Quality of Life Research

, Volume 21, Issue 4, pp 697–706 | Cite as

PROMIS Pediatric Anger Scale: an item response theory analysis

  • Debra E. Irwin
  • Brian D. Stucky
  • Michelle M. Langer
  • David Thissen
  • Esi Morgan DeWitt
  • Jin-Shei Lai
  • Karin B. Yeatts
  • James W. Varni
  • Darren A. DeWalt



The Patient-Reported Outcomes Measurement Information System (PROMIS) aims to develop patient-reported outcome (PROs) instruments for use in clinical research. The PROMIS pediatrics (ages 8–17) project focuses on the development of PROs across several health domains (physical function, pain, fatigue, emotional distress, social role relationships, and asthma symptoms). The objective of the present study was to report on the psychometric properties of the PROMIS Pediatric Anger Scale.


Participants (n = 759) were recruited from public school settings, hospital-based outpatient, and subspecialty pediatrics clinics. The anger items (k = 10) were administered on one test form. A hierarchical confirmatory factor analytic model (CFA) was conducted to evaluate scale dimensionality and local dependence. Item response theory (IRT) analyses were then used to finalize the item scale and short form.


CFA confirmed that the anger items are representative of a unidimensional scale, and items with local dependence were removed, resulting in a six-item short form. The IRT-scaled scores from summed scores and each score’s conditional standard error were calculated for the new six-item PROMIS Pediatric Anger Scale.


This study provides initial calibrations of the anger items and creates the PROMIS Pediatric Anger Scale, version 1.0


PROMIS Anger HRQOL PRO Scale development Surveys Pediatrics 



Patient-Reported Outcomes Measurement Information System


Pediatric Quality of Life Inventory™


Health-related quality of life


Patient-reported outcomes


Confirmatory factor analysis


Item response theory


Local dependence


Differential item function



We would like to acknowledge the contribution of Harry A. Guess, MD, PhD to the conceptualization and operationalization of this research prior to his death. This work was funded by the National Institutes of Health through the NIH Roadmap for Medical Research, Grant 1U01AR052181-01, and by SBIR contract HHSN-2612007-00013C with the National Cancer Institute of the National Institutes of Health. Information on the Patient-Reported Outcomes Measurement Information System (PROMIS) can be found at and


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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Debra E. Irwin
    • 1
  • Brian D. Stucky
    • 2
  • Michelle M. Langer
    • 3
  • David Thissen
    • 2
  • Esi Morgan DeWitt
    • 4
  • Jin-Shei Lai
    • 5
  • Karin B. Yeatts
    • 1
  • James W. Varni
    • 6
    • 7
  • Darren A. DeWalt
    • 8
  1. 1.Department of Epidemiology, CB #7295University of North Carolina at Chapel HillChapel HillUSA
  2. 2.Department of PsychologyUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.National Board of Medical ExaminersPhiladelphiaUSA
  4. 4.Division of Rheumatology, James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical CenterCincinnatiUSA
  5. 5.Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoUSA
  6. 6.Department of Pediatrics, College of MedicineTexas A&M UniversityCollege StationUSA
  7. 7.Department of Landscape Architecture and Urban Planning, College of ArchitectureTexas A&M UniversityCollege StationUSA
  8. 8.Division of General Medicine and Clinical Epidemiology, Cecil G. Sheps Center for Health Services ResearchUniversity of North Carolina at Chapel HillChapel HillUSA

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