PROMIS® ( Patient-Reported Outcome Measurement Information System) is a clinically validated system of person-centered measures developed by the National Institute of Health and Northwestern University. In short, it is a series of standardized questions designed to measure a patient’s current health status and calculate an associated score. PROMIS® is designed to enhance communication between providers and patients, and allow for better understanding of the patient’s experience.
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:
Measuring the extent to which pain hinders an individual’s engagement with physical, mental, cognitive, emotional, recreational, and social activities.
Measuring the outcome of patients with MSK disorders by assessing physical function through a grading scale of activities of daily living (ADLs).
Measuring the upper extremity function of patients with hand and upper extremity disorders through a grading scale of ADLs.
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
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.
The MCID is the smallest change that a patient would notice and appreciate, and can be used to determine whether they are responding to treatment.
Higher scores indicate a greater impact of pain on daily activities. The MCID for general MSK pain is -2.0 points.
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Functional PROMIS T-scores have been researched extensively, and can be associated with over 100 specific ADLs. This relationship enables physical therapy 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.
At Limber Health, we use these measures as a way to track a patient’s progress throughout their rehabilitation therapy home exercise program and care plan. With these measures, we can monitor a patient’s subjective recovery and improvement with a simple number: their PROMIS® score.
PROMIS measures offer significant advantages over traditional patient-reported outcomes by eliminating common floor and ceiling effects seen in legacy tools. These measures are quick for patients to complete, use a straightforward MCID (Minimal Clinically Important Difference) to track meaningful change, and are easily tied to activities of daily living (ADLs). This makes PROMIS ideal for setting patient-centered goals and monitoring progress in physical therapy and occupational therapy.
Limber Health’s Outcomes platform streamlines the collection of PROMIS and other patient-reported outcomes, reducing provider burden while delivering actionable insights to improve care.
