Advances in patient-reported outcomes最新文献

{"title":"Effects of Age and Cognitive Impairment on PROMIS-57 Profile Responses: Qualitative Analyses from Cognitive Interviews.","authors":"Ann L Gruber-Baldini, G Jay Unick, Lisa M Shulman","doi":"10.1016/j.apro.2026.100317","DOIUrl":"10.1016/j.apro.2026.100317","url":null,"abstract":"<p><p>This study uses qualitative cognitive interviews to study meanings and processes used by participants, stratified by age and cognitive status, who are responding to questions on the PROMIS-57 Profile measure. The thirty-eight participants included 36% (n=13) with MoCA (Montreal Cognitive Assessment) 30-26, 36% (n=13) MoCA 25-18, 28% (n=12) MoCA 17-10; 56% (n=21) age 65-79, and 44% (n=17) age 80+. Four themes of response difficulty were identified: 1) comprehension, 2) use of the response set, 3) adaptation and activity limitations related to disability, and 4) positive frame of mind. Problems with Comprehension of Question or Concept were most common in the lowest MoCA group (10-17). Difficulty with Mapping Experience onto Response Set was also most common in the lowest MoCA group, and slightly more common in those age 80+. Adherence to the 7-day timeframe and mismatches of response and rationale were surprisingly more common in the middle MoCA group (18-25; associated with Mild Cognitive Impairment) and those age 65-79. Disability-related adaptive strategies were more common in the lower age group (65-79), and somewhat more common in the highest and middle MoCA groups (normal cognition and MCI). An optimistic outlook (Positive Frame of Mind) was more likely to influence responses in the cognitively intact group and the 80+ group. Twenty-one PROMIS Profile items were misinterpreted frequently: 6 items in the Fatigue scale, 6 in Anxiety, 4 in Pain Interference, 2 in Depression, 2 in Social Roles, and 1 in Sleep. This study shows that cognitive impairment and aging affect the accuracy and reliability of patient responses on the PROMIS Profile measure, indicating the need for development of patient-reported outcome measures customized for these populations. Based on these results, clinicians caring for older adults and those with cognitive impairment should be aware of the common limitations of patient responses on validated questionnaires.</p>","PeriodicalId":520969,"journal":{"name":"Advances in patient-reported outcomes","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147577613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coefficients of Repeatability for Likely Change: Comparison between PROMIS Computer Adaptive Tests and Short Forms.","authors":"M K Lee, D Cella, V Grzegorczyk, K J Ruddy, A L Cheville","doi":"10.1016/j.apro.2025.100309","DOIUrl":"10.1016/j.apro.2025.100309","url":null,"abstract":"<p><strong>Objectives: </strong>The study identified necessary score changes to categorize patients as likely to have changed in PROMIS computer adaptive testing (CAT) and to compare these with selected 4-item or 8-item short forms (SF 4a or 8a).</p><p><strong>Methods: </strong>In a large health system symptom management intervention project, 5823 completed PROMIS CAT with the stopping rule of standard error < 3 for anxiety (v1.0), depression (v1.0), pain interference (v1.1), and physical function (v2.0) at baseline and at 4 months. Coefficients of repeatability (CRs) for likely change were determined using 68 % confidence level based on the reliable change index statistics using item response theory standard errors, which were compared with those using 90 % confidence level. CRs for 8-item or 4-item short forms (SFs) were estimated for comparison using established item parameters.</p><p><strong>Results: </strong>CRs at 68 % confidence ranged from |3| to |4| for CAT and SF 4a and |2| to |3| for SF 8a across domains for baseline scores in the mildly-to-severely impaired ranges. For baseline scores within normal limits across improvement or worsening, CRs at 68 % confidence were |3|-|8| for CAT, |3|-|14| for SF 4a, and |2|-|14| for SF 8a. Across score ranges, directions of change, and domains, relaxing confidence level from 90 % to 68 % lowered the change thresholds by up to 7 points for CAT, 14 points for SF 8a, and 14 points for SF 4a, with the largest reductions for baseline scores within the normal range.</p><p><strong>Conclusions: </strong>In symptomatic score ranges, smaller and somewhat constant CRs were observed compared to scores within normal ranges. SF 8a achieved CR of 1 point lower than CAT with 4 more items on average in the symptomatic score range. CAT achieved lower CR than either SF length in the healthiest score range.</p>","PeriodicalId":520969,"journal":{"name":"Advances in patient-reported outcomes","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13313576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards enhancing the representativeness of patient-reported outcomes collection at community cancer centers.","authors":"Chengbo Zeng, Neil E Martin, Peter M Meyers, Marc DeAngelo, Tanja Xing-Yu He, Yu-Jen Chen, Boyu Ren, Andrea L Pusic, Maria O Edelen, Jason B Liu","doi":"10.1016/j.apro.2025.100301","DOIUrl":"10.1016/j.apro.2025.100301","url":null,"abstract":"<p><strong>Objectives: </strong>While patient-reported outcome measures (PROMs) can enhance cancer care, their implementation in community-based settings remains underexplored. This study compared patient characteristics and response rates between community and academic hospitals within the Mass General Brigham (MGB) health system, a large integrated health network with a standardized PROM program.</p><p><strong>Methods: </strong>We analyzed data from 31,164 adult cancer patients seen at three community and two academic radiation oncology clinics within MGB from 2020 to 2024. The Patient-Reported Outcomes Measurement Information System Global-10 health questionnaire was consistently administered to all patients seen at these clinics. Patient characteristics and response rates were compared by site of care.</p><p><strong>Results: </strong>Community sites had higher proportions of older adults, females, English speakers, and patients with a high school or less education. Over time, PROM collection improved significantly overall and across subgroups at both community and academic sites. Response rates were relatively lower at community sites than at academic sites, with disparities most evident among older adults, males, and those with federal insurance.</p><p><strong>Conclusion: </strong>Although PROM collection improved over time across MGB-affiliated radiation oncology clinics, older male patients and those with federal insurance remain key targets for further efforts to enhance PROM representativeness between community and academic settings.</p>","PeriodicalId":520969,"journal":{"name":"Advances in patient-reported outcomes","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13484357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity evidence for the Patient Reported Outcome Measurement Information System (PROMIS)^® Cognitive Screener (PRO-CS) to detect risk for cognitive decline as part of the Medicare Annual Wellness Visit.","authors":"Manrui Zhang, Anthony Rodriguez, Rebecca Weir, Janel Hanmer, Jordan M Harrison, Maria O Edelen","doi":"10.1016/j.apro.2025.100190","DOIUrl":"10.1016/j.apro.2025.100190","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to provide evidence on the validity of the Patient Reported Outcome Measurement Information System (PROMIS)^® Cognitive Screener (PRO-CS) in a large sample of older adults who completed the screening as part of the Medicare Annual Wellness visit.</p><p><strong>Methods: </strong>We analyzed data of 19,037 patients aged 65+ who completed the cognitive screener during their Medicare Annual Wellness visit (Once=16,115; Twice= 2922) in a large healthcare system. Bivariate and multivariate ordinary least squares and logistic regression were used to examine key risk factors and their cross-sectional and predictive relationships with PRO-CS scores and cognitive decline.</p><p><strong>Results: </strong>We found cognitive impairment based on PRO-CS scores was associated with having a clinical diagnosis (unadjusted Odds Ratio = -3.22(0.18), p < .001). PRO-CS scores were also found to have cross-sectional relationships with a wide range of known risk factors for cognitive impairment, including age, emotional distress, social needs, frailty, and overall general health (all ps < .001). Group-level analyses indicate that PRO-CS scores were useful for detecting subjective cognitive decline occurring within one year, with declining scores predicted by indicators of frailty and general health (all ps < .001).</p><p><strong>Conclusion: </strong>Our findings support the validity of using the PRO-CS to detect risk for subjective cognitive decline among older adults during Medicare Annual Wellness visits. Specifically, the PRO-CS is useful in detecting potential cases of MCI and subjective cognitive decline who are at higher risk of transitioning into a confirmed diagnosis of MCI or dementia in the future.</p>","PeriodicalId":520969,"journal":{"name":"Advances in patient-reported outcomes","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief report: Relationships of frailty and age with nonresponse to patient reported outcome measures.","authors":"Claire R Morton, Zara R Cooper, Ronald Bleday, Jennifer E Fanning, Jill Steinberg, Chengbo Zeng, Andrea L Pusic, Jason B Liu","doi":"10.1016/j.apro.2025.100197","DOIUrl":"10.1016/j.apro.2025.100197","url":null,"abstract":"<p><p>Patient-reported outcome measures are increasingly being used to evaluate health care interventions and systems, including in surgery. Simultaneously, older adults comprise a greater proportion of patients undergoing surgery. Frailty, a clinical syndrome more prevalent among older adults has not been examined as a factor associated with PROM response. In this single center retrospective analysis, we sought to understand the association between age and frailty with response to PROMs among a pilot group of patients. We find that within this sample of patients, adults between 66 and 84 and those with prefrailty were more likely to respond than patients less than 65 and those who are robust, respectively.</p>","PeriodicalId":520969,"journal":{"name":"Advances in patient-reported outcomes","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12680023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between social media use and loneliness across the lifespan in the United States: Population-based study using Health Information National Trends Survey data.","authors":"Christian E Vazquez, Derek Falk, Dana P Urbanski, Katherine Kwong, Diana Abudu-Birresborn, Juanita-Dawne Bacsu, Moka Yoo-Jeong, Hye Won Chai, Wonkyung Jung, Matthew Lee Smith","doi":"10.1016/j.apro.2025.100196","DOIUrl":"10.1016/j.apro.2025.100196","url":null,"abstract":"<p><strong>Objectives: </strong>Loneliness can affect all age groups and is continuing to grow as a major public health issue. One approach that has been proposed to address loneliness involves digital inclusivity because the ubiquity of technology and social media provides new avenues for activities to satisfy individuals' needs for social connection. It is unclear which age groups could benefit more from using social media related to loneliness. The current study advances the limited research on the relationship between social media use and loneliness looking across multiple age groups with nationally representative data.</p><p><strong>Methods: </strong>Data were analyzed from the 2022 Health Information National Trends Survey (HINTS; n = 4774). This study used multiple linear regression stratified by four age cohorts (Millennials, Generation X, Baby Boomers, Silent Generation) to examine the association of social media use with PROMIS Social Isolation scores and to assess differences across age cohorts. Covariates included age, gender, race and ethnicity, education, income, living with other adults, marital status, having a friend to talk to about health, self-rated health, PROMIS Meaning and Purpose, and the PHQ-4.</p><p><strong>Results: </strong>For Baby Boomers, compared to never using social media, using social media daily (<i>b</i>=1.53, <i>p</i> = .008) was associated with a higher loneliness score. For the Silent Generation, compared to never using social media, using social media daily (<i>b</i>=2.43, <i>p</i> = .04) was associated with a higher loneliness score. There was not a significant relationship between social media and loneliness for Millennials and Generation X.</p><p><strong>Conclusions: </strong>Social media use may be a risk factor for loneliness particularly for those who are from the Baby Boomer and Silent Generation and use social media daily. Social media interventions aimed at decreasing loneliness among older adults should consider the directional of this relationship, which needs to be confirmed.</p>","PeriodicalId":520969,"journal":{"name":"Advances in patient-reported outcomes","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crosswalk between PROMIS computer adaptive tests and numerical rating scales in cancer patients: Anxiety, depression, pain interference, physical function.","authors":"M K Lee, X Tang, D Cella, V Grzegorczyk, K J Ruddy, A L Cheville","doi":"10.1016/j.apro.2025.100195","DOIUrl":"10.1016/j.apro.2025.100195","url":null,"abstract":"<p><strong>Aims: </strong>The study aimed to establish crosswalk between PROMIS computer adaptive tests (CATs) and numerical rating scales (NRS) in emotional distress-anxiety, emotional distress-depression, pain interference, and physical function.</p><p><strong>Methods: </strong>This retrospective analysis assessed data collected from patients from E2C2 (4/2019-1/2023), a pragmatic symptom management trial. We linked 0-10 numerical rating scales (NRS) to corresponding PROMIS CAT scores using responses within 10 min of each other and randomly selected one visit per participant. A single-group equipercentile linking method was used, with polynomial log-linear smoothing to reduce sample errors. Assumptions were tested by examining NRS-PROMIS correlations and population invariance across subgroups by sex, race, and ethnicity. Linked scores were compared with observed PROMIS scores using intraclass correlations and differences in means and standard deviations (SDs).</p><p><strong>Results: </strong>The sample sizes for the four domains ranged from 32,434 to 33,081, with 34,029 unique patients with median age 64 (range 18-102), 56 % female, 92 % white, and 1 % Hispanic. About 30 % of patients provided the highest or lowest NRS scores. The NRS and PROMIS scores were strongly correlated (0.72-0.78). Population invariance across three subgroups and four domains was supported with the standardized Root Expected Mean Square Difference (REMSD) ranging from 0.8 % to 7 % SD, which were under 8 % SD threshold. The correlations between the linked and observed T scores were high ranging from 0.73 to 0.81. All four domains had small mean differences from the observed T scores.</p><p><strong>Conclusion: </strong>This study linked the NRS and PROMIS CAT in four domains and created a crosswalk table for conversion. This study facilitates the interpretability of NRS on the metric of PROMIS CAT T-scores.</p>","PeriodicalId":520969,"journal":{"name":"Advances in patient-reported outcomes","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13293501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing three measures of sleep disturbance in persons with chronic low back and neck pain.","authors":"Nabeel Qureshi, Daniel Siconolfi, Anthony Rodriguez, Ron D Hays, Ian D Coulter, Patricia M Herman","doi":"10.1016/j.apro.2025.100187","DOIUrl":"https://doi.org/10.1016/j.apro.2025.100187","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the concordance among three sleep disturbance items from the Oswestry Disability Index (ODI), Neck Disability Index (NDI), and the Patient-Reported Outcomes Measurement Information System (PROMIS^®).</p><p><strong>Methods: </strong>We examined the effects of item wording in a sample of patients with chronic low back pain (CLBP) and chronic neck pain (CNP) who responded to three measures that included sleep disturbance items. We administered the items at baseline and 3-month follow-up in an observational study of patients in the United States (N=1,020). We estimated associations among the items using correlations and cross-tabulations.</p><p><strong>Results: </strong>Polychoric correlations among the sleep items ranged from 0.56 to 0.71. The ODI, NDI, and PROMIS-29 were strongly correlated at baseline and three months later. The cross-tabulations revealed that the ODI and NDI responses were compressed, with most responses indicating low levels of sleep disturbance. Answers to the PROMIS-29 item were more widely distributed across its response categories.</p><p><strong>Conclusion: </strong>When determining the value of each measure, researchers should weigh their different properties and tie the selected measures to their unique research objectives.</p>","PeriodicalId":520969,"journal":{"name":"Advances in patient-reported outcomes","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144987047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing Minimal Clinically Important Difference for PROMIS Physical Function Improvement After Revascularization for Peripheral Artery Disease.","authors":"Teryn A Holeman, Benjamin S Brooke, Julie B Hales, Yingjia Wei, Yue Zhang, Benjamin A Steinberg, Amy M Cizik","doi":"10.1016/j.apro.2025.100188","DOIUrl":"10.1016/j.apro.2025.100188","url":null,"abstract":"<p><strong>Objective: </strong>Patients with peripheral arterial disease (PAD) undergo revascularization to improve physical function, yet meaningful improvement has not been defined. This study aims to define a threshold for improvement in patient-reported physical function (PROMIS-PF) and establish factors predictive of improvement following lower extremity revascularization.</p><p><strong>Methods: </strong>This study is a single-center retrospective cohort analysis of adults undergoing elective revascularization for PAD 2016-2023 who had PROMIS-PF scores. Anchor- and distribution-based approaches were used to triangulate a single minimal clinically important difference (MCID) value representing an improvement in PROMIS-PF after revascularization. The anchor question was a general health question. A least absolute shrinkage selection operator (LASSO) selected for relevant variables that predict if a patient will reach the MCID that were inputted into generalized linear mixed model regression.</p><p><strong>Results: </strong>Forty five percent of patients (N=60/132) had an anchor question that changed over time (improved or declined) with a corresponding PROMIS-PF anchor-based MCID value of 5.2 (±8.3). The distribution-based MCID was calculated from 62 patients with a PROMIS-PF standard deviation (SD) of 8.4, corresponding to a distribution-based MCID (1/2 × SD) of 4.2. The MCID values from both approaches converged on a conservative MCID estimate of ≥ 5. Forty percent of patients (N=25/62) met MCID following revascularization. Patients with higher baseline PROMIS-PF scores and more advanced age are less likely to meet MCID (OR 0.81, 95%CI 0.71 - 0.93, OR 0.94, 95%CI 0.88 - 1.00, respectively). However, only 41% of patients who had an improvement in ankle brachial index (ABI) value also met the MCID.</p><p><strong>Conclusions: </strong>A 5-point change in PROMIS-PF represents a meaningful improvement after revascularization for patients with PAD. Surgical technical success with a clinically meaningful improvement in ABI does not predict a corresponding improvement in function. Whether patients achieve functional improvement after revascularization depends on their baseline function score and age.</p>","PeriodicalId":520969,"journal":{"name":"Advances in patient-reported outcomes","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}