Quality of Life Research

, Volume 28, Issue 5, pp 1217–1229 | Cite as

Determining a transitional scoring link between PROMIS® pediatric and adult physical health measures

  • David S. TulskyEmail author
  • Pamela A. Kisala
  • Aaron J. Boulton
  • Alan M. Jette
  • David Thissen
  • Pengsheng Ni
  • Darren A. DeWalt
  • I-Chan Huang
  • Yang Liu
  • M. J. Mulcahey
  • Mary Slavin
  • Brooke Magnus
  • Holly Crump
  • Robin Hanks
  • Susan Charlifue
  • Bryce B. Reeve



Having independent versions of the PROMIS® scales (for Pediatric and Adults) is problematic as scores cannot be evaluated longitudinally as individuals move from childhood into adulthood. The primary aim of this research project is to use item response theory (IRT) to develop a transitional scoring link (or “crosswalk”) between the PROMIS adult and pediatric physical health measures.


Sample 1 was collected at 6 rehabilitation hospitals in the U.S., and participants in Sample 2 were recruited from public health insurance programs and an online research panel.


PROMIS pediatric and adult physical function, mobility, upper extremity, fatigue, and pain measures were administered to a sample of 874 individuals aged 14–20 years old with special health needs and a sample of 641 individuals aged 14–25 years with a disability. IRT-based scores were linked using a linear approximation to calibrated projection.


Estimated latent variable correlations ranged between 0.84 and 0.95 for the PROMIS pediatric and adult scores. Root Expected Mean Square Difference values were below the 0.08 threshold in all cases except when comparing genders on the Mobility (0.097) and Pain (0.10) scales in the special health care needs sample. Sum score conversion tables for the pediatric and adult PROMIS measures are presented.


The linking coefficients can be used to calculate scale scores on PROMIS adult measures from pediatric measure scores and vice versa. This may lead to more accurate measurement in cross-sectional studies spanning multiple age groups or longitudinal studies that require comparable measurement across distinct developmental stages.


Patient-reported outcome measures Psychometrics Mobility limitation Pain Fatigue Test equating Test linking 



Children’s Health Insurance Program


Cerebral palsy


Expected a Posteriori


Health-related quality of life


Institutional Review Board


Item response theory


Linear approximation to calibrated projection


Opinions for good


Patient-Reported Outcomes


Patient-Reported Outcomes Measurement Information System®


Root Expected Mean Square Difference


Spinal cord injury


Short form


Special health care needs


Standardized mean difference


Traumatic brain injury



PROMIS was funded with cooperative agreements from the National Institutes of Health (NIH) Common Fund Initiative Northwestern University, PI: David Cella, PhD, U54AR057951, U01AR052177; Northwestern University, PI: Richard C. Gershon, PhD, U54AR057943; American Institutes for Research, PI: Susan (San) D. Keller, PhD, U54AR057926; State University of New York, Stony Brook, PIs: Joan E. Broderick, PhD and Arthur A. Stone, PhD, U01AR057948, U01AR052170; University of Washington, Seattle, PIs: Heidi M. Crane, MD, MPH, Paul K. Crane, MD, MPH, and Donald L. Patrick, PhD, U01AR057954; University of Washington, Seattle, PI: Dagmar Amtmann, PhD, U01AR052171; University of North Carolina, Chapel Hill, PI: Harry A. Guess, MD, PhD (deceased), Darren A. DeWalt, MD, MPH, Bryce B. Reeve, PhD, U01AR052181; Children’s Hospital of Philadelphia, PI: Christopher B. Forrest, MD, PhD, U01AR057956; Stanford University, PI: James F. Fries, MD, U01AR052158; Boston University, PIs: Alan Jette, PT, PhD, Stephen M. Haley, PhD (deceased), and David Scott Tulsky, PhD (University of Michigan, Ann Arbor), U01AR057929; University of California, Los Angeles, PIs: Dinesh Khanna, MD (University of Michigan, Ann Arbor) and Brennan Spiegel, MD, MSHS, U01AR057936; University of Pittsburgh, PI: Paul A. Pilkonis, PhD, U01AR052155; 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, U01AR057940; University of Maryland, Baltimore, PI: Lisa M. Shulman, MD, U01AR057967; and Duke University, PI: Kevin P. Weinfurt, PhD, U01AR052186). NIH Science Officers on this project have included Deborah Ader, PhD, Vanessa Ameen, MD (deceased), Susan Czajkowski, PhD, Basil Eldadah, MD, PhD, Lawrence Fine, MD, Dr PH, 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, Peter Scheidt, MD, Ashley Wilder Smith, PhD, MPH, Susana Serrate-Sztein, MD, William Phillip Tonkins, Dr PH, Ellen Werner, PhD, Tisha Wiley, PhD, and James Witter, MD, PhD. The contents of this article uses data developed under PROMIS. These contents do not necessarily represent an endorsement by the US Federal Government or PROMIS. See for additional information on the PROMIS initiative.


This study was funded by the National Institutes of Health (U01AR057929 and U01AR052181).

Compliance with ethical standards

Conflict of interest

David Tulsky, Alan Jette, Bryce Reeve, and Darren DeWalt received a research grant from the National Institutes of Health. All other authors declare no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • David S. Tulsky
    • 1
    • 2
    Email author
  • Pamela A. Kisala
    • 1
  • Aaron J. Boulton
    • 1
  • Alan M. Jette
    • 3
  • David Thissen
    • 4
  • Pengsheng Ni
    • 5
  • Darren A. DeWalt
    • 4
  • I-Chan Huang
    • 6
    • 7
  • Yang Liu
    • 8
  • M. J. Mulcahey
    • 9
  • Mary Slavin
    • 5
  • Brooke Magnus
    • 10
  • Holly Crump
    • 4
  • Robin Hanks
    • 11
  • Susan Charlifue
    • 12
  • Bryce B. Reeve
    • 13
  1. 1.Center for Health Assessment Research and TranslationUniversity of DelawareNewarkUSA
  2. 2.Departments of Physical Therapy and Psychological and Brain SciencesUniversity of DelawareNewarkUSA
  3. 3.MGH Institute of Health ProfessionsBostonUSA
  4. 4.University of North Carolina at Chapel HillChapel HillUSA
  5. 5.Boston University School of Public HealthBostonUSA
  6. 6.Department of Health Outcomes and Policy, College of MedicineUniversity of FloridaGainesvilleUSA
  7. 7.Department of Epidemiology and Cancer ControlSt. Jude Children’s Research HospitalMemphisUSA
  8. 8.University of MarylandCollege ParkUSA
  9. 9.Department of Occupational Therapy, School of Health ProfessionsThomas Jefferson UniversityPhiladelphiaUSA
  10. 10.Marquette UniversityMilwaukeeUSA
  11. 11.Rehabilitation Institute of MichiganDetroitUSA
  12. 12.Craig HospitalEnglewoodUSA
  13. 13.Duke UniversityDurhamUSA

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