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Evaluation of options for presenting health-states from PROMIS® item banks for valuation exercises.

ABSTRACT: PURPOSE:Health status descriptive systems based on item response theory (IRT), such as the Patient-Reported Outcomes Measurement Information System (PROMIS®), have item banks to measure domains of health. We developed a method to present such banks for health-state valuation. METHODS:We evaluated four different presentation approaches: a single item (1S), 2 items presented separately (2S), 2 items presented together (2T), or 5 items presented together (5T). We evaluated these four approaches in three PROMIS item banks (depression, physical function, and sleep disturbance). Adult community members valued health-state descriptions using the visual analog scale and standard gamble methods. We compared the approaches by the range of item bank theta scores captured, participants' assessments of difficulty (1?=?very easy to 7?=?very hard), and exit interviews. RESULTS:Participants (n?=?118) ranged in age from 18 to 71; 63% were female and 54% were white. The 1S approach captured the smallest range of theta scores. A monotonic relationship between theta score and mean standard gamble estimate was found with all approaches except 2S. Across all 3 item banks, mean difficulty assessments were 2.35 (1S), 2.69 (2T), 2.78 (5T), and 2.80 (2S). In exit interviews, participants generally found all four approaches similarly meaningful and realistic. CONCLUSIONS:Creating health descriptions by presenting 2 items maximized the range of theta while minimizing difficulty and maintaining a monotonic relationship with utility estimates. We recommend this approach for valuation of IRT-based descriptive systems such as PROMIS.

SUBMITTER: Hanmer J

PROVIDER: S-EPMC6611549 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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Evaluation of options for presenting health-states from PROMIS® item banks for valuation exercises.

Hanmer Janel J Cella David D Feeny David D Fischhoff Baruch B Hays Ron D RD Hess Rachel R Pilkonis Paul A PA Revicki Dennis D Roberts Mark M Tsevat Joel J Yu Lan L

Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 20180412 7

<h4>Purpose</h4>Health status descriptive systems based on item response theory (IRT), such as the Patient-Reported Outcomes Measurement Information System (PROMIS®), have item banks to measure domains of health. We developed a method to present such banks for health-state valuation.<h4>Methods</h4>We evaluated four different presentation approaches: a single item (1S), 2 items presented separately (2S), 2 items presented together (2T), or 5 items presented together (5T). We evaluated these four ...[more]

PMID: 29651650

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Project description:The Patient-Reported Outcomes Measurement Information System (PROMIS) Smoking Initiative has developed item banks for assessing six smoking behaviors and biopsychosocial correlates of smoking among adult cigarette smokers. The goal of this study is to evaluate the performance of the Spanish version of the PROMIS smoking item banks as compared to the original banks developed in English.The six PROMIS banks for daily smokers were translated into Spanish and administered to a sample of Spanish-speaking adult daily smokers in the United States (N = 302). We first evaluated the unidimensionality of each bank using confirmatory factor analysis. We then conducted a two-group item response theory calibration, including an item response theory-based Differential Item Functioning (DIF) analysis by language of administration (Spanish vs. English). Finally, we generated full bank and short form scores for the translated banks and evaluated their psychometric performance.Unidimensionality of the Spanish smoking item banks was supported by confirmatory factor analysis results. Out of a total of 109 items that were evaluated for language DIF, seven items in three of the six banks were identified as having levels of DIF that exceeded an established criterion. The psychometric performance of the Spanish daily smoker banks is largely comparable to that of the English versions.The Spanish PROMIS smoking item banks are highly similar, but not entirely equivalent, to the original English versions. The parameters from these two-group calibrations can be used to generate comparable bank scores across the two language versions.In this study, we developed a Spanish version of the PROMIS smoking toolkit, which was originally designed and developed for English speakers. With the growing Spanish-speaking population, it is important to make the toolkit more accessible by translating the items and calibrating the Spanish version to be comparable with English-language scores. This study provided the translated item banks and short forms, comparable unbiased scores for Spanish speakers and evaluations of the psychometric properties of the new Spanish toolkit.

Project description:IntroductionThe outcomes anxiety and depression are measured frequently by healthcare providers to assess the impact of a disease, but with numerous instruments. PROMIS item banks provide an opportunity for standardized measurement. Cross-cultural validity of measures and the availability of reference values are prerequisites for standardized measurement.MethodsPROMIS Anxiety and Depression item banks were completed by 1002 representative Dutch persons. To evaluate cross-cultural validity, data from US participants in PROMIS wave 1 were used and differential item functioning (DIF) was investigated, using an iterative hybrid of logistic regression and item response theory. McFadden's pseudo R2-change of 2% was the critical threshold. The impact of any DIF on full item banks and short forms was investigated. To obtain Dutch reference values, T-scores for anxiety and depression were calculated for the complete Dutch sample, and age-group and gender subpopulations. Thresholds corresponding to normal limits, mild, moderate and severe symptoms were computed.ResultsIn both item banks, two items had DIF but with minimal impact on population level T-scores for full item banks and short forms. The Dutch general population had a T-score of 49.9 for anxiety and 49.6 for depression, similar to the T-scores of 50.0 of the US general population. T-scores for age-group and gender subpopulations were also similar to T-scores of the US general population. Thresholds for mild, moderate and severe anxiety and depression were set to 55, 60 and 70, identical to US thresholds.ConclusionsThe limited number of items with DIF and its minimal impact, enables the use of standard (US) item parameters and comparisons of scores between Dutch and US populations. The Dutch reference values provide an important tool for healthcare professionals and researchers to evaluate and interpret symptoms of anxiety and depression, stimulating the uptake of PROMIS measures, and contributing to standardized outcome measurement.

Project description:BackgroundPatients with rheumatoid arthritis (RA) commonly experience pain despite the availability of disease-modifying treatments. Sleep disturbances are frequently reported in RA, with pain often a contributing factor. The Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference and Sleep Disturbance item banks were initially developed to provide insights into the patient experience of pain and sleep, respectively, though they were not specifically intended for use in RA populations. This study evaluated the content validity of the PROMIS Pain Interference and Sleep Disturbance item banks in RA and identified relevant content for short forms for patients with RA that achieved high measurement precision across a broad range of health.MethodsA qualitative approach consisting of hybrid concept elicitation and cognitive debriefing interviews was used to evaluate the content validity of the item banks in RA. Interviews were semi-structured and open-ended, allowing a range of concepts and responses to be captured. Findings from the qualitative interviews were used to select the most relevant items for the short forms, and psychometric evaluation, using existing item-response theory (IRT) item parameters, was used to evaluate the marginal reliability and measurement precision of the short forms across the range of the latent variables (i.e. pain interference and sleep disturbance).ResultsThirty-two participants were interviewed. Participants reported that RA-related pain and sleep disturbances have substantial impacts on their daily lives, particularly with physical functioning. The PROMIS Pain Interference and Sleep Disturbance item banks were easy to understand and mostly relevant to their RA experiences, and the 7-day recall period was deemed appropriate. Qualitative and IRT-based approaches identified short forms for Pain Interference (11 items) and Sleep Disturbance (7 items) that had high relevance and measurement precision, with good coverage of the concepts identified by participants during concept elicitation.ConclusionPain and sleep disturbances affect many aspects of daily life in patients with RA and should be considered when novel treatments are developed. This study supports the use of the PROMIS Pain Interference and Sleep Disturbance item banks in RA, and the short forms developed herein have the potential to be used in clinical studies of RA.

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Evaluation of options for presenting health-states from PROMIS® item banks for valuation exercises.

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Evaluation of options for presenting health-states from PROMIS® item banks for valuation exercises.

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