Cited by 102Psychometric Methodologies and TestingMusculoskeletal pain and rehabilitationHealth Systems, Economic Evaluations, Quality of Life

Patient-Reported Outcomes Measurement Information System (PROMIS) instruments among individuals with symptomatic knee osteoarthritis: a cross-sectional study of floor/ceiling effects and construct validity

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Driban, Jeffrey B., Morgan, Nani, Price, Lori Lyn, Cook, Karon F., Wang, Chenchen·2015·BMC Musculoskeletal Disorders

Abstract

BACKGROUND: The psychometric properties of Patient Reported Outcomes Measurement Information System (PROMIS) instruments have been explored in a number of general and clinical samples. No study, however, has evaluated the psychometric function of these measures in individuals with symptomatic knee osteoarthritis (KOA). The aim of this project was to evaluate the construct (structural) validity and floor/ceiling effects of four PROMIS measures in this population. METHODS: We conducted a secondary analysis of baseline data from a randomized trial comparing Tai Chi and physical therapy. Participants completed four PROMIS static short-form instruments (i.e., Anxiety, Depression, Physical Function, and Pain Interference) as well as six well-validated (legacy) measures that assess pain, function, and psychological health. We calculated descriptive statistics and percentages of participants scoring the minimum (floor) and maximum (ceiling) possible scores for PROMIS and legacy measures. We also estimated the association between PROMIS scores and scores on legacy measures using Spearman's rank correlations coefficients. RESULTS: Data from 204 participants were analyzed. Mean age of the sample was 60 years; 70% were female. The PROMIS Anxiety and Depression had floor effects with 17 and 24% of participants scoring the minimum, respectively. PROMIS Anxiety and Depression scores had strongest associations with general mental health, including stress (Perceived Stress Scale, r ≥ 0.65) and depression (Beck Depression Index-II, r = 0.70). PROMIS Pain Interference scores correlated most strongly with measures of whole body pain (Short-Form 36 Bodily Pain, r = -0.73) and physical health (Short-Form 36 Physical-Component Summary, r = -0.73); their correlations were lower with other legacy measures, including with the WOMAC knee-specific pain (r = 0.47). PROMIS Physical Function scores had stronger associations with scores on the Short-Form 36 Physical Function (r = 0.79) than with scores on other legacy measures. CONCLUSION: The four PROMIS static-short forms performed well among individuals with symptomatic knee osteoarthritis as evidenced in correlations with legacy measures. PROMIS Anxiety and Depression target general mental health (e.g., stress, depression), and PROMIS Pain Interference and Physical Function static-short forms target whole-body outcomes among participants with symptomatic knee osteoarthritis. Floor effects in the PROMIS Anxiety and Depression scores should be considered if needing to distinguish among patients with very low levels of these outcomes. TRIAL REGISTRATION: Clinicaltrials.gov NCT01258985. Registered 10 December 2010.

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  • 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)”

    From Patient-Reported Outcomes Measurement Information System (PROMIS) Instruments: Reliability and Validity in Veterans Following Orthopedic Surgery. (2020) · cites this paper as Driban et al., 2015

    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)

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Cited by

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Authors
Driban, J. B., Morgan, N., Price, L. L., Cook, K. F., & Wang, C.
Affiliations
  • Tufts Medical Center (US)
  • University of Hawaiʻi at Mānoa (US)
  • Tufts University (US)
  • Northwestern University (US)
Corresponding author
Driban, Jeffrey B.
Venue
BMC Musculoskeletal Disorders
Published
2015-09-14
Volume
16
Issue
1
Pages
253-253
ISSN
1471-2474 (ISSN-L)
OpenAlex
W1839510815
Cited by
102
References
4
Citations by year
2025: 9 · 2024: 6 · 2023: 9 · 2022: 5 · 2021: 21 · 2020: 15 · 2019: 11 · 2018: 15 · 2017: 5 · 2016: 5
FWCI
10.41
Type
journal article
Language
en
Open access
Locations
  • BMC Musculoskeletal Disorders (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (UL1TR001064)
  • National Center for Complementary and Alternative Medicine
  • National Center for Advancing Translational Sciences
  • National Center for Complementary and Integrative Health (K24AT007323, R01AT005521)
Topics
  • Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Keywords
knee osteoarthritis, PROMIS, patient-reported outcomes, floor effect, ceiling effect, construct validity, anxiety, depression, pain interference, physical function, psychometric properties, Tai Chi, physiotherapy, perceived stress, Short Form-36, general mental health, physical health, older adults
MeSH terms
Aged, Anxiety, Cross-Sectional Studies, Depression, Female, Humans, Male, Middle Aged, Pain Measurement, Reproducibility of Results, Osteoarthritis, Knee, Tai Ji, Physical Therapy Modalities, Self Report, Patient Outcome Assessment

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