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  2. PROMIS - Pain Intensity

PROMIS - Pain Intensity

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Purpose

To assess patient-reported pain intensity.. 

Link to Instrument

Acronym PROMIS S-I

Area of Assessment

Pain

Assessment Type

Patient Reported Outcomes

Administration Mode

Computer

Cost

Free

Actual Cost

$0.00

Cost Description

If using the NIH toolbox app, cost is $499 subscription per year

CDE Status

NINDS CDE Notice of Copyright
PROMIS Pain Interference Short Form
Availability
Publicly Available from the PROMIS website:
Classification
Supplemental: Huntington's Disease (HD), Multiple Sclerosis(MS)
 
Exploratory: Myalgic encephalomyelitis/Chronic fatigue syndrome (ME/CFS)

Populations

Musculoskeletal Conditions
Spinal Injuries
Osteoarthritis

Key Descriptions

  • Usually 4-12 items for each section domain depending on which type of test is being performed (Short Form, CAT, or Profile)
  • Scoring: Item-levels are scored numerically for an individual's response to
    each question. PROMIS recommends the best way to find the total raw score is using the free HealthMeasures Scoring Service (https://www.assessmentcenter.net/ac_scoringservice) or a tool that can automatically calculate scores. Scores can also be added up by hand to find the total raw score. Then the raw score is converted to a T-score using the table in the Appendix This standardizes the score with a mean of 50 and standard deviation of 10.
  • Higher scores means more of the concept being measured. Example = more pain intensity.

Number of Items

3

Time to Administer

5-15 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Elderly Adult

+

years

Instrument Reviewers

Holly O’Hearn, SPT

Jensyn Bradley SPT, ATC, LAT

Chi-Lun Chiao, SPT

Holt McPherson, SPT

Kenna Peters, SPT

Corinne Woodbine, SPT

Duke University, School of Medicine, Division of Physical Therapy.

ICF Domain

Body Function

Measurement Domain

General Health

Considerations

  • PROMIS measures can be used in the general population and with adult populations with a chronic condition(s)
  • PROMIS measures have a larger range of measurement than most conventional measures, decreasing floor and ceiling effects as a result
  • PROMIS measures have fewer items than conventional measures, thereby decreasing respondent burden. When used as computer adaptive tests, PROMIS measures usually require 4-6 items for precise measurement of health-related constructs
  • Translations: The assessments are available via PDF in Spanish and can be obtained in other languages by contacting translations@Healthmeasures.net

Spinal Injuries

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Minimally Clinically Important Difference (MCID)

Anterior Cervical Spine Patients
Purvis et al, 2017; n=148; mean age = 53                  
   - MCID = 5.2

Osteoarthritis

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Minimally Clinically Important Difference (MCID)

Osteoarthritis
Broderick et al, 2013; n=98; mean age = 56.9                  
   - MCID = +or- 1.7

Test/Retest Reliability

Osteoarthritis (Broderick et al, 2013; n=98; mean age = 56.9)

  • Excellent test re-test reliability (ICC = 0.84)

Musculoskeletal Conditions

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Normative Data

Chronic Musculoskeletal Pain: (Deyo 2016, n=198, age = 66.5 (8.2) years old, 62.1% female, recruited from primary care physicians’ offices, Computer Adaptive Testing (CAT))

  • PROMIS 29 domain (score 0-10)
    • Baseline mean: 5.9 (1.8)
    • 3 month follow-up mean: 5.4 (2.1)

Test/Retest Reliability

Adults chronic MSK pain not receiving opiates (Deyo et al, 2016; n=198; mean age = 66.56)

  • Poor test-retest reliability (ICC = 0.44)

Internal Consistency

Adults chronic MSK pain not receiving opiates

Deyo et al, 2016; n=198; mean age = 66.56                   

  •  Excllent internal consistency (Chronbach's alpha = 0.92)

Construct Validity

Chronic Musculoskeletal Pain: (Deyo 2016, n=198, age = 66.5 (8.2) years old, 62.1% female, recruited from primary care physicians’ offices, Computer Adaptive Testing (CAT))

 

Evidence of construct validity of baseline PROMIS measures and the derived impact score

 

Worker’s compensation

 

Catastrophizing score (total)

 

Falls in previous 3 months

PROMIS measure

Yes

No

<14

≥14

Yes

No

N 

29.0

169.0 

109.0

78.0 

57.0 

139.0 

Pain intensity 

6.9 (1.9)

5.8 (1.7)

5.5 (1.6)

6.6 (1.9)

6.3 (1.8)

5.8 (1.8)

Floor/Ceiling Effects

Adults chronic MSK pain not receiving opiates

Deyo et al, 2016; n=198; mean age = 66.56                  

-Adequate floor/ceiling effects (1.8% of responses with lowest possible score at baseline and 3 months, 3.3% of responses with highest possible score at baseline and 3 months)

Chronic Musculoskeletal Pain: (Deyo 2016, n=198, age = 66.5 (8.2) years old, 62.1% female, recruited from primary care physicians’ offices, Computer Adaptive Testing (CAT))

  • Ceiling effect: 1.8%
  • Floor Effect: 3.3%

Responsiveness

Chronic Musculoskeletal Pain: (Deyo 2016, n=198, age = 66.5 (8.2) years old, 62.1% female, recruited from primary care physicians’ offices, Computer Adaptive Testing (CAT))

Effect Size: Change in pain at 3 months compared to baseline

 

Much less (n?=?20)

A little less (n?=?23)

About the same (n?=?91)

A little worse (n?=?47)

Much worse (n?=?16)

Pain intensity (10-point scale) 

?1.93 

?0.79 

?0.20 

0.24 

0.67 

Bibliography

Broderick, J. E., Schneider, S., Junghaenel, D. U., Schwartz, J. E., Stone, A. A. (2013). Validity and reliability of patient-reported outcomes measurement information system instruments in osteoarthritis. Arthritis Care Res (Hoboken), 65, 1625–1633.

 

Deyo, R.A., Ramsey, K., Buckley, D.I., Michaels, L., Kobus, A., Eckstrom, E., Forro, V., Morris, C. (2016). Performance of a Patient Reported Outcomes Measurement Information System (PROMIS) Short Form in Older Adults with Chronic Musculoskeletal Pain. Pain medicine (Malden, Mass.), 17(2), 314–324. doi:10.1093/pm/pnv046

 

Purvis, T. E., Neuman, B. J., Riley, L. H., & Skolasky, R. L. (2018). Discriminant Ability,  Concurrent Validity, and Responsiveness of PROMIS Health Domains Among Patients With  Lumbar Degenerative Disease Undergoing Decompression With or Without Arthrodesis. Spine, 43(21), 1512-1520. doi:10.1097/brs.0000000000002661

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