Abstract 10: The PROMIS Physical Function Scale- a Promising Scale for use in Stroke

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Irene Katzan ◽  
Sandra Griffith ◽  
Youran Fan

Background: Functional status is a critically important outcome measure after stroke. The ability to electronically capture this through self-report is increasing. The Patient Reported Outcomes Measurement Information System (PROMIS) uses computer adaptive testing (CAT), which can increase score precision and reduce patient burden. The number of questions depends on the patient’s responses. The objective of this study was to evaluate the performance of the PROMIS physical function scale (PROMIS PF) compared to the validated Stroke Impact Scale 16 (SIS16) in an ambulatory stroke clinic. Methods: Patient-reported PROMIS PF (CAT version) and SIS16 were electronically collected on patients seen in the stroke clinic using the Knowledge Program platform. Patient completion rates were > 70%. Distribution of scores was compared to assess ceiling/floor effects. Internal consistency was assessed by calculating the SEM for PROMIS PF and Cronbach’s alpha for SIS16. Correlations with NIHSS were performed to assess convergent validity. Results: The PROMIS PF and SIS16 were collected on 5,691 patients from Jan 2010 - May 2014. Mean SIS16 score = 81.4 (SD 21.5), mean PROMIS PF score = 42.8 (SD 11.2). The SIS16 had a22% ceiling effect, <1 % ceiling effect was seen with PROMIS PF (Figure). Patients completed 16 SIS16 items and a median of 4 [IQR 4, 5] PROMIS PF items. Cronbach’s alpha for SIS16 = 0.959, SEM for PROMIS PF = 2.3; both values suggest excellent internal consistency. Test-retest correlation was 0.867 for SIS16 and 0.87 for PROMIS PF. Correlations between NIHS and the 2 scales were -0.461 (p<0.001) for PROMIS PF and -0.559 (p<0.0001) for SIS16. Conclusion: The use of the PROMIS system to obtain electronic patient-reported functional status in ambulatory stroke clinic is feasible. PROMIS PF is an option for measurement of physical function in patients with stroke. It had similar test characteristics as the SIS16 but with lower patient burden and no ceiling effect.

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 897
Author(s):  
Christos Bakirtzis ◽  
Artemios Artemiadis ◽  
Elli Nteli ◽  
Marina Kleopatra Boziki ◽  
Maria-Valeria Karakasi ◽  
...  

The Multiple Sclerosis Work Difficulties Questionnaire-23 (MSWDQ-23) is a self-report instrument developed to assess barriers faced by People with Multiple Sclerosis (PwMS) in the workplace. The aim of this study was to explore the psychometric properties of the Greek version of the MSWDQ-23. The study sample consisted of 196 PwMS, all currently working in part- or full-time jobs. Participants underwent clinical examination and cognitive screening with the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and completed self-report measures of fatigue, psychological functioning, and quality of life, along with the MSWDQ-23 questionnaire. Confirmatory Factor Analysis (CFA) was performed, and goodness-of-fit measures were used to evaluate construct validity. Convergent validity was checked by correlating MSWDQ-23 scores with study measures. Cronbach’s alpha value was produced to assess internal consistency. CFA yielded a model with a fair fit confirming the three-factor structure of the instrument. Higher work difficulties were associated with higher Expanded Disability Status Scale (EDSS) scores, poorer cognitive function, more fatigue, stress, anxiety, and depression, and poorer health status, supporting the convergent validity of MSWDQ-23. Internal consistency (Cronbach’s alpha = 0.94) and test–retest reliability (ICC = 0.996, 95%, CI = 0.990–0.998) were excellent. The Greek MSWDQ-23 can be considered a valid patient-reported outcome measure and can be used in interventions aiming to improve the vocational status of PwMS.


2018 ◽  
Vol 43 (1) ◽  
pp. 80-87 ◽  
Author(s):  
Robert Gailey ◽  
Anat Kristal ◽  
Jennifer Lucarevic ◽  
Shane Harris ◽  
Brooks Applegate ◽  
...  

Background: Prosthetic socket fit is an important element associated with successful ambulation and use of a prosthesis. Prosthetists and rehabilitation clinicians would benefit from an assessment tool that discriminates between and quantifies the multiple determinants that influence the lower limb amputee’s performance and satisfaction of a prosthetic socket. Objectives: To determine the internal consistency of the comprehensive lower limb amputee socket survey, a new self-report measure of prosthetic socket satisfaction that quantifies suspension, stability, comfort, and appearance. Study design: Cross-sectional sample of active amputees. Methods: Interviews were conducted with prosthetists, physical therapists, and lower limb amputees to identify clinical concerns and common activities influencing socket fit. An expert panel of five clinicians reviewed the items and constructed the original version of the comprehensive lower limb amputee socket survey which was then administered to a convenience sample of 47 active lower limb amputees. Item analysis and Cronbach’s alpha were used to determine the final version of the comprehensive lower limb amputee socket survey. Results: Following item raw score-to-total score correlation with Cronbach’s alpha for comprehensive lower limb amputee socket survey determinants, internal consistency improved when nine questions were eliminated. Conclusion: The comprehensive lower limb amputee socket survey is a self-report measure of prosthetic socket satisfaction with very good internal consistency. Clinical relevance When socket problems occur, the ability to determine the specific cause can reduce modification time, enhance socket fit, and promote patient satisfaction. A standardized multi-dimensional assessment measure of socket satisfaction enables prosthetists to quantify the multiple determinants of socket satisfaction, improve patient communication, and demonstrate the value of socket interventions.


2021 ◽  
Author(s):  
Giuliana V Zarrella ◽  
Alice Perez ◽  
Jorg Dietrich ◽  
Michael W Parsons

Abstract Background Subjective cognitive function is an important outcome measure in oncology. The Functional Assessment of Cancer Therapy-Brain (FACT-Br) is a quality of life (QoL) measure that includes indices of physical, emotional, social, and neurologic aspects of disease, but does not measure cognitive function. This study seeks to validate a novel index of cognition derived from the FACT-Br. Methods Patients with heterogeneous cancer diagnoses (N=214) completed neuropsychological evaluation and self-report measures. Nine FACT-Br items regarding cognition were combined to form the FACT-Br-Cognitive Index (CI). Reliability was evaluated by exploratory factor analysis and internal consistency. Concurrent validity was assessed by correlating FACT-Br-CI with the Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive-8 scales. Discriminant validity was assessed by correlating FACT-Br-CI with other FACT-Br indices and the Beck Depression and Anxiety Inventories (BDI, BAI). Exploratory analyses evaluated the impact of cognitive performance and disease variables on FACT-Br-CI. Results The FACT-Br-CI consisted of a single factor that demonstrated high internal consistency (α=.867) and strong concurrent validity, correlating strongly with PROMIS-Cognitive-8 scales (r=.675-.782). The relationship between the FACT-Br-CI and other FACT subscales ranged from moderate to strong (r=.372-.601), as did correlations with measures of depression (BDI, r=-.621) and anxiety (BAI, r=-.450). Modest correlations were observed with neuropsychological measures (r’s=.249-.300). Conclusions The FACT-Br-CI is a reliable and valid measure of self-reported cognition. Studies that included the FACT-Br could be retrospectively analyzed to assess subjective cognitive outcomes, enriching the information from prior research. Integration of the FACT-Br-CI in routine clinical care may be an efficient method of monitoring cognition.


2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0010
Author(s):  
Robert Kollmorgen ◽  
Brian Lewis ◽  
Richard C. Mather ◽  
Steven Olson

Objectives: Current Hip Patient Reported Outcome Scores (PROs) are not universally obtained, centers use different forms to try to interpret treatment outcomes, and are limited by floor and ceiling effects. Legacy scores of Modified Harris Hip Score (mHHS), International Hip Outcome Tool (iHOT), and Hip Outcomes Score (HOS) are common place and used in the literature. Patient compliance for legacy PROs have been shown to limit proper data collection. PROMIS measures were developed through NIH funding, vetted against a population norm and PROMIS Computer Adaptive Testing (CAT) has been shown in recent literature to compare well with knee and shoulder legacy scores, and are completed in a quicker amount of time. We hypothesize that in a hip preservation population, the CAT PROMIS Profile V2.0 and PROMIS physical function (PF) would show high correlation with legacy scores of (mHHS, iHOT, and HOS). Methods: After obtaining IRB approval, power analysis revealed 86 patients were needed to detect a significant difference. 100 patients were prospectively enrolled. Patients were asked to complete the iHOT-12, mHHS, HOS and then complete the CAT PROMIS Profile v 2.0. Inclusion criteria for the current study included all Initial encounter and single follow-up patients that have completed the CAT portion and started the legacy scores before opting out. Exclusion criteria will be any patient with a repeat encounter, patients under the age of 18 or a patient that did not complete the legacy or CAT scores. Repeat encounters were excluded due to statistical analysis assuming independence among observers. Correlation between instruments was defined as excellent (>0.7), excellent-good (0.7-0.61), good (0.6-0.4), and poor (0.3-0.2). Results: Demographics of 75 females and 25 males, mean BMI 26.3, and mean age 36.1 (range 18-67). The PROMIS Physical function, Pain Intensity, and Ability to Participate in Social Roles showed excellent correlation with the iHOT-12 (r=0.71 P<0.001), mHHS (r=0.8 P<0.001) and HOS (r=0.82 P<0.001). Patients averaged 21.6 questions to complete all seven arms of the PROMIS Profile. No patient experienced a ceiling effect utilizing the PROMIS Profile CAT. Conclusion: The PROMIS Profile allows for an in-depth look at patients’ dysfunction, not asked in current legacy scores. The PROMIS Physical function and Pain Intensity show excellent correlation with iHOT-12, mHHS and HOS. The CAT PROMIS Profile, shows no observed ceiling effect and can be considered to replace current legacy measures in hip preservation.


2013 ◽  
Vol 41 (1) ◽  
pp. 153-158 ◽  
Author(s):  
James F. Fries ◽  
James Witter ◽  
Matthias Rose ◽  
David Cella ◽  
Dinesh Khanna ◽  
...  

Objective.Patient-reported outcome (PRO) questionnaires record health information directly from research participants because observers may not accurately represent the patient perspective. Patient-reported Outcomes Measurement Information System (PROMIS) is a US National Institutes of Health cooperative group charged with bringing PRO to a new level of precision and standardization across diseases by item development and use of item response theory (IRT).Methods.With IRT methods, improved items are calibrated on an underlying concept to form an item bank for a “domain” such as physical function (PF). The most informative items can be combined to construct efficient “instruments” such as 10-item or 20-item PF static forms. Each item is calibrated on the basis of the probability that a given person will respond at a given level, and the ability of the item to discriminate people from one another. Tailored forms may cover any desired level of the domain being measured. Computerized adaptive testing (CAT) selects the best items to sharpen the estimate of a person’s functional ability, based on prior responses to earlier questions. PROMIS item banks have been improved with experience from several thousand items, and are calibrated on over 21,000 respondents.Results.In areas tested to date, PROMIS PF instruments are superior or equal to Health Assessment Questionnaire and Medical Outcome Study Short Form-36 Survey legacy instruments in clarity, translatability, patient importance, reliability, and sensitivity to change.Conclusion.Precise measures, such as PROMIS, efficiently incorporate patient self-report of health into research, potentially reducing research cost by lowering sample size requirements. The advent of routine IRT applications has the potential to transform PRO measurement.


Author(s):  
Adriana Marcela Jácome Hortúa ◽  
Adriana Angarita-Fonseca ◽  
Carmen Juliana Villamizar Jaimes ◽  
Rocio del Pilar Martínez Marín ◽  
Hugo Celso Dutra de Souza ◽  
...  

Cardiac rehabilitation is supported by the highest level of scientific evidence. However, less than 25% of those eligible to participate in a cardiac rehabilitation program initiate it; and of these, 50% drop out prematurely. A modified Spanish Cardiac Rehabilitation Barriers Scale (CRBS) has been translated, culturally adapted and validated in Colombia, however, the reliability remains to be evaluated. This study aimed to determine the internal consistency and test–retest reliability of the CRBS in a Colombian population. In total, 193 patients (67% men, average age = 65 ± 12 years) completed the scale twice, with an average of eight days between applications. Cronbach’s Alpha and intraclass correlation coefficients (ICC) were calculated. The internal consistency of the Colombian version of the CRBS was acceptable (Cronbach’s alpha = 0.84). The ICC of the CRBS was 0.69 (95% CI 0.61–0.76); 0.78 (95% CI 0.71–0.84) when the CRBS was completed by interview; and 0.47 (95% CI 0.21–0.67) when the CRBS was self-reported. The reliability of the interview version of the CRBS was substantial in the Colombian population; however, the reliability of the self-report version was lower. The use of this scale will allow developing strategies to increase participation and adherence to cardiac rehabilitation programs.


2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Mahamed Ateef ◽  
Sivachidambaram Kulandaivelan ◽  
Mazen Alqahtani

Purpose. The primary aim of this study was to translate a self-reported questionnaire (KOOS) from English to Urdu and then to see its internal consistency, agreement, test-retest reliability, and validity among primary OA knee patients. Methodology. First, KOOS questionnaire was translated from English language to Urdu through standardized cross-cultural protocol. This translated version of KOOS was administered to 111 radiographically diagnosed primary OA knee patients at two times with 48-hour interval in-between. Cronbach’s alpha, floor and ceiling effect, intraclass correlation coefficient (ICC), absolute agreement %, and Spearman correlation were used to fulfill our objectives. Results. Average time to administer this questionnaire was 20 minutes. There was good internal consistency with Cronbach’s alpha ranging from 0.7246 to 0.9139. The absolute agreement of each item between two tests ranged from 81.08% to 98.20%. Test-retest reliability was excellent (“r” ranged from 0.9673 to 0.9782). There was no ceiling effect; however less than 4% floor effect was seen in two subscales. There was significant difference that existed between different X-ray grades in all subscales meaning good content validity for disease prognosis. Conclusion. The present results show that KOOS Urdu version is a reliable and valid measure for primary OA knee patients.


Author(s):  
Sameer A. Ashaie ◽  
Leora R. Cherney

Purpose Depression assessment is challenging in persons with aphasia given their language impairment. Studies have used both self-report scales and by-proxy measures of depression in persons with aphasia. However, the validity of these measures has been called into question. The aim of this study was to conduct a preliminary investigation into aspects of validity of the community version of the Stroke Aphasia Depression Questionnaire (SADQ-10) and the Center for Epidemiological Studies Depression Scale–Revised (CESD-R). Method Twenty-four participants with chronic aphasia completed the CESD-R, the Patient-Reported Outcomes Measurement Information System Global Mental Health scale (PROMIS GMH), and the Dynamic Visual Assessment of Mood Scales (D-VAMS) while their caregivers completed the SADQ-10. Internal consistency of the CESD-R and the SADQ-10 and the convergent validity of the CESD-R, SADQ-10, PROMIS GMH, and D-VAMS were examined. Results The SADQ-10 and the CESD-R were internally consistent. The CESD-R was moderately correlated with the SADQ-10, PROMIS GMH, and D-VAMS. However, the SADQ-10 was not correlated with the PROMIS GMH and D-VAMS. Conclusions We suggest both the CESD-R and the SADQ-10 be used together to screen for depression in persons with aphasia. Further studies with larger sample sizes need to be conducted to establish validity of other depression screening instruments in person with aphasia.


BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016152 ◽  
Author(s):  
Kai Cong Seow ◽  
Diana Mohamed Yusoff ◽  
Yi Ling Eileen Koh ◽  
Ngiap Chuan Tan

ObjectivesSelf-efficacy and self-care measures are key attributes to optimal control of essential hypertension. Self-efficacy can be measured by the Hypertension Self-Care Profile (HTN-SCP) tool but its utility is dependent on the literacy and understanding of the subjects. A Malay version of the HTN-SCP Tool was developed to assess self-efficacy of Malay-literate patients with hypertension in the multi-ethnic Asian population in Singapore. The study aimed to determine the test-retest reliability of this tool which has been translated in Malay language.Methods and Material145 Malay-literate patients, aged 41-70 years, with essential hypertension were recruited in a polyclinic (primary care clinic) in Singapore. Forty-three percent of them completed both the first and second HTN SCP tool online, with a period of two weeks in between. The Cronbach’s alpha and Intra-class correlation coefficient (ICC) were computed to assess its test-retest reliability and internal consistency.ResultsThe Cronbach’s alpha/ICC for “Behavior” (0.851/0.664)), “Motivation” (0.928/0.655) and “Self-efficacy” (0.945/0.682) domains showed high internal consistency, fair to good reliability and stability. No floor or ceiling effect was found for the "behavior" and "motivation" domains. However, the borderline ceiling effect (15.2) for "self-efficacy" suggested limited discriminating power of the tool for patients with high self-efficacy. Positive association was shown between the HTN-SCP score and reported self-care measures but it was not statistically significant.ConclusionOverall, the translated HTN-SCP tool showed satisfactory test-retest reliability and internal consistency amongst the Malay-literate study population. Further research is needed for its application in general practice to identify patients with low self-efficacy for possible intervention.


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