Quality of Life Research

, Volume 19, Issue 7, pp 1035–1044 | Cite as

Measuring social health in the patient-reported outcomes measurement information system (PROMIS): item bank development and testing

  • Elizabeth A. Hahn
  • Robert F. DeVellis
  • Rita K. Bode
  • Sofia F. Garcia
  • Liana D. Castel
  • Susan V. Eisen
  • Hayden B. Bosworth
  • Allen W. Heinemann
  • Nan Rothrock
  • David Cella
  • on behalf of the PROMIS Cooperative Group



To develop a social health measurement framework, to test items in diverse populations and to develop item response theory (IRT) item banks.


A literature review guided framework development of Social Function and Social Relationships sub-domains. Items were revised based on patient feedback, and Social Function items were field-tested. Analyses included exploratory factor analysis (EFA), confirmatory factor analysis (CFA), two-parameter IRT modeling and evaluation of differential item functioning (DIF).


The analytic sample included 956 general population respondents who answered 56 Ability to Participate and 56 Satisfaction with Participation items. EFA and CFA identified three Ability to Participate sub-domains. However, because of positive and negative wording, and content redundancy, many items did not fit the IRT model, so item banks do not yet exist. EFA, CFA and IRT identified two preliminary Satisfaction item banks. One item exhibited trivial age DIF.


After extensive item preparation and review, EFA-, CFA- and IRT-guided item banks help provide increased measurement precision and flexibility. Two Satisfaction short forms are available for use in research and clinical practice. This initial validation study resulted in revised item pools that are currently undergoing testing in new clinical samples and populations.


Patient-reported outcomes Social health Social function Social relationships Item banks 



The Patient-Reported Outcomes Measurement Information System (PROMIS) is a National Institutes of Health (NIH) Roadmap initiative to develop a computerized system measuring patient-reported outcomes in respondents with a wide range of chronic diseases and demographic characteristics. PROMIS was funded by cooperative agreements to a Statistical Coordinating Center (Northwestern University, PI: David Cella, PhD, U01AR52177) and six Primary Research Sites (Duke University, PI: Kevin Weinfurt, PhD, U01AR52186; University of North Carolina, PI: Darren DeWalt, MD, MPH, U01AR52181; University of Pittsburgh, PI: Paul A. Pilkonis, PhD, U01AR52155; Stanford University, PI: James Fries, MD, U01AR52158; Stony Brook University, PI: Arthur Stone, PhD, U01AR52170; and University of Washington, PI: Dagmar Amtmann, PhD, U01AR52171). NIH Science Officers on this project have included Deborah Ader, PhD, Susan Czajkowski, PhD, Lawrence Fine, MD, DrPH, Laura Lee Johnson, PhD, Louis Quatrano, PhD, Bryce Reeve, PhD, William Riley, PhD, Susana Serrate-Sztein, PhD, and James Witter, MD, PhD. This manuscript was reviewed by the PROMIS Publications Subcommittee prior to external peer review. The authors thank Ron Hays, PhD, and Paul Pilkonis, PhD, for helpful suggestions on the final version of the manuscript, and Jacquelyn George for assistance with research coordination. See the web site at for additional information on the PROMIS cooperative group. Presented in part at the International Symposium on Measurement of Participation in Rehabilitation Research, Toronto, Ontario, Canada, October 14–15, 2008.


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Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Elizabeth A. Hahn
    • 1
  • Robert F. DeVellis
    • 2
  • Rita K. Bode
    • 3
  • Sofia F. Garcia
    • 1
  • Liana D. Castel
    • 4
  • Susan V. Eisen
    • 5
  • Hayden B. Bosworth
    • 6
  • Allen W. Heinemann
    • 3
  • Nan Rothrock
    • 1
  • David Cella
    • 1
  • on behalf of the PROMIS Cooperative Group
  1. 1.Department of Medical Social Sciences, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  2. 2.Department of Health Behavior and Health Education, School of Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.Department of Physical Medicine and Rehabilitation, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  4. 4.Institute for Medicine and Public Health and Vanderbilt Epidemiology CenterVanderbilt University Medical CenterNashvilleUSA
  5. 5.Department of Health Policy and Management, Boston University School of Public Health and Center for Health Quality, Outcomes & Economic ResearchENRM Veterans HospitalBedfordUSA
  6. 6.Center for Health Services Research, Durham VAMC; Departments of Medicine, Psychiatry, and NursingDuke University Medical CenterDurhamUSA

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