Adapting the PROMIS Physical Function Outcome Bank for MS AT users.

TitleAdapting the PROMIS Physical Function Outcome Bank for MS AT users.
Publication TypeJournal Article
AuthorsCook KF, Dudgeon BJ, Roddey TS, Johnson KL, Bamer AM, Amtmann D
JournalMultiple Sclerosis
Issue9 Suppl
Animals, Humans, Multiple Sclerosis

Background: Physical function is an important aspect of health related quality of life and significant research has been conducted related to the assessment of function and quality of life in persons with MS. However, assessing physical function with traditional patient reported outcomes in persons with MS is often complicated by use of wheelchairs or other assistive technology (AT). The NIH funded Patient Reported Outcomes Measurement Information Systems (PROMIS) has recently developed an item bank for measuring physical function. However, many items in the bank were not appropriate for individuals with MS because of high use of AT in this population. Objective: The objective of this study was to ensure the PROMIS physical function (PROMIS-PF) bank was appropriate and relevant to people with MS who use AT. Methods: We conducted interviews with panels of experts to create a working definition of physical function for AT users. Items from the PF bank were then reviewed by experts and categorized regarding relevance and appropriateness for users of AT. New items were added to assure that aspects of PF most relevant to AT users were included. All new and revised items were submitted to several rounds of reviews by expert panels and individuals with MS. Based on results, the candidate item bank was finalized and administered to 276 participants with MS. A subset of unchanged PROMIS items was administered for anchoring the subsequent item response theory calibration to the original PROMIS-PF metric. Test information for revised and original PROMIS-PF banks was compared to levels of functioning in persons with MS. Results: Physical function was defined by the expert panels as including ‘‘what an individual can do while using existing AT,’’ though the importance of comparing function with and without use of AT was recognized. New and modified items were calibrated to the PROMIS metric using a graded response model. The additional items substantially improved the precision of the bank in measuring MS participants with physical function challenges. Conclusions: Inclusion of MS AT users in item development resulted in a more effective PROMIS-PF item bank that is meaningful for measuring both users and non-users of AT. Because the new items do not specifically reference AT, the increased precision provided by the items improves measurement of all individuals with functioning difficulties. The improved item bank is now publically available to MS researchers and clinicians.

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