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APHA Scientific Session and Event Listing

Recorded presentation

William Riley, PhD, National Institute of Mental Health, 6001 Executive Blvd., MSC 9615, Bethesda, MD 20892-9615, 301-435-0301, wiriley@mail.nih.gov and Bryce Reeve, PhD, National Cancer Institute, 6130 Executive Blvd., MSC 7344, Bethesda, MD 20892.

Patient-reported outcomes are a critical component of most clinical research and quality improvement procedures. As part of the NIH Roadmap Initiative of Re-Engineering the Clinical Research Enterprise, the NIH funded six primary research sites and a statistical coordinating research center to develop ways to measure patient-reported symptoms such as pain and fatigue and aspects of health-related quality of life across a wide variety of chronic diseases and conditions. The goal of the PROMIS (Patient Reported Outcomes Measurement Information System) project, now in its third year, is to utilize Item Response Theory (IRT) and Computerized Adaptive Testing (CAT) to provide an efficient, automated, comprehensive, and publicly accessible system that can be used by clinical researchers and health care providers to assess patient reported outcomes. Using Delphic and data-based strategies, a domain hierarchy was developed with five primary domains selected for initial item-bank development: physical functioning, pain, fatigue, emotional distress, and social role participation. Item banks were generated for each domain and subdomain based on an exhaustive review of the assessment literature in each area. Qualitative item review using expert opinion, focus groups, and cognitive testing was used to improve item quality and refine the item bank. The resulting item bank is currently being evaluated in approximately 10,000 participants including both general population and medical samples. From these data, the item bank will be further refined and the psychometric properties of each item will be determined. When completed, the PROMIS system will allow medical researchers and health professionals to validly and efficiently assess patient reported outcomes across a number of measurement domains. Use of this tool to routinely assess patient outcomes in a range of medical settings has substantial implications for health policy and quality improvement initiatives.

Learning Objectives:

• Describe the goals of the PROMIS initiative.
• Describe how IRT and CAT can be used to produce valid measurement of constructs with only a few items.
• List the measurement domains of the PROMIS system.
• Identify how this tool can be used for quality improvement and its potential impacts on health polcy.

Keywords: Assessments, Quality Improvement

Related Web page: nihroadmap.nih.gov/clinicalresearch/promis.asp

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation