Quality of Life Research

, Volume 19, Issue 9, pp 1311–1321 | Cite as

Patient-reported outcomes measurement information system (PROMIS) domain names and definitions revisions: further evaluation of content validity in IRT-derived item banks

  • William T. RileyEmail author
  • Nan Rothrock
  • Bonnie Bruce
  • Christopher Christodolou
  • Karon Cook
  • Elizabeth A. Hahn
  • David Cella



Content validity of patient-reported outcomes (PROs) is evaluated primarily during item development, but subsequent psychometric analyses, particularly for item response theory (IRT)-derived scales, often result in considerable item pruning and potential loss of content. After selecting items for the PROMIS banks based on psychometric and content considerations, we invited external content expert reviews of the degree to which the initial domain names and definitions represented the calibrated item bank content.


A minimum of four content experts reviewed each item bank and recommended a domain name and definition based on item content. Domain names and definitions then were revealed to the experts who rated how well these names and definitions fit the bank content and provided recommendations for definition revisions.


These reviews indicated that the PROMIS domain names and definitions remained generally representative of bank content following item pruning, but modifications to two domain names and minor to moderate revisions of all domain definitions were needed to optimize fit with the item bank content.


This reevaluation of domain names and definitions following psychometric item pruning, although not previously documented in the literature, appears to be an important procedure for refining conceptual frameworks and further supporting content validity.


Content validity Conceptual framework Domain definition Item response theory 



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, MD, and James Witter, MD, PhD. This manuscript was reviewed by the PROMIS Publications Subcommittee prior to external peer review. See the Web site at for additional information on the PROMIS cooperative group.


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Copyright information

© US Government 2010

Authors and Affiliations

  • William T. Riley
    • 1
    Email author
  • Nan Rothrock
    • 2
  • Bonnie Bruce
    • 3
  • Christopher Christodolou
    • 4
  • Karon Cook
    • 5
  • Elizabeth A. Hahn
    • 2
  • David Cella
    • 2
  1. 1.National Heart Lung and Blood InstituteBethesdaUSA
  2. 2.Northwestern UniversityChicagoUSA
  3. 3.Stanford UniversityStanfordUSA
  4. 4.Stony Brook UniversityStony BrookUSA
  5. 5.University of WashingtonSeattleUSA

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