The PROMIS Physical Function Correlates With the QuickDASH in Patients With Upper Extremity Illness
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To assess disability more efficiently with less burden on the patient, the National Institutes of Health has developed the Patient Reported Outcomes Measurement Information System (PROMIS) Physical Function—an instrument based on item response theory and using computer adaptive testing (CAT). Initially, upper and lower extremity disabilities were not separated and we were curious if the PROMIS Physical Function CAT could measure upper extremity disability and the Quick Disability of Arm, Shoulder and Hand (QuickDASH).
We aimed to find correlation between the PROMIS Physical Function and the QuickDASH questionnaires in patients with upper extremity illness. Secondarily, we addressed whether the PROMIS Physical Function and QuickDASH correlate with the PROMIS Depression CAT and PROMIS Pain Interference CAT instruments. Finally, we assessed factors associated with QuickDASH and PROMIS Physical Function in multivariable analysis.
A cohort of 93 outpatients with upper extremity illnesses completed the QuickDASH and three PROMIS CAT questionnaires: Physical Function, Pain Interference, and Depression. Pain intensity was measured with an 11-point ordinal measure (0–10 numeric rating scale). Correlation between PROMIS Physical Function and the QuickDASH was assessed. Factors that correlated with the PROMIS Physical Function and QuickDASH were assessed in multivariable regression analysis after initial bivariate analysis.
There was a moderate correlation between the PROMIS Physical Function and the QuickDASH questionnaire (r = −0.55, p < 0.001). Greater disability as measured with the PROMIS and QuickDASH correlated most strongly with PROMIS Depression (r = −0.35, p < 0.001 and r = 0.34, p < 0.001 respectively) and Pain Interference (r = −0.51, p < 0.001 and r = 0.74, p < 0.001 respectively). The factors accounting for the variability in PROMIS scores are comparable to those for the QuickDASH except that the PROMIS Physical Function is influenced by other pain conditions while the QuickDASH is not.
The PROMIS Physical Function instrument may be used as an upper extremity disability measure, as it correlates with the QuickDASH questionnaire, and both instruments are influenced most strongly by the degree to which pain interferes with achieving goals.
Level of Evidence
Level III, diagnostic study. See the Instructions for Authors for a complete description of levels of evidence.
KeywordsItem Response Theory Numeric Rating Scale Pain Interference Worker Compensation Patient Report Outcome Measurement Information System
- 2.Angst F, Goldhahn J, Drerup S, Flury M, Schwyzer HK, Simmen BR. How sharp is the short QuickDASH? A refined content and validity analysis of the short form of the disabilities of the shoulder, arm and hand questionnaire in the strata of symptoms and function and specific joint conditions. Qual Life Res. 2009;18:1043−1051.PubMedCrossRefGoogle Scholar
- 8.Budd HR, Larson D, Chojnowski A, Shepstone L. The QuickDASH score: a patient-reported outcome measure for Dupuytren’s surgery. J Hand Ther. 2011;24:15−20; quiz 21.Google Scholar
- 9.Cella D, Chang CH. A discussion of item response theory and its applications in health status assessment. Med Care. 2000;38(9 suppl);1166−1172.Google Scholar
- 10.Cella D, Riley W, Stone A, Rothrock N, Reeve B, Yount S, Amtmann D, Bode R, Buysse D, Choi S, Cook K, Devellis R, DeWalt D, Fries JF, Gershon R, Hahn EA, Lai JS, Pilkonis P, Revicki D, Rose M, Weinfurt K, Hays R (2010) PROMIS Cooperative Group. The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005−2008. J Clin Epidemiol. 63:1179−1194.PubMedCentralPubMedCrossRefGoogle Scholar
- 17.Gibbons LE, Feldman BJ, Crane HM, Mugavero M, Willig JH, Patrick D, Schumacher J, Saag M, Kitahata MM, Crane PK. Migrating from a legacy fixed-format measure to CAT administration: calibrating the PHQ-9 to the PROMIS depression measures. Qual Life Res. 2011;20:1349−1357.PubMedCentralPubMedCrossRefGoogle Scholar
- 22.Hung M, Stuart AR, Higgins TF, Saltzman CL, Kubiak EN. Computerized adaptive testing using the PROMIS Physical Function item bank reduces test burden with less ceiling effects compared to the Short Musculoskeletal Function Assessment in orthopaedic trauma patients. J Orthop Trauma. 2013 Dec 27. [Epub ahead of print].Google Scholar
- 28.Mehta S, Macdermid JC, Carlesso LC, McPhee C. Concurrent validation of the DASH and the QuickDASH in comparison to neck-specific scales in patients with neck pain. Spine (Phila Pa 1976). 2010;35:2150−2156.Google Scholar
- 31.Pilkonis PA, Choi SW, Reise SP, Stover AM, Riley WT, Cella D; PROMIS Cooperative Group. Item banks for measuring emotional distress from the Patient-Reported Outcomes Measurement Information System (PROMIS(R)): depression, anxiety, and anger. Assessment. 2011;18:263−283.PubMedCentralPubMedCrossRefGoogle Scholar
- 33.PROMIS Health Organization, PROMIS Cooperative Group. PROMIS® Instrument Development and Validation Scientific Standards Version 2.0 (revised May 2013). Available at: http://www.nihpromis.org/Documents/PROMISStandards_Vers2.0_Final.pdf. Accessed February 5, 2014.
- 36.Sahlqvist S, Song Y, Bull F, Adams E, Preston J, Ogilvie D; iConnect consortium. Effect of questionnaire length, personalisation and reminder type on response rate to a complex postal survey: randomised controlled trial. BMC Med Res Methodol. 2011;11:62.Google Scholar
- 41.Wong JY, Fung BK, Chu MM, Chan RK. The use of Disabilities of the Arm, Shoulder, and Hand Questionnaire in rehabilitation after acute traumatic hand injuries. J Hand Ther. 2007;20:49−55; quiz 56.Google Scholar