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Validating the PROMIS cognitive function short form in cancer survivors

  • Original Laboratory Investigation
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

The Patient-Reported Outcome Measurement Information System Cognitive Function Short Form 8a  (PROMIS Cog) could provide a shorter, useful alternative to the often used Functional Assessment of Cancer Therapy – Cognition (FACT-Cog) in research and clinical care. This study aimed to determine the convergent validity and internal reliability of the PROMIS Cog in 3 separate samples of breast cancer survivors and to explore clinical cut points.

Methods

Data from three samples of breast cancer survivors were used for this secondary analysis. Convergent validity was determined by evaluating correlation strength among the derived PROMIS Cog and measures of depression, anxiety, stress, fatigue, sleep, loneliness, the FACT-Cog . Clinical cut-points for the PROMIS Cog were determined by plotting the receiver operating characteristic curves.

Results

3 samples of breast cancer survivors (N = 471, N = 132, N = 90) were included. Absolute values of correlations demonstrating convergent validity ranged from 0.21 to 0.82, p’s < 0.001, and were comparable to correlations with the full FACT-Cog 18 item perceived cognitive impairments (PCI) scale. ROC curve plots indicated a clinical cut off < 34 for the combined sample.

Conclusion

The 8-item PROMIS Cog demonstrated good convergent validity and internal reliability in breast cancer survivors, comparable to the 18-item FACT-Cog PCI. The PROMIS Cog 8a is a brief self-report measure that can be easily incorporated into cancer-related cognitive impairment research designs or used in clinical settings.

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Data availability

The datasets analyzed in the current study are available from the corresponding author on reasonable request.

Abbreviations

AUC:

area under the curves

BDI-2:

beck depression inventory-2nd edition

CABC:

cognition after breast cancer

CESD:

center for epidemiologic studies depression scale

CRCI:

cancer-related cognitive impairment

FACT-Cog:

functional assessment of cancer therapy – cognition

FACT-F:

functional assessment of chronic illness therapy – fatigue

MFSI:

multidimensional fatigue symptom inventory

PCI:

perceived cognitive impairment

PSQI:

pittsburgh sleep quality index

PROs:

patient reported outcomes

PROMIS Anxiety:

PROMIS version 1.0 emotional distress- anxiety short form 8a

PROMIS Cog:

patient-reported outcome measurement information system cognitive function short form 8a

PROMIS Depressive:

PROMIS version 1.0 emotional distress- depressive short form 8a

PROMIS Fatigue:

PROMIS version 1.0 fatigue short form 8a

ROC:

receiver operating characteristic

STAI-S:

state trait anxiety inventory – state

TLC:

thinking and living with cancer

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Funding

Research reported in this publication was supported by the National Institute of Nursing Research of the National Institutes of Health under Award Numbers K01NR018970; F31NR015707 (AMH), R56AG068086 (JC, JM), R35CA197289 (JM), R01AG068193 (JM), the National Cancer Institute awards R01 CA 109650 (PAG), K08CA241337 (KVD), R01CA129769 (JM), the Loan Repayment Award (KVD), the American Cancer Society Award Number DSCN-15-072 (AMH), and the Breast Cancer Research Foundation (to PAG). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the American Cancer Society.

Author information

Author notes

  1. Ashley M. Henneghan and Kathleen Van Dyk contributed equally to this work.

Authors and Affiliations

  1. School of Nursing, University of Texas at Austin, Austin, TX, USA

    Ashley M. Henneghan

  2. Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA

    Kathleen Van Dyk

  3. Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA, USA

    Kathleen Van Dyk & Patricia A. Ganz

  4. Georgetown Lombardi Comprehensive Cancer Center Georgetown University, Washington, DC, USA

    Xingtao Zhou & Jeanne Mandeblatt

  5. Department of Psychiatry, University of California San Diego, San Diego, CA, USA

    Raeanne C. Moore

  6. Memorial Sloan Kettering Cancer Center, New York, NY, USA

    James C. Root & Tim A. Ahles

  7. Department of Psychiatry, University of North Carolina–Chapel Hill, Chapel Hill, NC, USA

    Zev M. Nakamura

  8. Department of Health Policy and Management, UCLA Fielding School of Public Health, University of California at Los Angeles, Los Angeles, CA, USA

    Patricia A. Ganz

Authors
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Contributions

AMH and KVD: conceived and planned the secondary analysis design, conducted the analyses, drafted and revised the manuscript and coordinated review and feedback from all co-authors; JM, PAG, and AMH: were the PIs on the 3 funded studies that provided the data for this study; AMH, KVD, and XZ: conducted the psychometric analyses; KVD: conducted the receiver operating characteristic curve analyses; AMH, KVD, XZ, RCM, JCJ, TAA, ZMN, JM, and PAG: all reviewed and provided critical feedback the drafts and final version of the manuscript.

Corresponding author

Correspondence to Kathleen Van Dyk.

Ethics declarations

Conflict of interest

R.C.M. is a co-founder of KeyWise AI, Inc. and a consultant for NeuroUX. The terms of this arrangement have been reviewed and approved by UC San Diego in accordance with its conflict of interest policies. The remaining authors declare that they have no competing interests.

Ethical approval

All study procedures and protocols were in accordance with the Declaration of Helsinki and were approved by local Institutional Review Boards (Georgetown University IRB # 2008-363; UCLA IRB #11-001178; UT Austin IRB #2015-10-0039).

Consent to participate

All participants in the studies provided written informed consent to participate and publish the findings.

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Henneghan, A.M., Van Dyk, K., Zhou, X. et al. Validating the PROMIS cognitive function short form in cancer survivors. Breast Cancer Res Treat 201, 139–145 (2023). https://doi.org/10.1007/s10549-023-06968-2

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