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Item response theory, computerized adaptive testing, and PROMIS: assessment of physical function
James F Fries1, James Witter, Matthias Rose
1From the Department of Medicine, Stanford University School of Medicine, Stanford, California; National Institutes of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), Bethesda, Maryland, USA; Medical School Charité, University Medicine Berlin, Berlin, Germany; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan; Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA.
Patient-reported outcome (PRO) measures like PROMIS enhance health research precision. These advanced tools improve data accuracy and reduce costs by optimizing sample sizes.
Area of Science:
- Health outcomes research
- Psychometrics
- Biostatistics
Background:
- Patient-reported outcome (PRO) questionnaires capture direct participant health data, crucial for accurate representation.
- The Patient-reported Outcomes Measurement Information System (PROMIS) aims to standardize and improve PROs across diseases using item response theory (IRT).
Purpose of the Study:
- To develop and validate advanced PRO measures using IRT for enhanced precision and standardization.
- To improve the efficiency and reliability of health outcome measurement in research.
Main Methods:
- Item response theory (IRT) calibrates items within domains like physical function (PF) to create item banks.
- Efficient static and tailored forms, including computerized adaptive testing (CAT), are constructed from calibrated items.
- PROMIS item banks are calibrated using data from over 21,000 respondents.
Main Results:
- PROMIS physical function (PF) instruments demonstrate superiority or equivalence to legacy instruments (HAQ, SF-36) in key areas.
- PROMIS instruments excel in clarity, translatability, patient importance, reliability, and sensitivity to change.
Conclusions:
- PROMIS provides precise measures that efficiently integrate patient self-report into research.
- Routine IRT applications, exemplified by PROMIS, have the potential to revolutionize PRO measurement and reduce research costs.
