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General Interest

Session: ITCF Podium Session V: General Interest

Age and Sex-Specific Reference Values of PROMIS Physical Function, Upper Extremity, and Pain Interference

Thursday, October 19, 2023
9:25 AM – 9:31 AM PST
Location: 608-609
Purpose: Interpretation of patient-reported outcomes (PROs) in orthopaedic trauma research and clinical practice requires the availability of appropriate and relevant comparison data. We aim to provide such data for Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF), Upper Extremity (UE), and Pain Interference (PI) scales in populations age 50 years and older in Germany, US, and UK.

Methods: We collected custom PROMIS PF (22 items), UE (8 Items), and PI (8 items) short forms via telephone interviews from the general population in Germany (N = 921), US (N = 905), and UK (N = 900). We investigated differential item functioning (DIF) between countries using iterative hybrid ordinal logistic regression. Using imputation of plausible values and quantile regression, we modeled age-, sex-, and country -specific distributions of PROMIS scores.

Results: Three items from the PROMIS PF scale showed negligible DIF by country, indicating that all scales are valid for inter-country comparisons. We found significant effects of sex, age, and country on PROMIS PF, UE, and PI, indicating that stratification of reference data is warranted. Participants from the US reported mean PROMIS T-Scores of 47.7 for PF, 47.9 for UE, and 49.5 for PI. Women reported lower scores in both PF (–3.2) and UE (–4.1) and higher scores in PI (1.6) compared to men. Older participants reported lower PF (–0.3 T-Scores per year) and UE (–0.3) and higher PI (0.1). We also observed significant differences across countries with higher PF and UE in both UK (1.3 and 2.8 T-Scores, respectively) and Germany (2.6 and 2.8).

Conclusion: We modeled reference values for PROMIS PF, UE, and PI measures stratified by individual patients’ characteristics. Substantial differences in the PROMIS scores with regard to sex, age, and countries highlight the importance of patient-specific reference values. We provide a web application ( http://www.common-metrics.org/PROMIS_PF_and_PI_Reference_scores.php ), which enables clinicians to use personalized reference values. The population reference values provided can also serve as comparators to data collected with other PROMIS short forms or computer-adaptive tests.