Reliability and Validity of Patient-reported Outcomes Measurement Information System Short Forms in Ankylosing Spondylitis

Mark C Hwang; Alexis Ogdie; Abin Puravath; John D Reveille

doi:10.3899/jrheum.190201

Reliability and Validity of Patient-reported Outcomes Measurement Information System Short Forms in Ankylosing Spondylitis

J Rheumatol. 2020 Aug 1;47(8):1182-1188. doi: 10.3899/jrheum.190201. Epub 2019 Aug 1.

Authors

Mark C Hwang^{1

2}, Alexis Ogdie^{3

4}, Abin Puravath^{3

4}, John D Reveille^{3

4}

Affiliations

¹ From the Division of Rheumatology and Clinical Immunogenetics, Department of Internal Medicine, John P. and Kathrine G. McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, Texas; the Division of Rheumatology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Mark.C.Hwang@uth.tmc.edu.
² M.C. Hwang, MD, Division of Rheumatology and Clinical Immunogenetics, Department of Internal Medicine, John P. and Kathrine G. McGovern Medical School, UTHealth; A. Ogdie, MD, MSCE, Division of Rheumatology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania; A. Puravath, MD, Division of Rheumatology and Clinical Immunogenetics, Department of Internal Medicine, John P. and Kathrine G. McGovern Medical School, UTHealth; J.D. Reveille, MD, Division of Rheumatology and Clinical Immunogenetics, Department of Internal Medicine, John P. and Kathrine G. McGovern Medical School, UTHealth. Mark.C.Hwang@uth.tmc.edu.
³ From the Division of Rheumatology and Clinical Immunogenetics, Department of Internal Medicine, John P. and Kathrine G. McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, Texas; the Division of Rheumatology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁴ M.C. Hwang, MD, Division of Rheumatology and Clinical Immunogenetics, Department of Internal Medicine, John P. and Kathrine G. McGovern Medical School, UTHealth; A. Ogdie, MD, MSCE, Division of Rheumatology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania; A. Puravath, MD, Division of Rheumatology and Clinical Immunogenetics, Department of Internal Medicine, John P. and Kathrine G. McGovern Medical School, UTHealth; J.D. Reveille, MD, Division of Rheumatology and Clinical Immunogenetics, Department of Internal Medicine, John P. and Kathrine G. McGovern Medical School, UTHealth.

PMID: 31371654
DOI: 10.3899/jrheum.190201

Abstract

Objective: To assess the reliability and validity in ankylosing spondylitis (AS) of selected Patient Reported Outcomes Measurement Information System (PROMIS) Short Forms (SF) developed by the US National Institutes of Health. The analysis was done across core sets and patient-identified domains of the Assessment of Spondyloarthritis international Society.

Methods: Participants in the Prospective Study of Outcomes in Ankylosing Spondylitis (PSOAS), an ongoing, prospective longitudinal observational study, completed 6 PROMIS SF assessing global health, depression, fatigue, physical function, pain intensity, and pain interference during their PSOAS visits from September 2017 to January 2019. Test-retest reliability and internal consistency were assessed using intraclass correlation coefficients and Cronbach's alpha coefficient, respectively. PROMIS SF were compared to legacy measures collected. Construct validity was evaluated through examination of score distributions and floor effects, and through examination of the Spearman correlation coefficients between PROMIS measures and existing legacy AS measures. Discriminant validity was tested across Ankylosing Spondylitis Disease Activity Score (ASDAS) groups.

Results: Participants (n = 119) were mostly male (69%), white (81%), and with a mean (SD) age of 51 (± 15) years. Legacy measures demonstrated floor effects that were not present in PROMIS SF. Good test-retest reliability (r > 0.8) and excellent internal consistency (α > 0.9) was noted in the PROMIS SF. The 6 PROMIS SF correlated moderately to strongly [ρ 0.68 (Depression) to -0.87 (Physical Function)] with appropriate legacy measures. PROMIS scores measures worsened significantly (p < 0.05) with higher ASDAS groups.

Conclusion: This study supports the reliability and construct validity of PROMIS SF to assess AS symptoms from a single-center sample of patients with AS. Further research is needed to test responsiveness, feasibility/resource burden, and different cultural/societal contexts for patients with AS.

Keywords: ANKYLOSING SPONDYLITIS; ARTHRITIS IMPACT PATIENT REPORTED OUTCOMES; MEASUREMENT INSTRUMENT; PSYCHOMETRICS; SURVEYS.

Publication types

Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Female
Humans
Information Systems
Male
Middle Aged
Patient Reported Outcome Measures
Prospective Studies
Quality of Life
Reproducibility of Results
Spondylitis, Ankylosing* / diagnosis
Surveys and Questionnaires

Abstract

Publication types

MeSH terms

Grants and funding