Abstract
Objective
To compare dimensionality, item-level characteristics, scale-level reliability, and
construct validity of PROMIS Physical Function short forms (PROMIS-PF) and 24-item
Roland Morris Disability Questionnaire (RMDQ-24) in patients with chronic low back
pain (LBP).
Design
Cross-sectional study.
Setting
Secondary care center for rehabilitation and rheumatology.
Participants
Patients with nonspecific LBP ≥3 months (N=768). Mean age was 49±13 years, 77% were
female, and 54% displayed pain for more than 5 years.
Interventions
Not applicable.
Main Outcome Measures
Dutch versions of the 4-, 6-, 8-, 10-, and 20-item PROMIS-PF and of the RMDQ-24.
Results
PROMIS-PF-6, PROMIS-PF-8, and RMDQ-24 exhibited sufficient unidimensionality (confirmatory
factor analysis: comparative fit index>0.950, Tucker-Lewis index>0.950, root means
square error of approximation<0.060), whereas the other instruments did not. All instruments
were free of local dependence except PROMIS-PF-20 with 4 item pairs with clear residual
correlations. Mokken scale analysis found 1 nonmonotone item for PROMIS-PF-20 and
8 for RMDQ-24 (ie, the probability of endorsing these items was not increasing with
increasing level on the underlying construct). PROMIS-PF-20 displayed 2 misfitting
items (S-χ2 P value>.001). Two-parameter item response theory models found 2 items with low discrimination
for RMDQ-24. All other instruments had adequate fit statistics and item parameters.
PROMIS-PF-20 displayed the best scale-level reliability. Construct validity was sufficient
for all instruments as all hypotheses on expected correlations with other instruments
and differences between relevant subgroups were met.
Conclusions
PROMIS-PF-6, PROMIS-PF-8, and RMDQ-24 exhibited better unidimensionality, whereas
PROMIS-PF-4, PROMIS-PF-6, PROMIS-PF-8, and PROMIS-PF-10 showed superior item-level
characteristics. PROMIS-PF-20 was the instrument with the best scale-level reliability.
This study warrants assessment of other measurement properties of PROMIS-PF short
forms in comparison with disease-specific physical functioning instruments in LBP.
Keywords
List of abbreviations:
CAT (computerized adaptive testing), CFA (confirmatory factor analysis), COSMIN (consensus-based standards for the selection of health measurement instruments), IRT (item response theory), LBP (low back pain), NRS (numeric rating scale), PROM (patient-reported outcome measure), RMDQ-24 (24-item Roland Morris Disability Questionnaire), PROMIS (Patient Reported Outcomes Measurement Information System), PROMIS-PF (Patient Reported Outcomes Measurement Information System Physical Function), PROMIS-PF-4 (4-item PROMIS Physical Function short form), PROMIS-PF-6 (6-item PROMIS Physical Function short form), PROMIS-PF-8 (8-item PROMIS Physical Function short form), PROMIS-PF-10 (10-item PROMIS Physical Function short form), PROMIS-PF-20 (20-item PROMIS Physical Function short form), PROMIS-GH-10 (10-item PROMIS Global Health short form)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 02, 2019
Footnotes
Disclosures: none.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
