TY - JOUR T1 - Progress in assessing physical function in arthritis: PROMIS short forms and computerized adaptive testing JF - Journal of Rheumatology Y1 - 2009 A1 - Fries, J.F. A1 - Cella, D. A1 - Rose, M. A1 - Krishnan, E. A1 - Bruce, B. KW - *Disability Evaluation KW - *Outcome Assessment (Health Care) KW - Arthritis/diagnosis/*physiopathology KW - Health Surveys KW - Humans KW - Prognosis KW - Reproducibility of Results AB - OBJECTIVE: Assessing self-reported physical function/disability with the Health Assessment Questionnaire Disability Index (HAQ) and other instruments has become central in arthritis research. Item response theory (IRT) and computerized adaptive testing (CAT) techniques can increase reliability and statistical power. IRT-based instruments can improve measurement precision substantially over a wider range of disease severity. These modern methods were applied and the magnitude of improvement was estimated. METHODS: A 199-item physical function/disability item bank was developed by distilling 1865 items to 124, including Legacy Health Assessment Questionnaire (HAQ) and Physical Function-10 items, and improving precision through qualitative and quantitative evaluation in over 21,000 subjects, which included about 1500 patients with rheumatoid arthritis and osteoarthritis. Four new instruments, (A) Patient-Reported Outcomes Measurement Information (PROMIS) HAQ, which evolved from the original (Legacy) HAQ; (B) "best" PROMIS 10; (C) 20-item static (short) forms; and (D) simulated PROMIS CAT, which sequentially selected the most informative item, were compared with the HAQ. RESULTS: Online and mailed administration modes yielded similar item and domain scores. The HAQ and PROMIS HAQ 20-item scales yielded greater information content versus other scales in patients with more severe disease. The "best" PROMIS 20-item scale outperformed the other 20-item static forms over a broad range of 4 standard deviations. The 10-item simulated PROMIS CAT outperformed all other forms. CONCLUSION: Improved items and instruments yielded better information. The PROMIS HAQ is currently available and considered validated. The new PROMIS short forms, after validation, are likely to represent further improvement. CAT-based physical function/disability assessment offers superior performance over static forms of equal length. VL - 36 SN - 0315-162X (Print)0315-162X (Linking) N1 - Fries, James FCella, DavidRose, MatthiasKrishnan, EswarBruce, BonnieU01 AR052158/AR/NIAMS NIH HHS/United StatesU01 AR52177/AR/NIAMS NIH HHS/United StatesConsensus Development ConferenceResearch Support, N.I.H., ExtramuralCanadaThe Journal of rheumatologyJ Rheumatol. 2009 Sep;36(9):2061-6. ER - TY - JOUR T1 - The Patient-Reported Outcomes Measurement Information System (PROMIS): progress of an NIH Roadmap cooperative group during its first two years JF - Medical Care Y1 - 2007 A1 - Cella, D. A1 - Yount, S. A1 - Rothrock, N. A1 - Gershon, R. C. A1 - Cook, K. F. A1 - Reeve, B. A1 - Ader, D. A1 - Fries, J.F. A1 - Bruce, B. A1 - Rose, M. AB - The National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) Roadmap initiative (www.nihpromis.org) is a 5-year cooperative group program of research designed to develop, validate, and standardize item banks to measure patient-reported outcomes (PROs) relevant across common medical conditions. In this article, we will summarize the organization and scientific activity of the PROMIS network during its first 2 years. VL - 45 ER - TY - JOUR T1 - The promise of PROMIS: using item response theory to improve assessment of patient-reported outcomes JF - Clinical and Experimental Rheumatology Y1 - 2005 A1 - Fries, J.F. A1 - Bruce, B. A1 - Cella, D. KW - computerized adaptive testing AB - PROMIS (Patient-Reported-Outcomes Measurement Information System) is an NIH Roadmap network project intended to improve the reliability, validity, and precision of PROs and to provide definitive new instruments that will exceed the capabilities of classic instruments and enable improved outcome measurement for clinical research across all NIH institutes. Item response theory (IRT) measurement models now permit us to transition conventional health status assessment into an era of item banking and computerized adaptive testing (CAT). Item banking uses IRT measurement models and methods to develop item banks from large pools of items from many available questionnaires. IRT allows the reduction and improvement of items and assembles domains of items which are unidimensional and not excessively redundant. CAT provides a model-driven algorithm and software to iteratively select the most informative remaining item in a domain until a desired degree of precision is obtained. Through these approaches the number of patients required for a clinical trial may be reduced while holding statistical power constant. PROMIS tools, expected to improve precision and enable assessment at the individual patient level which should broaden the appeal of PROs, will begin to be available to the general medical community in 2008. VL - 23 ER -