Enhancing Interpretability of Patient Reported Outcome Measurement Information System (PROMIS) and Related Measures in Rehabilitation Populations: A Systematic Review of Clinical and Research Applications.
To evaluate and synthesize interpretability metrics, including minimal important change (MIC), minimal important difference (MID), and minimal detectable change (MDC), across PROMIS and related systems (Neuro-QoL, TBI-QoL, SCI-QoL) in rehabilitation populations.
Comprehensive searches of electronic databases (MEDLINE, EMBASE, PsycINFO, HaPI, CINAHL, Cochrane Library, Web of Science) and clinical trial registries (ISRCTN Registry, ClinicalTrials.gov) were conducted from inception through March 23, 2024, in consultation with an information specialist.
Eligible studies assessed interpretability metrics in rehabilitation populations using PROMIS, Neuro-QoL, TBI-QoL, or SCI-QoL. Studies of pediatric or non-rehabilitation populations, abstracts, posters, or consensus statements were excluded. A total of 202 studies met inclusion criteria.
Two independent reviewers extracted study characteristics, interpretability metrics, and analytic methods following COnsensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines.
MIC, MID, and MDC values varied widely across populations and domains. PROMIS mental health domains (e.g., depression, anxiety, fatigue) demonstrated relatively consistent estimates, whereas physical function domains were more variable, particularly in chronic and geriatric groups. PROMIS Computer Adaptive Testing (CAT) measures showed fewer floor and ceiling effects than short forms, indicating enhanced sensitivity to change. Limited data were available for SCI-QoL and TBI-QoL.
Standardizing interpretability metrics and expanding research on SCI-QoL and TBI-QoL are critical to improving the clinical utility of these measures in rehabilitation. Future work should incorporate response-shift considerations and establish population-specific cut-points to support patient-centered care and evidence-based practice.
Comprehensive searches of electronic databases (MEDLINE, EMBASE, PsycINFO, HaPI, CINAHL, Cochrane Library, Web of Science) and clinical trial registries (ISRCTN Registry, ClinicalTrials.gov) were conducted from inception through March 23, 2024, in consultation with an information specialist.
Eligible studies assessed interpretability metrics in rehabilitation populations using PROMIS, Neuro-QoL, TBI-QoL, or SCI-QoL. Studies of pediatric or non-rehabilitation populations, abstracts, posters, or consensus statements were excluded. A total of 202 studies met inclusion criteria.
Two independent reviewers extracted study characteristics, interpretability metrics, and analytic methods following COnsensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines.
MIC, MID, and MDC values varied widely across populations and domains. PROMIS mental health domains (e.g., depression, anxiety, fatigue) demonstrated relatively consistent estimates, whereas physical function domains were more variable, particularly in chronic and geriatric groups. PROMIS Computer Adaptive Testing (CAT) measures showed fewer floor and ceiling effects than short forms, indicating enhanced sensitivity to change. Limited data were available for SCI-QoL and TBI-QoL.
Standardizing interpretability metrics and expanding research on SCI-QoL and TBI-QoL are critical to improving the clinical utility of these measures in rehabilitation. Future work should incorporate response-shift considerations and establish population-specific cut-points to support patient-centered care and evidence-based practice.
Authors
Alhasani Alhasani, Ataman Ataman, Nafees Nafees, Luong Luong, Auneau-Enjalber Auneau-Enjalber, Quigley Quigley, Michael Michael, Ahmed Ahmed
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