Development of physical and mental health summary scores from the Patient Reported Outcomes Measurement Information System (PROMIS) global items

Department of Medicine, UCLA, Los Angeles, CA, USA.
Quality of Life Research (Impact Factor: 2.49). 07/2009; 18(7):873-80. DOI: 10.1007/s11136-009-9496-9
Source: PubMed


The use of global health items permits an efficient way of gathering general perceptions of health. These items provide useful summary information about health and are predictive of health care utilization and subsequent mortality.
Analyses of 10 self-reported global health items obtained from an internet survey as part of the Patient-Reported Outcome Measurement Information System (PROMIS) project. We derived summary scores from the global health items. We estimated the associations of the summary scores with the EQ-5D index score and the PROMIS physical function, pain, fatigue, emotional distress, and social health domain scores.
Exploratory and confirmatory factor analyses supported a two-factor model. Global physical health (GPH; 4 items on overall physical health, physical function, pain, and fatigue) and global mental health (GMH; 4 items on quality of life, mental health, satisfaction with social activities, and emotional problems) scales were created. The scales had internal consistency reliability coefficients of 0.81 and 0.86, respectively. GPH correlated more strongly with the EQ-5D than did GMH (r = 0.76 vs. 0.59). GPH correlated most strongly with pain impact (r = -0.75) whereas GMH correlated most strongly with depressive symptoms (r = -0.71).
Two dimensions representing physical and mental health underlie the global health items in PROMIS. These global health scales can be used to efficiently summarize physical and mental health in patient-reported outcome studies.

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    • "PROMIS Depression items assess negative mood, negative views of the self, negative cognitions, and decreased positive emotion and engagement. Unlike traditional, static assessment tools that utilize a composite score using a set number of items, PROMIS instruments are based on an Item Response Theorybased assessment that utilizes item-level responses [2] [20]. PROMIS measures utilize U.S. population norms and have a mean of 50 points and a standard deviation of 10 points [6]. "
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    • "Health status is represented in part by the Elixhauser index, which summarizes the presence or absence of 30 medical comorbidities [26]. Patients also report their subjective global health status at baseline through selected items pertaining to health and well-being from the NIH Patient Reported Outcomes Measurement Information System (PROMIS) [27]. "
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    • "The Pain Numeric Rating scale was a single (0–10) item that asks patients to rate, from " none " (0) to " the worst pain you can think of " (10), the severity of their worst pain during the past week. The PROMIS Global Health Scale [48] refers to evaluations of health in general rather than specific elements of health. The PROMIS global health items include global ratings of the five primary PROMIS domains (physical function, fatigue, pain, emotional distress, and social health) and general health perceptions that cut across domains. "
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