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Computerized adaptive testing of psychological factors: relation to upper-extremity disability
Mariano E Menendez1, Arjan G J Bot, Michiel G J S Hageman
1Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, 55 Fruit Street, Suite 2100, Boston, MA 02114. E-mail address for M.E. Menendez: memenendez@partners.org. E-mail address for A.G.J. Bot: abot@partners.org. E-mail address for M.G.J.S. Hageman: mhageman@partners.org. E-mail address for V. Neuhaus: vneuhaus@partners.org. E-mail address for C.S. Mudgal: cmudgal@partners.org. E-mail address for D. Ring: dring@partners.org.
Web-based Patient Reported Outcomes Measurement Information System (PROMIS) tools accurately measure upper-extremity pain and psychological factors. These user-friendly assessments correlate well with traditional questionnaires, offering a more efficient approach to assessing disability.
Area of Science:
- Orthopedics
- Rheumatology
- Psychology
Background:
- Psychological factors significantly influence the discrepancy between physical impairment and functional disability.
- Traditional disability and psychological measures are often lengthy paper-based questionnaires.
- The study aimed to evaluate user-friendly, web-based Patient Reported Outcomes Measurement Information System (PROMIS) tools for assessing disability and psychological factors.
Purpose of the Study:
- To assess the correlation between perceived disability and psychological factors using the PROMIS initiative.
- To compare the correlation of PROMIS measures with a traditional paper-based pain self-efficacy questionnaire.
- To evaluate the utility of web-based PROMIS tools in capturing maladaptive responses to upper-extremity pain.
Main Methods:
- A cohort of 213 patients completed web-based questionnaires.
- Included were the Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire, pain self-efficacy questionnaire, PROMIS Pain Interference Computerized Adaptive Testing (CAT), and PROMIS Depression CAT.
- Bivariate and multivariable analyses were performed to determine correlations with QuickDASH scores.
Main Results:
- Strong correlations were observed between QuickDASH and PROMIS Pain Interference CAT (r=0.74), PROMIS Pain Interference CAT and pain self-efficacy (r=-0.72), and QuickDASH and pain self-efficacy (r=-0.76).
- PROMIS Depression CAT showed moderate correlations with QuickDASH (r=0.37) and PROMIS Pain Interference CAT (r=0.40).
- Pain interference alone explained 51% of the variability in QuickDASH scores; a multivariable model including pain interference, prior treatment, and smoking explained 57%.
Conclusions:
- User-friendly, web-based PROMIS Computerized Adaptive Testing (CAT) questionnaires effectively measure maladaptive responses to upper-extremity pain.
- PROMIS tools provide a reliable and efficient alternative to traditional paper-based assessments.
- These findings support the integration of PROMIS into clinical practice for better pain management and disability assessment.
