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Abstract Number: 2041

Validity and Reliability of Patient Reported Outcomes Measurement Information System (PROMIS®) Global Health Short Form in Patients with SLE

Shanthini Kasturi1, Jayme C. Burket2, Jessica Berman1, Kyriakos A. Kirou1, Alana B. Levine1, Lisa R. Sammaritano1 and Lisa Mandl1, 1Rheumatology, Hospital for Special Surgery, New York, NY, 2Healthcare Research Institute, Hospital for Special Surgery, New York, NY

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: patient outcomes, PROMIS, Quality of care and systemic lupus erythematosus (SLE)

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Session Information

Date: Monday, November 14, 2016

Title: Quality Measures and Quality of Care I

Session Type: ACR Concurrent Abstract Session

Session Time: 4:30PM-6:00PM

Background/Purpose: The measurement of patient reported outcomes (PROs) is a growing priority for performance improvement in clinical care of chronic conditions such as SLE. Measuring PROs at the point of care requires validated instruments with minimal responder burden. PROMIS¨ Global Health Short Form (GHSF) is a 10 question generic PRO instrument measuring global physical and mental health domains with T-scores normalized to the general population (mean score = 50). The validity and reliability of the PROMIS GHSF have not been demonstrated in SLE. The aims of this study were to evaluate: 1) validity and 2) test-retest reliability of PROMIS GHSF in adults with SLE.

Methods: Adult outpatients meeting 1997 ACR SLE classification criteria were recruited from a SLE Center of Excellence. Subjects completed the SF-36, LupusQoL-US, selected PROMIS CATs, and PROMIS GHSF. PROMIS GHSF global physical and mental health scores were compared with PROMIS CATs and legacy instruments using Spearman correlations. Test-retest reliability was evaluated among subjects reporting stable SLE activity at two assessments a week apart using intraclass correlation coefficients (ICC).

Results: PROMIS GHSF demonstrated face validity with SLE patients scoring worse than the general population in global physical health (mean T-score 41.6 +/- SD 8.8; range 19.9 – 67.7) and global mental health (mean T-score 43.7 +/- SD 8.7; range 25.1 – 67.6). PROMIS GHSF physical health scores correlated strongly with physical function, pain, and social health domains in the PROMIS CATs, SF-36, and LupusQoL, while PROMIS GHSF mental health scores correlated strongly with the PROMIS depression CAT and the LupusQoL emotional health domain (table 1). Correlation between PROMIS GHSF physical health and the SF-36 physical component scores (PCS) was weak, while correlation between PROMIS GHSF mental health and the SF-36 mental component scores (MCS) was moderate (table 1). Test-retest reliability for both PROMIS GHSF physical and mental health scores was high with ICCs of 0.89 and 0.85 respectively. Median time to complete the short form was less than 2 minutes.

Conclusion: This study is the first to demonstrate the validity and reliability of PROMIS GHSF in adults with SLE. PROMIS GHSF can be used to quickly, accurately, and reliably screen for impaired physical function, pain, and depression and could be an important tool in the measurement of patient centered outcomes and improvement of quality of care in SLE.

Table 1. Spearman Correlations of PROMIS GHSF with PROMIS CATs, SF-36, and LupusQoL

PROMIS Global Physical Health (n = 199) PROMIS Global Mental Health (n = 187)
PROMIS CATs
Physical Function 0.77 0.54
Mobility 0.75 0.49
Pain Behavior -0.71 -0.59
Pain Interference -0.80 -0.59
Fatigue -0.65 -0.60
Anger -0.42 -0.57
Anxiety -0.41 -0.61
Depression -0.48 –0.73
Ability to Participate in Social Roles 0.74 0.65
Satisfaction with Participation in Social Roles 0.61 0.59
Sleep-Related Interference -0.51 -0.52
Sleep Disturbance -0.53 -0.52
Applied Cognition-Abilities 0.52 0.59
Applied Cognition-Concerns -0.55 -0.63
SF-36
Physical Function 0.75 0.46
Role Physical 0.61 0.46
PCS 0.34 0.08* (p = 0.25)
Mental Health 0.17* (p = 0.014) 0.23* (p = 0.002)
Role Emotional 0.50 0.61
MCS 0.52 0.68
Bodily Pain -0.80 -0.55
Social Function 0.70 0.66
Vitality 0.53 0.54
Global Health -0.38 -0.27
LupusQoL
Physical Health 0.77 0.59
Emotional Health 0.52 0.70
Pain 0.74 0.56
Fatigue 0.62 0.62
Planning 0.69 0.62
Intimate Relations 0.53 0.46
Burden to Others 0.52 0.53
Body Image 0.35 0.46
Correlations > 0.7 are considered strong. All p-values are < 0.0001, except where indicated by *.

Disclosure: S. Kasturi, None; J. C. Burket, None; J. Berman, None; K. A. Kirou, None; A. B. Levine, None; L. R. Sammaritano, None; L. Mandl, None.

To cite this abstract in AMA style:

Kasturi S, Burket JC, Berman J, Kirou KA, Levine AB, Sammaritano LR, Mandl L. Validity and Reliability of Patient Reported Outcomes Measurement Information System (PROMIS®) Global Health Short Form in Patients with SLE [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/validity-and-reliability-of-patient-reported-outcomes-measurement-information-system-promis-global-health-short-form-in-patients-with-sle/. Accessed .
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