Country-specific reference values for PROMIS^® pain, physical function and participation measures compared to US...

Area of Science:

• Health Measurement
• Psychometrics
• Cross-cultural Adaptation

Background:

• Patient-Reported Outcomes Measurement Information System (PROMIS) is widely used for assessing patient outcomes across various medical conditions.
• Standardized interpretation of PROMIS scores is crucial for international research and clinical practice.
• Existing US reference values may not be directly applicable to other populations.

Purpose of the Study:

• To calculate Dutch reference values for key PROMIS measures: Physical Function (PROMIS-PF), Pain Interference (PROMIS-PI), Pain Behavior (PROMIS-PB), Ability to Participate in Social Roles and Activities (PROMIS-APSRA), and Satisfaction with Social Roles and Activities (PROMIS-SSRA).
• To compare these Dutch reference values with existing US reference values.
• To inform the development of country-specific reference values for PROMIS.

Main Methods:

• A Dutch panel completed full PROMIS item banks for PF, PI, PB, APSRA, and SSRA.
• Participants reported their health status per domain (no, mild, moderate, severe limitations).
• T-scores were calculated, and distribution-based and anchor-based thresholds for severity were determined.

Main Results:

• Mean T-scores for Dutch participants were comparable to US values for PROMIS-PF (49.8 vs 50) and PROMIS-APSRA (50.6 vs 50).
• Deviations were observed for PROMIS-SSRA (47.5 vs 50), PROMIS-PI (54.9 vs 50), and PROMIS-PB (52.0 vs 50).
• While thresholds for severity were similar, Dutch participants perceived limitations at lower score levels than suggested by US cut-offs.

Conclusions:

• Dutch reference values for some PROMIS domains differ from US values, highlighting the need for country-specific norms.
• Implementing country-specific reference values is recommended to enhance the global utility of PROMIS.
• Further research is required to establish reliable and patient-centered cut-off values for score interpretation.