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Understanding PROMIS® Outcome Measures

July 16, 2023
PROMIS measures are a valuable tool that can be used to track patient progress throughout their plan of care. Here, we break down the basics of PROMIS, and highlight the benefits of using the system as a patient-reported outcome measure.
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What is PROMIS®?

PROMIS® is an acronym for Patient-Reported Outcome Measurement Information System. The system is clinically validated, and was created in conjunction with the National Institute of Health. In short, it is a series of standardized questions designed to measure your patient’s current health status.

Frequently Utilized PROMIS Measures:

The PROMIS umbrella has approximately 70 pediatric and adult domains available, measuring conditions such as pain, fatigue, depression, anxiety, sleep disturbance, physical function, and social function. The measures used most commonly in the adult musculoskeletal (MSK) population include:

PROMIS Pain Interference®

Measuring the extent to which pain hinders an individual’s engagement with physical, mental, cognitive, emotional, recreational, and social activities.

PROMIS Physical Function®

Measuring the outcome of patients with MSK disorders by assessing physical function through a grading scale of activities of daily living (ADLs).

PROMIS Upper Extremity®

Measuring the upper extremity function of patients with hand and upper extremity disorders through a grading scale of ADLs.

How are PROMIS Scores Calculated?

PROMIS is a computer adaptive test (CAT) that changes the subsequent question based on the patient’s answer to the previous one. CATs not only allow for improved patient specificity, but they also maximize efficiency, reducing respondent burden.

Out of 126 total questions, a reliable result is calculated by only asking the patient an average of 4-12 items, taking approximately 1 minute to complete. Results are provided on a T-score scale, ranging from 20-80

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PROMIS Physical Function & PROMIS Upper Extremity

Higher scores indicate greater physical and upper extremity function, respectively. The minimal clinically important difference (MCID) for physical and upper extremity function is +2.1 points.

PROMIS Pain Interference

Higher scores indicate a greater impact of pain on daily activities. The MCID for general MSK pain is -2.0 points.

Applying PROMIS Results

Functional PROMIS T-scores have been researched extensively, and can be associated with over 100 specific ADLs. This relationship enables providers to associate functional value to a patient’s score, provide a meaningful reference for patient goal setting, and tie patient questions about return to activity back to outcomes data.

PROMIS Physical Function

PROMIS Upper Extremity

The Bottom Line: PROMIS demonstrates many benefits when compared to traditional patient-reported outcomes, eliminating the floor and ceiling effects commonly seen in legacy measures. The measures are quick to complete, use a simple MCID to show meaningful change, and can be associated with a wealth of ADLs, allowing a seamless and impactful goal setting experience for patients.