scholarly journals Using Item Response Theory to Identify Responders to Treatment: Examples with the Patient-Reported Outcomes Measurement Information System (PROMIS®) Physical Function Scale and Emotional Distress Composite

Psychometrika ◽  
2021 ◽  
Author(s):  
Ron D. Hays ◽  
Karen L. Spritzer ◽  
Steven P. Reise
Keyword(s):  
Item Response Theory ◽  
Physical Function ◽  
Item Response ◽  
Emotional Distress ◽  
Classical Test Theory ◽  
Test Theory ◽  
Measurement Information ◽  
Response Theory ◽  
Reliable Change ◽  
Patient Reported

AbstractThe reliable change index has been used to evaluate the significance of individual change in health-related quality of life. We estimate reliable change for two measures (physical function and emotional distress) in the Patient-Reported Outcomes Measurement Information System (PROMIS®) 29-item health-related quality of life measure (PROMIS-29 v2.1). Using two waves of data collected 3 months apart in a longitudinal observational study of chronic low back pain and chronic neck pain patients receiving chiropractic care, and simulations, we compare estimates of reliable change from classical test theory fixed standard errors with item response theory standard errors from the graded response model. We find that unless true change in the PROMIS physical function and emotional distress scales is substantial, classical test theory estimates of significant individual change are much more optimistic than estimates of change based on item response theory.

scholarly journals Item Response Theory, Computerized Adaptive Testing, and PROMIS: Assessment of Physical Function

2013 ◽  
Vol 41 (1) ◽  
pp. 153-158 ◽  
Author(s):  
James F. Fries ◽  
James Witter ◽  
Matthias Rose ◽  
David Cella ◽  
Dinesh Khanna ◽  
...  
Keyword(s):  
Item Response Theory ◽  
Physical Function ◽  
Item Response ◽  
Computerized Adaptive Testing ◽  
Short Form ◽  
Adaptive Testing ◽  
Self Report ◽  
Measurement Information ◽  
Response Theory ◽  
Patient Reported

Objective.Patient-reported outcome (PRO) questionnaires record health information directly from research participants because observers may not accurately represent the patient perspective. Patient-reported Outcomes Measurement Information System (PROMIS) is a US National Institutes of Health cooperative group charged with bringing PRO to a new level of precision and standardization across diseases by item development and use of item response theory (IRT).Methods.With IRT methods, improved items are calibrated on an underlying concept to form an item bank for a “domain” such as physical function (PF). The most informative items can be combined to construct efficient “instruments” such as 10-item or 20-item PF static forms. Each item is calibrated on the basis of the probability that a given person will respond at a given level, and the ability of the item to discriminate people from one another. Tailored forms may cover any desired level of the domain being measured. Computerized adaptive testing (CAT) selects the best items to sharpen the estimate of a person’s functional ability, based on prior responses to earlier questions. PROMIS item banks have been improved with experience from several thousand items, and are calibrated on over 21,000 respondents.Results.In areas tested to date, PROMIS PF instruments are superior or equal to Health Assessment Questionnaire and Medical Outcome Study Short Form-36 Survey legacy instruments in clarity, translatability, patient importance, reliability, and sensitivity to change.Conclusion.Precise measures, such as PROMIS, efficiently incorporate patient self-report of health into research, potentially reducing research cost by lowering sample size requirements. The advent of routine IRT applications has the potential to transform PRO measurement.

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