Validity of the Arabic Version of the PROMIS Anxiety and PROMIS Depression in Cancer Questionnaires: Measuring...

Background/Objectives: The cancer experience has a significant affective impact on patients, often causing anxiety and depression. Given the importance of this condition, there is a true need for psychometrically valid and culturally appropriate assessment tools for anxiety and depression in this condition. This is also true for Arabic-speaking populations. This study evaluates the measurement properties of the PROMIS Depression in Cancer (PROMIS-Ca-D) and Anxiety in Cancer (PROMIS-Ca-A) questionnaires, part of the Patient-Reported Outcomes Measurement Information System^® (PROMIS^®), for assessing depression and anxiety in Saudi Arabian cancer patients. Methods: The PROMIS-Ca-D was translated into Arabic and subsequently tested with 30 participants from five Arabic-speaking countries. The PROMIS-Ca-A had been previously translated into Arabic. The second phase recruited 213 cancer patients in Riyadh, Saudi Arabia, who completed the PROMIS-Ca-D and PROMIS-Ca-A. Rasch analysis (rating scale model) was used to assess category functioning, item fit, unidimensionality, differential item functioning, and measures reliability. Results: The translation process confirmed the cultural appropriateness of the Arabic PROMIS-Ca-D. In the validation cohort (N = 213), Rasch analysis indicated excellent reliability for both scales. Although disordered modal thresholds and signs of multidimensionality were observed, control analyses confirmed that these features did not compromise the item calibrations or the person's measures. Item fit was adequate, and Differential Item Functioning was negligible. However, suboptimal item-person targeting was noted. Conclusions: The Arabic PROMIS-Ca-D and PROMIS-Ca-A are psychometrically sound instruments for evaluating psychological distress in Arabic-speaking cancer patients. Future research should focus on assessing responsiveness and evaluating metric equivalence with legacy measures.