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Correlation of PROMIS scales and clinical measures among chronic obstructive pulmonary disease patients with and without exacerbations

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Abstract

Purpose

The Patient-Reported Outcomes Measurement Information System (PROMIS®) initiative was developed to advance the methodology of PROs applicable to chronic diseases. Chronic obstructive pulmonary disease (COPD) is a progressive chronic disease associated with poor health. This study was designed to examine the correlation of PROMIS health-related quality of life (HRQOL) scales and clinical measures among COPD patients.

Methods

A cross-sectional analysis was conducted comparing patients who were stable (n = 100) with those currently experiencing a COPD exacerbation (n = 85). All PROMIS measures for adults available at the time of the study (2008), disease-targeted and other HRQOL instruments, health literacy, percent predicted FEV1, and a 6-min walk distance were assessed when patients were considered clinically stable.

Results

Stable COPD patients reported significantly (p ≤ 0.05) better health-related quality of life on PROMIS domains than patients experiencing an exacerbation. PROMIS domain scores were significantly (p ≤ 0.01) correlated with each of legacy measures. Six-min walk scores were most highly correlated with the PROMIS physical function domain scores (r = 0.53) followed by the fatigue (r = −0.26), social (r = 0.24) and to a lesser extent depression (r = −0.23), and anxiety (r = −0.22) domain scores. Percent predicted FEV1 score was significantly associated with PROMIS physical function scores (r = 0.27).

Conclusion

This study provides support for the validity of the PROMIS measures in COPD patients.

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Abbreviations

ADL:

Activities of daily living

BMI:

Body mass index

CAT:

Computerized adaptive testing

COPD:

Chronic obstructive pulmonary disease

DSA:

Discretionary social activities

ER:

Emergency room

EXACT-PRO:

EXAcerbations of Chronic pulmonary disease Tool—Patient Reported Outcomes

FACIT:

Functional assessment of chronic illness therapy

FEV1:

Forced expiratory volume in 1 s

GOLD:

Global initiative for chronic obstructive lung disease

HRQOL:

Health-related quality of life

IRB:

Institutional Review Board

IRT:

Item response theory

NIH:

National Institutes of Health

MRC:

Medical Research Council Dyspnea Scale

PRO:

Patient Reported Outcomes

PROMIS:

Patient Reported Outcomes Measurement Information System

PSQI:

Pittsburgh Sleep Quality Index

SGRQ:

St. George’s Respiratory Questionnaire

SR:

Social roles

s-TOFLHA:

Short test of functional health literacy in adults

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Acknowledgments

This work was supported by the National Institutes of Health [Grants U01AR052181 and U01AR052177]. The patient-reported outcomes measurement information system (PROMIS) is an NIH Roadmap initiative to develop a computerized system measuring PROs in respondents with a wide range of chronic diseases and demographic characteristics. PROMIS II was funded by cooperative agreements with a Statistical Center (Northwestern University, PI: David Cella, PhD, 1U54AR057951), a Technology Center (Northwestern University, PI: Richard C. Gershon, PhD, 1U54AR057943), a Network Center (American Institutes for Research, PI: Susan (San) D. Keller, PhD, 1U54AR057926), and thirteen Primary Research Sites which may include more than one institution (State University of New York, Stony Brook, PIs: Joan E. Broderick, PhD and Arthur A. Stone, PhD, 1U01AR057948; University of Washington, Seattle, PIs: Heidi M. Crane, MD, MPH, Paul K. Crane, MD, MPH, and Donald L. Patrick, PhD, 1U01AR057954; University of Washington, Seattle, PIs: Dagmar Amtmann, PhD and Karon Cook, PhD, 1U01AR052171; University of North Carolina, Chapel Hill, PI: Darren A. DeWalt, MD, MPH, 2U01AR052181; Children’s Hospital of Philadelphia, PI: Christopher B. Forrest, MD, PhD, 1U01AR057956; Stanford University, PI: James F. Fries, MD, 2U01AR052158; Boston University, PIs: Stephen M. Haley, PhD and David Scott Tulsky, PhD (University of Michigan, Ann Arbor), 1U01AR057929; University of California, Los Angeles, PIs: Dinesh Khanna, MD and Brennan Spiegel, MD, MSHS, 1U01AR057936; University of Pittsburgh, PI: Paul A. Pilkonis, PhD, 2U01AR052155; Georgetown University, PIs: Carol. M. Moinpour, PhD (Fred Hutchinson Cancer Research Center, Seattle) and Arnold L. Potosky, PhD, U01AR057971; Children’s Hospital Medical Center, Cincinnati, PI: Esi M. Morgan DeWitt, MD, MSCE, 1U01AR057940; University of Maryland, Baltimore, PI: Lisa M. Shulman, MD, 1U01AR057967; and Duke University, PI: Kevin P. Weinfurt, PhD, 2U01AR052186). NIH Science Officers on this project have included Deborah Ader, PhD, Vanessa Ameen, MD, Susan Czajkowski, PhD, Basil Eldadah, MD, PhD, Lawrence Fine, MD, DrPH, Lawrence Fox, MD, PhD, Lynne Haverkos, MD, MPH, Thomas Hilton, PhD, Laura Lee Johnson, PhD, Michael Kozak, PhD, Peter Lyster, PhD, Donald Mattison, MD, Claudia Moy, PhD, Louis Quatrano, PhD, Bryce Reeve, PhD, William Riley, PhD, Ashley Wilder Smith, PhD, MPH, Susana Serrate-Sztein,MD, Ellen Werner, PhD, and James Witter, MD, PhD. This manuscript was reviewed by PROMIS reviewers before submission for external peer review. See the Web site at www.nihpromis.org for additional information on the PROMIS initiative.

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Authors and Affiliations

  1. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina–Chapel Hill, Chapel Hill, NC, 27599, USA

    Debra E. Irwin

  2. Division of Pulmonary Medicine, University of Pittsburgh and the Pittsburgh Veterans Affairs Medical Center, Pittsburgh, PA, USA

    Charles A. Atwood Jr.

  3. Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA

    Ron D. Hays & Karen Spritzer

  4. Department of Dentistry, University of California, Los Angeles, Los Angeles, CA, USA

    Honghu Liu

  5. Division of Pulmonary Medicine, University of North Carolina School of Medicine–Chapel Hill, Chapel Hill, NC, USA

    James F. Donohue

  6. United Biosource Corporation, Bethesda, MD, USA

    Nancy Kline Leidy

  7. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Susan E. Yount

  8. Division of General Medicine and Clinical Epidemiology and the Cecil G. Sheps Center for Health Services Research, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    Darren A. DeWalt

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  1. Debra E. Irwin
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  2. Charles A. Atwood Jr.
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  9. Darren A. DeWalt
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Correspondence to Debra E. Irwin.

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Irwin, D.E., Atwood, C.A., Hays, R.D. et al. Correlation of PROMIS scales and clinical measures among chronic obstructive pulmonary disease patients with and without exacerbations. Qual Life Res 24, 999–1009 (2015). https://doi.org/10.1007/s11136-014-0818-1

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