Quality of Life Research

, Volume 23, Issue 1, pp 239–244

Testing measurement invariance of the patient-reported outcomes measurement information system pain behaviors score between the US general population sample and a sample of individuals with chronic pain

  • Hyewon Chung
  • Jiseon Kim
  • Karon F. Cook
  • Robert L. Askew
  • Dennis A. Revicki
  • Dagmar Amtmann

DOI: 10.1007/s11136-013-0463-0

Cite this article as:
Chung, H., Kim, J., Cook, K.F. et al. Qual Life Res (2014) 23: 239. doi:10.1007/s11136-013-0463-0



In order to test the difference between group means, the construct measured must have the same meaning for all groups under investigation. This study examined the measurement invariance of responses to the patient-reported outcomes measurement information system (PROMIS) pain behavior (PB) item bank in two samples: the PROMIS calibration sample (Wave 1, N = 426) and a sample recruited from the American Chronic Pain Association (ACPA, N = 750). The ACPA data were collected to increase the number of participants with higher levels of pain.


Multi-group confirmatory factor analysis (MG-CFA) and two item response theory (IRT)-based differential item functioning (DIF) approaches were employed to evaluate the existence of measurement invariance.


MG-CFA results supported metric invariance of the PROMIS–PB, indicating unstandardized factor loadings with equal across samples. DIF analyses revealed that impact of 6 DIF items was negligible.


Based on the results of both MG-CFA and IRT-based DIF approaches, we recommend retaining the original parameter estimates obtained from the combined samples based on the results of MG-CFA.


Multi-group confirmatory factor analysisDifferential item functioningItem response theoryPatient outcome measuresPain measurementPsychometrics



American Chronic Pain Association


Confirmatory factor analysis


Differential item functioning


Item response theory


Multi-group confirmatory factor analysis


Pain behavior


Patient-reported outcomes measurement information system

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Hyewon Chung
    • 1
  • Jiseon Kim
    • 2
  • Karon F. Cook
    • 3
  • Robert L. Askew
    • 4
  • Dennis A. Revicki
    • 5
  • Dagmar Amtmann
    • 6
  1. 1.Department of EducationChungnam National UniversityDaejeonKorea
  2. 2.Department of Rehabilitation MedicineUniversity of WashingtonSeattleUSA
  3. 3.Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoUSA
  4. 4.Department of Rehabilitation MedicineUniversity of WashingtonSeattleUSA
  5. 5.Outcomes ResearchUnited BioSource CorporationBethesdaUSA
  6. 6.Department of Rehabilitation MedicineUniversity of WashingtonSeattleUSA