Evaluation of the PROMIS physical function computer adaptive test in the upper extremity.

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Health Outcomes Research

Background:

• Assessing physical function in hand and upper extremity conditions is crucial for patient care and research.
• Traditional instruments like the Disabilities of Arm, Shoulder, and Hand (DASH) have established utility but may present responder burden.
• The Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Computer Adaptive Test (PF CAT) offers a modern, adaptive approach to outcome measurement.

Purpose of the Study:

• To compare the psychometric properties and responder burden of the PROMIS PF CAT against the DASH instrument.
• To evaluate the performance of both instruments within a tertiary hand and upper extremity clinical setting.

Main Methods:

• Adult patients presenting to a university-based tertiary care center hand and upper extremity clinic were enrolled.
• Participants completed both the DASH and PROMIS PF CAT via tablet.
• Statistical analyses included Pearson correlation, Rasch item response theory analysis for dimensionality, reliability, and effects.

Main Results:

• 134 patients were included. PROMIS PF CAT completion time (57 seconds) was significantly faster than DASH (262 seconds).
• Both instruments demonstrated strong correlation (r=0.726).
• PROMIS PF CAT showed higher reliability (0.99) and no ceiling or floor effects, unlike DASH (0.97 reliability, 5% ceiling, 1% floor).

Conclusions:

• PROMIS PF CAT exhibits favorable psychometric characteristics comparable to the DASH instrument.
• PROMIS PF CAT significantly reduces patient time burden, enhancing the efficiency of outcome assessment in upper extremity practice.