Evidence from diverse clinical populations supported clinical validity of PROMIS pain interference and pain behavior

Robert L Askew, Karon F Cook, Dennis A Revicki, David Cella, Dagmar Amtmann, Robert L Askew, Karon F Cook, Dennis A Revicki, David Cella, Dagmar Amtmann

Abstract

Objective: To evaluate clinical validity, including responsiveness, of Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference (PROMIS-PI) and pain behavior (PROMIS-PB) T-scores.

Study design and setting: Data were aggregated from longitudinal studies of cancer, chronic low back pain (cLBP), rheumatoid arthritis, chronic obstructive pulmonary disease (COPD), and major depressive disorder (MDD). Linear mixed-effects models were used to compare baseline score differences and score changes over time. We calculated standardized response means (SRMs) for subgroups defined by self-reported change in general health and pain.

Results: A total of 1,357 individuals participated at baseline and 1,225 at follow-up. Hypotheses of significant change in PROMIS-PI and PROMIS-PB scores were supported in the intervention groups (cLBP and MDD). Differences in baseline scores for COPD exacerbators compared to stable COPD patients were in the hypothesized direction but were not statistically significant. Subgroups reporting better health showed corresponding negative SRM values supporting responsiveness of T-scores to improvement. Responsiveness to decrements was supported in some but not all clinical groups and varied by anchor. More congruent values were obtained when using a pain-specific anchor.

Conclusion: This study provides evidence that PROMIS-PI and PROMIS-PB scores are sensitive to changes in pain in studies of interventions expected to impact pain. The results inform estimation of meaningful change and support power analyses for comparative effectiveness research.

Keywords: Back pain; Cancer; Chronic pain; PROMIS; Pain behavior; Pain interference.

Conflict of interest statement

CONFLICT OF INTEREST

Robert L. Askew: None

Karon F. Cook is an unpaid officer of the PROMIS Health Organization

Dennis A. Revicki: None

David Cella is an unpaid member of the board of directors and officer of the PROMIS Health Organization

Dagmar Amtmann: None

Copyright © 2016 Elsevier Inc. All rights reserved.

Figures

Figure 1
Figure 1
Change in PROMIS Pain Interference and Pain Behavior scores by clinical sample *Cancer (group 1, n=51): patients reporting improved global health at follow-up *Cancer (group 2, n=85): patients reporting worsened global health at follow-up *RA (group 1, n=60): patients reporting improved global health at follow-up *RA (group 2, n=92): patients reporting worsened global health at follow-up

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