Cited by 17Psychometric Methodologies and TestingCancer survivorship and careHealth Education and Validation

Patient-Reported Outcomes Measurement Information System (PROMIS) Instruments: Reliability and Validity in Veterans Following Orthopedic Surgery.

Open access
Hadlandsmyth, Katherine, Dindo, Lilian N., St. Marie, Barbara J., Wajid, Roohina, Embree, Jennie L., Noiseux, Nicolas O., Tripp-Reimer, Toni, Zimmerman, M. Bridget +1 more·2020·Evaluation & the Health Professions

Abstract

The patient-reported outcomes measurement information system (PROMIS) offers standardized assessment measures of clinically relevant patient-reported outcomes. This study evaluated the reliability and validity of select PROMIS measures with U.S. military veterans following orthopedic surgery. Data for the current study were collected as part of a pilot randomized control trial assessing the efficacy of a 1-day Acceptance and Commitment Therapy workshop on persistent postsurgical pain in at-risk veterans undergoing orthopedic surgery. Sixty-seven participants completed surveys 3 months after surgery. Participants completed the following PROMIS instruments: PROMIS Anxiety Short Form 8a, PROMIS Depression Short Form 8b, and PROMIS Pain Interference Short Form 8a. PROMIS measures were compared to the Generalized Anxiety Disorder 7-Item Scale, the Patient Health Questionnaire 9-Item Scale, and the Brief Pain Inventory Pain Interference subscale, respectively. All three PROMIS measures demonstrated excellent internal consistency (Cronbach's αs ranged from .93 to .96) and each loaded onto a single factor. The PROMIS measures were moderately correlated with their respective comparison measures (r = .69 to .76). The PROMIS anxiety and PROMIS depression measures were highly correlated to one another (r = .91). Findings highlight the potential utility of these PROMIS measures in veterans following orthopedic surgery and the overlap between the PROMIS depression and anxiety measures in this sample.

Integrity signals

Registry

Crossref · 10.1177/0163278719856406

Cites

25 of 25 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

6 of 19 cited sources checked · 3 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    The PROMIS depression measure has demonstrated validity and reliability in patients with knee osteoarthritis, multiple sclerosis, and lumbar degenerative disease.

    “Validity and reliability of this measure have been demonstrated in patients with knee osteoarthritis (Driban et al., 2015), multiple sclerosis (Marrie et al., 2018), and lumbar degenerative disease (Purvis et al., 2018)”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites Driban et al., 2015 source

      The Results > PROMIS depression section (page not provided) reports strong correlations with depression and stress measures in participants with symptomatic knee osteoarthritis, supporting construct validity. The paper does not report a reliability assessment for this measure, so it does not support the reliability part of the claim. The multiple-sclerosis and lumbar-degenerative-disease portions are attributed to other citations, not Driban et al. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
    • cites Marrie et al., 2018 source
    • cites Purvis et al., 2018 source
  • Premisecitation

    Pain, depression, and anxiety affect orthopedic surgery outcomes.

    “Mounting evidence indicates that pain, depression, and anxiety impact orthopedic surgery outcomes (Lewis, Rice, McNair, & Kluger, 2015; Noiseux et al., 2014).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Lewis, Rice, McNair, & Kluger, 2015 source
    • cites Noiseux et al., 2014 source
  • Findingown data

    The PROMIS anxiety measure had a Cronbach's alpha of 0.93.

    “PROMIS anxiety Cronbach’s α was 0.93.”
    Quote in the paperSubstantial claim
  • Findingown data

    The PROMIS depression measure had a Cronbach's alpha of 0.95.

    “PROMIS depression Cronbach’s α was 0.95”
    Quote in the paperSubstantial claim
  • Findingown data

    For the PROMIS pain interference measure, a one-factor solution explained 85% of the total variance (eigenvalue = 6.83).

    “For the PROMIS pain interference measure, a one-factor solution was also indicated (eigenvalue = 6.83), accounting for 85% of total variance”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 15
  • May combine two claims. 9
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The PHQ-9 is a reliable (Cronbach's alpha = 0.89) and valid measure of depression severity in medical patients.

    “A validity study including 6,000 medical patients demonstrated that this is a reliable (Cronbach’s α of 0.89) and valid measure of depression severity”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Kroenke et al., 2001 source

      The Results report excellent PHQ-9 reliability, but Cronbach’s α was 0.89 in the primary-care sample and 0.86 in the obstetrics-gynecology sample—not 0.89 across all 6,000 patients. The Discussion supports its validity as a depression-severity measure across the two samples. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
  • Classified as probably not a substantial claim.

    Premisecitation

    Preoperative pain, depression, and anxiety indicate risk for persistent post-surgical pain.

    “Preoperative risk criteria were defined based on findings that preoperative pain, depression, and anxiety infer risk for persistent post-surgical pain (Lewis et al., 2015; Noiseux et al., 2014).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Lewis et al., 2015 source
    • cites Noiseux et al., 2014 source
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In surgical cardiac patients, the BPI pain interference subscale demonstrated good internal consistency before surgery (Cronbach's alpha = 0.91) and six months after surgery (Cronbach's alpha = 0.94), and it showed responsiveness between pre- and post-surgical time points.

    “In surgical cardiac patients, this measure demonstrated good internal consistency both prior to surgery (Cronbach’s α = 0.91) and six months following surgery (Cronbach’s α = 0.94) and demonstrated responsiveness between pre- and post-surgical time points (Gjeilo, Stenseth, Wahba, Lydersen, & Klepstad, 2007).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Gjeilo, Stenseth, Wahba, Lydersen, & Klepstad, 2007 source
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Veterans have a heightened risk for distress-based conditions, including depressive and anxious disorders.

    “Veterans have a heightened risk for distress-based conditions, including depressive and anxious disorders, (Pickett et al., 2015)”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Pickett et al., 2015 source

      The Incidence, Prevalence, and Base Rates section reports depressive and anxiety disorders among OEF/OIF/OND veterans receiving VA care and associates prolonged deployment with a greater likelihood of a mental health condition. It does not establish a heightened risk of depressive and anxiety disorders for veterans generally or specify a comparison group for those disorders. (LLM, conf=0.83)

      Experimental — accuracy not yet measured
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The mean age of the sample was 63.7 years (SD 8.9).

    “the mean age was 63.7 years (SD: 8.9)”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    The sample reported relatively low levels of depression, anxiety, and pain interference.

    “The sample reported relatively low levels of depression, anxiety, and pain interference.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    In the sample of 67 Veterans assessed three months after orthopedic surgery, all three PROMIS measures (anxiety, depression, and pain interference) showed excellent internal consistency, with Cronbach's alpha values between .93 and .96.

    “All three PROMIS measures demonstrated excellent internal consistency (Cronbach’s alphas ranged from .93 - .96)”
    • Also stated in: § Results · plain
      “All PROMIS measures demonstrated good internal consistency.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The sample was 93% male.

    “The sample was 93% male”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    The study included 67 participants who completed self-report questionnaires three months after orthopedic surgery.

    “This study included 67 participants who had completed self-report questionnaires three months following orthopedic surgery”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Polychoric correlations were used to improve the robustness and accuracy of the factor analysis results.

    “polychoric correlations were used to maximize the robustness and accuracy of the factor analysis findings.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study was approved by the local institutional review board.

    “This study was approved by the local institutional review board.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Participants completed the study measures three months after surgery with a blinded assessor.

    “Participants completed the measures for this study three months after surgery with a blinded assessor.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Individuals with missing data on a measure were excluded from analyses involving that measure.

    “Individuals with missing data on a measure were excluded from analyses with that measure.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The BPI pain interference subscale has demonstrated good reliability and validity.

    “This widely used measure has demonstrated good reliability and validity (Cleeland, 1991).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cleeland, 1991

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The GAD-7 has good reliability (Cronbach's alpha = .92; test-retest intraclass correlation = 0.83) and both criterion and construct validity in a large multisite primary care sample.

    “A large, multisite study including 2,740 adult patients in primary care settings demonstrated that this measure has good reliability (Cronbach α = .92 and test-re-test intraclass correlation = 0.83) and both criterion and construct validity”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Spitzer et al., 2006 source
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    PROMIS measures have been used in multiple studies of surgical care, including orthopedic surgeries.

    “PROMIS measures have been used in multiple studies about surgical care including orthopedic surgeries (Jones & Stukenborg, 2016).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Jones & Stukenborg, 2016

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    The PROMIS pain interference short-form has demonstrated concurrent validity and comparative responsiveness in patients undergoing cervical and lumbar spine surgeries.

    “The PROMIS pain interference short-form has demonstrated concurrent validity and comparative responsiveness in patients undergoing cervical and lumbar spine surgeries (Sharma, Ugiliweneza, Beswick, & Boakye, 2018)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Sharma, Ugiliweneza, Beswick, & Boakye, 2018 source
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    PROMIS measures were designed to standardize measurement of patient outcomes across a range of chronic conditions.

    “These measures were designed to standardize measurement of patient outcomes across a range of chronic conditions (NIH, 2018).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites NIH, 2018

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Chronic pain is prevalent among Veterans.

    “chronic pain is prevalent in Veterans (Haskell, Heapy, Reid, Papas, & Kerns, 2006)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Haskell, Heapy, Reid, Papas, & Kerns, 2006 source
19 of 19
  • The paper relies on this without support.

    PROMIS short-form measures have not been validated in orthopedic patients who have undergone surgeries that carry a risk for persistent postsurgical pain.

    “However, PROMIS short-form measures have not been validated in orthopedic patients having undergone surgeries that pose a risk for persistent postsurgical pain.”
  • The paper relies on this without support.

    Brief, comparable, standardized measures of pain, anxiety, and depression are needed in medical settings to maximize comparability of findings across studies and patient populations.

    “Brief, comparable, standardized measures of pain, anxiety, and depression are needed in medical settings, to maximize comparability of findings across studies and patient populations.”
2 of 2

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. 10.1016/j.jpain.2018.04.016 · DOI · Paper page

Cited by

Sorted by citations

Authors
Hadlandsmyth, K., Dindo, L. N., St. Marie, B. J., Wajid, R., Embree, J. L., Noiseux, N. O., Tripp-Reimer, T., Zimmerman, M. B., & Rakel, B. A.
Affiliations
  • University of Iowa (US)
  • Baylor College of Medicine (US)
  • College of Nursing, University of Iowa, Iowa City, IA, USA
Corresponding author
Hadlandsmyth, Katherine
Venue
Evaluation & the Health Professions
Published
2019-06-13
Volume
43
Issue
4
Pages
207-212
ISSN
  • 0163-2787 (ISSN-L)
  • 1552-3918
OpenAlex
W2952357041
Cited by
17
References
24
Citations by year
2026: 1 · 2025: 2 · 2024: 3 · 2023: 2 · 2022: 3 · 2021: 2 · 2020: 3 · 2019: 1
FWCI
1.61
Type
journal article
Language
en
Open access
Locations
  • Evaluation & the Health Professions (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health, NINDS (T32 NS045549)
Topics
  • Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Social Sciences › Education › Health Education and Validation
Keywords
PROMIS, patient-reported outcomes, veterans, orthopedic surgery, anxiety, depression, pain interference, reliability statistics, validity, internal consistency, chronic postoperative pain, acceptance and commitment therapy, GAD-7, PHQ-9, Brief Pain Inventory
MeSH terms
Patient Reported Outcome Measures, Humans, Information Systems, Surveys and Questionnaires, Veterans, Reproducibility of Results, Orthopedic Procedures, Acceptance and Commitment Therapy

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