With the new system, the patient could respond to the items quickly on a handheld device such as a Smart Phone or tablet, or on a laptop the day before the office visit, or even at the office. The scores would be immediately available, calibrated to the population norm, and ready for the visit with the physician.
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“With these instruments, we would be able to see how much impact pain is having on the patient’s life and more accurately see the burden of disease. Then as we treat them, we can see the changes or improvement relative to the population norm by administering the item banks at each visit,” Dr. Morgan DeWitt says. The PROMIS instruments are expected to be less taxing for ailing patients to complete, with more precise information across a wide variety of chronic conditions and diseases.
Another advantage with the new system is that abilities related to physical functioning can be measured when they exceed the average. According to Dr. Fries, some patients with rheumatic arthritis who are getting advanced therapies now have abilities that are above average. Current scales miss that improvement, which would be important information for both the clinician and to researchers who are evaluating a specific therapy.
Tools created by the PROMIS initiative are expected to outrank legacy scales in flexibility, in that they can be administered in a variety of ways and in different forms.
Clinicians and researchers can access PROMIS instruments (short forms, CATs, and profiles) in the instrument library found at http://assessmentcenter.net. These item banks are in the public domain, as are the PROMIS short forms of 4-, 6-, 8-, 10-, and 20-item length. Any measure can be downloaded for paper administration or be included in an online study. Visitors to the site can take a demonstration CAT on domains related to emotional, physical or social health. Each completed demonstration is followed by automatic scoring and rating. the rheumatologist
Kathy Holliman is a medical journalist based in New Jersey.
- Fries JF. Items, instruments, crosswalks, and PROMIS. J Rheumatol. 2009;36:6.
- Bruce B, Fries JF, Ambrosini D, et al. Better assessment of physical function: Item improvement is neglected but essential. Arthritis Res Ther. 2009:11:R191.
- Varni JW, Stucky BD, Thissen D, et al. PROMIS pediatric pain interference scale: An item response theory analysis of the pediatric pain item bank. J Pain. 2010;11:1109-1119.