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PROMIS global health: potential utility as a screener to trigger construct-specific patient-reported outcome measures in clinical care

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Abstract

Purpose

Patient-reported outcome measures (PROMs), including global health and construct-specific measures, are collected across healthcare systems. Efforts should be made to reduce data collection burden and individualize survey administration to patient needs. Our study evaluated the ability of utilizing items on a global health measure to identify patients who may require additional screening.

Methods

A cross-sectional study was conducted of patients who completed PROMIS Global Health (GH) as part of routine care, as well as additional construct-specific surveys, in a large healthcare system from 1/1/2016 to 12/31/2018. Receiver operating characteristic (ROC) analysis identified optimal thresholds for PROMIS GH items identifying clinically meaningful thresholds on construct-specific PROMs: PHQ-9 score ≥10, Neuro-QoL Cognitive Function, PROMIS Physical Function, and Satisfaction with Social Roles and Activities T-score ≤40, PROMIS Anxiety, Fatigue, Sleep Disturbance, and Pain Interference T-score ≥60.

Results

There were 206,685 patients who completed PROMIS GH and additional construct-specific surveys. Scores ≤3 on PROMIS GH item 10 (emotional problems) had 90.0% sensitivity (area under the curve (AUC) = 0.821) for identifying patients with moderate-severe depressive symptoms on PHQ-9. Similarly high sensitivities and AUCs were demonstrated for PROMIS GH items assessing mental and physical health, fatigue, and pain to identify poor scores on their corresponding construct-specific PROMs.

Conclusions

Our study provides preliminary support for the ability of utilizing PROMIS GH items as screening tools to identify patients with poor scores on additional construct-specific PROMs. Through directing construct-specific PROMs to patients for whom they are most applicable, survey burden could be reduced for many patients, allowing a more efficient and targeted use of PROMs in healthcare decision-making.

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Data not published within the article are available and will be shared by reasonable request.

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Authors and Affiliations

  1. Center for Outcomes Research & Evaluation, Neurological Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, JJ3-603, USA

    Brittany Lapin & Irene L. Katzan

  2. Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA

    Brittany Lapin

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Correspondence to Brittany Lapin.

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The study was approved by Cleveland Clinic’s Institutional Review Board (#07–591). Because the study consisted of analyses of pre-existing data, the requirement for patient informed consent was waived.

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Lapin, B., Katzan, I.L. PROMIS global health: potential utility as a screener to trigger construct-specific patient-reported outcome measures in clinical care. Qual Life Res 32, 105–113 (2023). https://doi.org/10.1007/s11136-022-03206-y

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