Confirmatory Factor Analysis of the Patient Reported Outcomes Measurement Information System (PROMIS) Adult Domain...

Area of Science:

• Health outcomes research
• Psychometrics
• Patient-reported outcomes

Background:

• The Patient reported Outcomes Measurement Information System (PROMIS) developed a hierarchical domain framework to guide measure development.
• The initial framework categorized Physical Health (PH), Mental Health (MH), and Social Health (SH) domains.
• Confirmatory factor analyses were used to evaluate the framework's fit to empirical data.

Purpose of the Study:

• To evaluate the fit of the hypothesized PROMIS domain framework using confirmatory factor analyses.
• To determine if the established health domains (PH, MH, SH) accurately represented the collected data.
• To refine the framework based on statistical analysis if necessary.

Main Methods:

• Utilized data from 14,098 participants in the PROMIS wave 1 field test.
• Estimated domain scores using item response theory parameters.
• Performed confirmatory factor analyses to assess the correspondence between data and the PROMIS domain framework.

Main Results:

• The initial model based on the PROMIS domain framework showed suboptimal fit (RMSEA=0.13, CFI=0.92, TLI=0.88, SRMR=0.09).
• Modification indices suggested allowing the Fatigue item to load on both Physical Health and Mental Health domains.
• The revised model demonstrated acceptable fit (RMSEA=0.08, CFI=0.97, TLI=0.96, SRMR=0.03).

Conclusions:

• The findings provide general support for the hierarchical PROMIS domain framework.
• Allowing the Fatigue domain to load on both Physical Health and Mental Health significantly improved the model's fit to the data.
• This suggests a nuanced relationship between physical and mental health symptoms, particularly concerning fatigue.