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J Rheumatol. 2018 Mar;45(3):397-404. doi: 10.3899/jrheum.170590. Epub 2018 Feb 1.

Feasibility, Validity, and Reliability of the 10-item Patient Reported Outcomes Measurement Information System Global Health Short Form in Outpatients with Systemic Lupus Erythematosus.

Author information

1
From the Division of Rheumatology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts; Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Weill Cornell Medicine, New York, New York, USA. skasturi@tuftsmedicalcenter.org.
2
S. Kasturi, MD, MS, Division of Rheumatology, Department of Medicine, Tufts Medical Center; J. Szymonifka, MA, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery; J.C. Burket, PhD, Healthcare Research Institute, Hospital for Special Surgery; J.R. Berman MD, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Weill Cornell Medicine; K.A. Kirou, MD, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Weill Cornell Medicine; A.B. Levine, MD, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Weill Cornell Medicine; L.R. Sammaritano, MD, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Weill Cornell Medicine; and L.A. Mandl, MD, MPH, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Weill Cornell Medicine. skasturi@tuftsmedicalcenter.org.
3
From the Division of Rheumatology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts; Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Weill Cornell Medicine, New York, New York, USA.
4
S. Kasturi, MD, MS, Division of Rheumatology, Department of Medicine, Tufts Medical Center; J. Szymonifka, MA, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery; J.C. Burket, PhD, Healthcare Research Institute, Hospital for Special Surgery; J.R. Berman MD, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Weill Cornell Medicine; K.A. Kirou, MD, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Weill Cornell Medicine; A.B. Levine, MD, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Weill Cornell Medicine; L.R. Sammaritano, MD, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Weill Cornell Medicine; and L.A. Mandl, MD, MPH, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Weill Cornell Medicine.

Abstract

OBJECTIVE:

To assess the feasibility, validity, and reliability of the Patient Reported Outcomes Measurement Information System Global Health Short Form (PROMIS10) in outpatients with systemic lupus erythematosus (SLE).

METHODS:

SLE outpatients completed PROMIS10, Medical Outcomes Study Short Form-36 (SF-36), LupusQoL-US, and selected PROMIS computerized adaptive tests (CAT) at routine visits at an SLE Center of Excellence. Construct validity was evaluated by correlating PROMIS10 physical and mental health scores with PROMIS CAT, legacy instruments, and physician-derived measures of disease activity and damage. Test-retest reliability was determined among subjects reporting stable SLE activity at 2 assessments 1 week apart using intraclass correlation coefficients (ICC).

RESULTS:

A diverse cohort of 204 out of 238 patients with SLE (86%) completed survey instruments. PROMIS10 physical health scores strongly correlated with physical function, pain, and social health domains in PROMIS CAT, SF-36, and LupusQoL, while mental health scores strongly correlated with PROMIS depression CAT, SF-36, and LupusQoL mental health domains (Spearman correlations ≥ 0.70). Active arthritis, comorbid fibromyalgia (FM), and anxiety were associated with worse PROMIS10 scores, but sociodemographic factors and physician-assessed flare status were not. Test-retest reliability for PROMIS10 physical and mental health scores was high (ICC ≥ 0.85). PROMIS10 required < 2 minutes to complete.

CONCLUSION:

PROMIS10 is valid and reliable, and can efficiently screen for impaired physical function, pain, and emotional distress in outpatients with SLE. With strong correlations to LupusQoL and SF-36 but significantly reduced responder burden, PROMIS10 is a promising tool for measuring patient-reported outcomes in routine SLE clinical care and value-based healthcare initiatives.

KEYWORDS:

PATIENT OUTCOME ASSESSMENT; QUALITY OF LIFE; SYSTEMIC LUPUS ERYTHEMATOSUS; VALIDATION STUDY

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