Two-item PROMIS® global physical and mental health scales
Two-item PROMIS® global physical and mental health scales
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DOI：
10.1186/s41687-017-0003-8
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发表时间：
2017-01-01
影响因子：
2.7
通讯作者：
Cella, David
中科院分区：
文献类型：
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作者：
Hays, Ron D.;Schalet, Benjamin D.;Cella, David
背景：健康自我报告提供了关于功能和健康的有用信息，可以改善患者和临床医生之间的沟通。全球健康项目提供预测医疗保健利用和死亡率的摘要信息。有必要编制简洁的全球健康量表，用于大样本调查。本研究评估了患者报告结果测量和信息系统（PROMIS (R)）项目中全球身体健康和心理健康简要测量的可靠性和有效性。方法：PROMIS开发样本共21,133人，其中女性52%；白人82%，黑人9%，西班牙裔9%；平均年龄50岁。我们确定了两个整体身体健康项目（GPH-2）和两个整体心理健康项目（GMH-2）具有最高的判别参数，并将其信度和结构效度与原始的4项量表（GPH-4和GMH-4）和单个整体健康项目（Global01）进行了比较。结果：GPH-2的内部一致性信度为0.73 (GPH-4为0.81)，GMH-2为0.81 （GMH-4为0.86）。Global的边际信度为0.55，GPH-2为0.70，GPH-4为0.79，GMH-2为0.80，GMH-4为0.86。GPH-2与GPH-4的积矩相关系数为0.94，GMH-2与GMH-4的积矩相关系数为0.97。2项和4项量表与PROMIS域得分、EQ-5D-3L和合并症的相关性相似，但4项量表与这些指标的相关性更强。结论：在一项大型横断面人口调查中增加一个项目可能要花费高达10万美元。PROMIS全球健康量表的2项变体将国家调查的使用成本降低了50%，节省了大量成本。这些较短的量表在临床实践中也更实用。PROMIS全球健康量表的2项版本在群体比较中显示出足够的可靠性，其与其他健康指标的关联与最初的4项量表相似。较短的量表在心理计量学上是合理的，并减轻了调查管理的负担。
Background: Self-reports of health provide useful information about function and well-being that can improve communication between patients and clinicians. Global health items provide summary information that are predictive of health care utilization and mortality. There is a need for parsimonious global health scales for use in large sample surveys. This study evaluates the reliability and validity of brief measures of global physical health and mental health in the Patient Reported Outcomes Measurement and Information System (PROMIS (R)) project.Methods: A total of 21,133 persons included in the PROMIS development sample: 52% female; 82% White, 9% Black, 9% Hispanic; median age of 50 years. We identified two global physical health items (GPH-2) and two global mental health items (GMH-2) with highest discrimination parameters and compared their reliabilities and construct validity to that of the original 4-item scales (GPH-4 and GMH-4) and a single global health item (Global01).Results: Internal consistency reliability was 0.73 for the GPH-2 (versus 0.81 for the GPH-4) and 0.81 for the GMH-2 (versus 0.86 for the GMH-4). Marginal reliabilities were 0.55 for Global, 0.70 for GPH-2, 0.79 for GPH-4, 0.80 for GMH-2, and 0.86 for GMH-4. The product-moment correlation between the GPH-2 and GPH-4 was 0.94 and between GMH-2 and GMH-4 was 0.97. The 2-item and 4-item versions of the scales had similar correlations with PROMIS domain scores, the EQ-5D-3L and comorbidities, but the 4-item scales were more strongly correlated with these measures.Conclusions: Adding a single item to a large cross-sectional population survey can cost as much as $100,000. The 2-item variants of the PROMIS global health scales reduce the cost of use on national surveys by 50%, a substantial cost savings. These briefer scales are also more practical for use in clinical practice. The 2-item versions of the PROMIS global health scales display adequate reliability for group comparisons and their associations with other indicators of health are similar to that of the original 4-item scales. The briefer scales are psychometrically sound and reduce burden of survey administration.