Highlights
- •A set of Patient Reported Outcome Measurement Information System (PROMIS) scales and a global rating of normal function (GRNF) were associated with patient status (patient acceptable symptom state [PASS]) in musculoskeletal patients seen in primary care.
- •Self-efficacy of managing symptoms was equally associated with patient status as other health domains typically associated with musculoskeletal problems (ie, physical function, pain interference).
- •Individual PROMIS scales and GRNF were successful at identifying up to ∼70% of patients with ∼70% accuracy.
- •Further studies are needed to evaluate whether combinations of PROMIS scales or other generic health scales can be combined to improve accuracy of determining patient status.
- •This analysis identifies thresholds associated with PROMIS physical function, pain interference, and GRNF scales that may assist providers with clinical decisions.
Abstract
Objectives
To determine if the Patient-Reported Outcome Measurement Information System (PROMIS)
physical function, pain interference, self-efficacy, and global rating of normal function
(GRNF) scales are able to accurately characterize a patient’s acceptable symptom state
(PASS).
Design
A cross-sectional analysis, using receiver operator curves and chi-square analysis
to explore criteria to determine thresholds (80% and 95% sensitivity/specificity)
for PASS that are applicable to PROMIS and GRNF scales.
Setting
Phone survey after primary care.
Participants
Patients (N=94) attending primary care for musculoskeletal problems.
Interventions
Not applicable.
Main Outcomes Measures
Accuracy and proportion of patients classified as PASS Yes or No.
Results
Receiver operator curve analysis showed significant area under the curve (AUC) values
for each PROMIS scale (AUC>.72) and the GRNF rating (AUC=.74). Identified PROMIS thresholds
suggested PASS was achieved when scores were at or slightly worse than the US population
average. A score of ≥7 and ≤4 characterized patients that were PASS Yes and No, respectively,
on the GRNF rating. A moderate (80%) specificity/sensitivity criteria yielded 72.3%-73.5%
accuracy for a majority of participants (>69.9%).
Conclusion
This analysis suggests the PROMIS and GRNF scales are able to characterize PASS status
with moderate accuracy (∼70%) for a large portion of patients (∼70%). New to this
study is the association of self-efficacy with PASS status. PROMIS scales at or slightly
worse than the US population average characterized PASS status.
Keywords
List of abbreviations:
AUC (area under the curve), GRNF (global rating of normal function), PASS (patient acceptable symptom state), PF (physical function), PI (pain interference), PROMIS (Patient-Reported Outcome Information System), SE (self-efficacy)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: September 12, 2018
Footnotes
Supported by Yamhill County Coordinated Care Organization - Build Forward Grant and Innovation Grant Providence Health and Services .
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
