticipated to provide further enhancements post-validation.
CAT-based assessment of physical function and disability shows superior performance compared to static forms of equivalent length, leading to more precise and powerful research outcomes.