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Assessment of Patient-Reported Physical Function in Persons With Upper Extremity Amputation: Comparison of Short Form
Linda J Resnik1, Phillip M Stevens, Pengsheng Ni
1From the Research Department, Providence VA Medical Center, Providence, Rhode Island (LJR, MLB); Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island (LJR, MAC); Hanger Institute for Clinical Research and Education, Austin, Texas (PMS); Department of Physical Medicine and Rehabilitation, University of Utah Health, Salt Lake City, Utah (PMS); Boston University, Boston, Massachusetts (PN); and Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts (MAC).
Objective:
The aim of the study was to compare psychometric properties of the Patient-Reported Outcomes Measurement Information System upper extremity measure (PROMIS UE) 7-item short form with 6- and 13-item versions for persons with upper limb amputation.
Design:
The study used a telephone survey of 681 persons with upper limb amputation. Versions were scored two ways: PROMIS health measure scoring (PROMIS UE HMSS) and sample-specific calibration (PROMIS UE AMP). Factor analyses and Rasch analyses evaluated unidimensionality, monotonicity, item fit, differential item functioning, and reliability. Known group validity was compared for all versions.
Results:
Model fit was acceptable for PROMIS-6 UE AMP and marginally acceptable for PROMIS-13 UE AMP and PROMIS-7 UE AMP. Item response categories were collapsed because of disordered categories. A total of 91.4% of participants had PROMIS-13 UE AMP scores with reliability greater than 0.8, compared with 70.4% for PROMIS-7 UE AMP, and 72.1% for PROMIS-6 UE AMP versions. No differences were observed by prosthesis use. Scores differed by amputation for all measures except the HMSS scored 13- and 7-item versions.
Conclusions:
The PROMIS-13 UE AMP short form was superior to the health measures scoring system scored PROMIS-7 UE or PROMIS-6 UE, and to the PROMIS-7 UE AMP and PROMIS-6 UE AMP. Issues with known group validation suggest a need for a population-specific measure of upper extremity function for persons with upper limb amputation.
