Validation of the PROMIS physical function measures in a diverse US population-based cohort of cancer patients
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To evaluate the validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) physical function measures in a diverse, population-based cancer sample.
Cancer patients 6–13 months post-diagnosis (n = 4840) were recruited for the Measuring Your Health study. Participants were diagnosed between 2010 and 2013 with non-Hodgkin lymphoma or cancers of the colorectum, lung, breast, uterus, cervix, or prostate. Four PROMIS physical function short forms (4a, 6b, 10a, and 16) were evaluated for validity and reliability across age and race–ethnicity groups. Covariates included gender, marital status, education level, cancer site and stage, comorbidities, and functional status.
PROMIS physical function short forms showed high internal consistency (Cronbach’s α = 0.92–0.96), convergent validity (fatigue, pain interference, FACT physical well-being all r ≥ 0.68), and discriminant validity (unrelated domains all r ≤ 0.3) across survey short forms, age, and race–ethnicity. Known-group differences by demographic, clinical, and functional characteristics performed as hypothesized. Ceiling effects for higher-functioning individuals were identified on most forms.
This study provides strong evidence that PROMIS physical function measures are valid and reliable in multiple race–ethnicity and age groups. Researchers selecting specific PROMIS short forms should consider the degree of functional disability in their patient population to ensure that length and content are tailored to limit response burden.
KeywordsPatient-reported outcomes Oncology Validation studies Physical function
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: Arnold L. Potosky, PhD and Carol. M. Moinpour, PhD (Fred Hutchinson Cancer Research Center, Seattle),U01AR057971; Children’s Hospital Medical Center, Cincinnati, PI: Esi M. Morgan DeWitt, MD, MSCE, 17 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 B. Reeve, PhD; William Riley, PhD; Ashley Wilder Smith, PhD, MPH; Susana Serrate-Sztein,MD; Ellen Werner, PhD; and James Witter, MD, PhD. This project was supported by the following: U01AR057971 (PIs: Potosky, Moinpour), National Cancer Institute supplement P30CA051008, NCI P30CA051008, UL1TR000101 (previously UL1RR031975) from the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, through the Clinical and Translational Science Awards Program (CTSA).
Conflict of interest
The authors have no conflicts of interest to disclose.
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