PROMIS-Based Assessment of Pelvic Pain

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Multiple questionnaires exist for the assessment of pelvic pain. There is a need for a measurement system that is sufficiently sensitive to identify persons with these symptoms, conditions, or at risk for the development of these conditions with a brief-yet-precise, tailored to the individual and easy system to implement. A system that meets these needs is likely to be accepted and routinely used by clinicians and families. Such a measurement system should: include items that capture the unique aspects of specific disease/treatment effects; across the disease continuum; take into account developmental differences among age groups; and produce scores calibrated onto a common metric. One of the most flexible approaches for addressing these measurement issues is to develop screening tools based upon a comprehensive item bank which in turn can facilitate individualized computerized adaptive testing (CAT) and short-forms (e.g., age- or content-specific). The NIH Roadmap Patient-Reported Outcomes Measurement Information System (PROMIS) is developing HRQL item banks applicable across disease populations.50 As comprehensive as the PROMIS is, it does not fully address the needs of pelvic pain patients. To fill this need we propose to develop and validate a pelvic pain item bank (PPIB). The PPIB can provide a means for timely referral for patients in need, which may then lead to early intervention. The PPIB bank will be developed via the completion of the following aims: Aim 1: Generate an item pool for the pelvic pain population. We will develop this item pool by reviewing the current literature, existing measures, and an item library that we have built via several federally-funded projects. Toward ensuring content validity, items will be rigorously reviewed by clinicians and patients items may/will be added to ensure the comprehensiveness of the pool. Aim 2: Develop item bank(s) and determine their psychometric properties, a) Evaluate the essential unidimensionality of the PPIB item pool. Results of this aim will determine the number of item banks to be developed; b) Calibrate the item bank(s) using item response theory (IRT) models. We will evaluate item/model/person fit, compare item discrimination power, and graph information function at both the item and scale levels. Additionally, we will assess the item parameter stability by estimating differential item functioning (DIP) across various demographic and clinical conditions in a nationally representative sample population, c) Develop userfriendly short-forms for screening patients in a clinical setting. Aim 3: Validate the PPIB item bank(s) in relation to external clinical criteria; Aim 4: Calculate Prevalence of self-reported pelvic pain conditions.