Background/Purpose: PROMIS® measures were developed to assess physical, mental, and social health across chronic diseases and include brief short forms (SFs; 4-8 items) to assess common symptoms and function. Because people with RA often live with high levels of debilitating symptoms, it is essential that the items query content that is relevant to people living with RA. Here, we report the results of cognitive debriefing of selected PROMIS SFs in people with RA.

Methods: Participants were patients with RA receiving treatment at one of 3 US academic rheumatology centers. One-on-one phone interviews were conducted using a “talk through” format after patients completed the following SFs: Physical Function v1.0 (PF 20a), Pain Interference v1.0 (PI; 8a), Fatigue v1.0 (FAT; 7a, 8a), Participation in Social Activities and Roles v2.0 (PSRA 8a). Perceived relevance of the items and responses were probed by a trained interviewer. Conversations were recorded and transcribed.

Results: The 32 participants were mostly female (72%) with a mean (SD) age of 54 (13) years and well-established disease (13 [10] yrs). Participants were racially (66% white, 19% black, 13% native American, 9% Asian, 13% multi-race) and geographically (34% mid-Atlantic; 41% East; 28% South; 28% rural) diverse. Ninety-seven percent had some college or higher education. On average, compared with the general US population, participants reported higher mean PI (57.9 [10.6]) FAT-7a (53.2 [9.9]), FAT-8a (55.3 [10.3]), and worse PF (42.2 [11.0]) and PSRA (46.7 [10.9]). Across domains, almost all items were rated as somewhat/very relevant (PF 87-100%; PI 87-100%; PSRA 84-100%) and question content and response options as somewhat/very easy to answer (PF 91%, PI 90%, PSRA 91%). Ratings were similar for fatigue except on one item (“How often were you too tired to take a bath or shower”) where 25% of respondents rated it “not at all relevant.” When asked how they select a response for pain and fatigue items, some (38% and 20%, respectively) thought of the intensity of symptoms, others (28% and 77%, respectively) thought of how the symptom impacted physical and role function, and the rest (34% and 33%, respectively) considered both intensity and function.

Conclusion: Almost all participants rated Physical Function, Pain Interference, Fatigue, and Participation in Social Roles and Activities SFs as relevant to their experience with RA and easy to answer. These results contribute new evidence of construct and content validation and the meaningfulness of scores in people with RA supporting use of these PROMIS SFs in research and clinical applications. Funding PCORI IP2-PI0000737 and SC14-1402-10818.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/promis-short-forms-are-relevant-to-people-living-with-ra-results-of-cognitive-debriefing-interviews/