Establishing a common metric for self-reported anxiety: linking the MASQ, PANAS, and GAD-7 to PROMIS Anxiety

Abstract

Researchers and clinicians wishing to assess anxiety must choose from among numerous assessment options, many of which purport to measure the same or a similar construct. A common reporting metric would have great value and can be achieved when similar instruments are administered to a single sample and then linked to each other to produce cross-walk score tables. Using item response theory (IRT), we produced cross-walk tables linking three popular "legacy" anxiety instruments--MASQ (N=743), GAD-7 (N=748), and PANAS (N=1120)--to the anxiety metric of the NIH Patient Reported Outcomes Measurement Information System (PROMIS(®)). The linking relationships were evaluated by resampling small subsets and estimating confidence intervals for the differences between the observed and linked PROMIS scores. Our results allow clinical researchers to retrofit existing data of three commonly used anxiety measures to the PROMIS Anxiety metric and to compare clinical cut-off scores.

Keywords: Anxiety; GAD-7; Linking; MASQ; PANAS; PROMIS.

Copyright © 2013 Elsevier Ltd. All rights reserved.

Figures

Figure 1

Figure 1a–c. IRT cross-walk function (based on fixed-parameter calibration) and equipercentile functions with different levels of smoothing. EQP = Equipercentile; SM = Post-Smoothing.

Figure 2

Comparison of clinically relevant scores on the PROMIS Anxiety metric. MASQ-GA: 25 for the mean of a general clinical sample with mood and anxiety disorders (Boschen & Oei, 2007); GAD-7: 5, 10, and 15 correspond to mild, moderate, and severe symptoms of generalized anxiety disorder (Spitzer, Kroenke, Williams, & Löwe, 2006); PANAS: 26 for the mean of a clinically mixed sample (Watson & Clark, 1999).