PM&R and Internal Medicine Research Team Lands Paper on PROMIS Scores in the Current Issue of PM&R

A research paper originally published digitally in April 2022 by Karen Barr, MD, and Christopher Standaert, MD, of the UPMC Department of Physical Medicine and Rehabilitation – as well as Janel Hanmer, MD, PhD, of the UPMC Department of Internal Medicine – was chosen for publication in the November 2022 edition of PM&R.

The paper, titled “PROMIS for the PM&R clinician using patient-reported outcomes in clinical care,” explores benefits of PROMIS and practical and technical considerations regarding integrating this into clinical care. In addition, the supplement to the article describes three clinical vignettes and how PROMIS is used to drive clinical decision making.

Patient-reported outcomes measures (PROMs) are now commonly used both as research outcomes and in clinical care. A proliferation of patient outcome measures has resulted in multiple competing measures of variable quality for the same symptom or health condition. This means clinicians are faced with the daunting task of comparing psychometric soundness, patient burden, and licensing costs across an array of possible measures to use in their practice. If a practice uses multiple measures, clinicians then need to remember different scoring rules and different important scores for each measure. These same difficulties are present when trying to compare the outcomes of different research studies that used different measures.

The Patient Reported Outcome Measurement Information System (PROMIS) is an initiative spearheaded by the National Institutes of Health to develop next-generation measures of health-related quality of life that address this problem. Strengths of PROMIS include that it:

• Is a wide set of measures studied across populations.
• Is widely validated.
• Is free to use in English.
• Has a uniform scoring system.
• Covers a broad range of clinical domains.

Many widely used disease-specific measures implicitly include a set of health domains. For example, the Oswestry Disability Index (ODI) includes domains such as pain, physical functioning, sexual functioning, social functioning, and sleep quality. PROMIS measures domains that are a single symptom or function such as anxiety, pain, or physical function. PROMIS domains are disease agnostic, so a clinician can select the set of PROMIS domains important for their clinical population. PROMIS currently has over 90 adult domains and over 20 pediatric domains (for ages 5 and older).

When compared to existing legacy outcome measures, PROMIS's measurement properties appear generally superior, and easier and faster to administer, all critical to implementation and acceptance.

Read the full study to learn more.