Testing measurement invariance of the patient-reported outcomes measurement information system pain behaviors score between the US general population sample and a sample of individuals with chronic pain

Qual Life Res. 2014 Feb;23(1):239-44. doi: 10.1007/s11136-013-0463-0. Epub 2013 Jul 4.


Purpose: In order to test the difference between group means, the construct measured must have the same meaning for all groups under investigation. This study examined the measurement invariance of responses to the patient-reported outcomes measurement information system (PROMIS) pain behavior (PB) item bank in two samples: the PROMIS calibration sample (Wave 1, N = 426) and a sample recruited from the American Chronic Pain Association (ACPA, N = 750). The ACPA data were collected to increase the number of participants with higher levels of pain.

Methods: Multi-group confirmatory factor analysis (MG-CFA) and two item response theory (IRT)-based differential item functioning (DIF) approaches were employed to evaluate the existence of measurement invariance.

Results: MG-CFA results supported metric invariance of the PROMIS-PB, indicating unstandardized factor loadings with equal across samples. DIF analyses revealed that impact of 6 DIF items was negligible.

Conclusions: Based on the results of both MG-CFA and IRT-based DIF approaches, we recommend retaining the original parameter estimates obtained from the combined samples based on the results of MG-CFA.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Chronic Pain / ethnology
  • Chronic Pain / psychology*
  • Discrimination, Psychological
  • Factor Analysis, Statistical
  • Female
  • Health Status Indicators*
  • Humans
  • Information Systems
  • Logistic Models
  • Male
  • Outcome Assessment, Health Care*
  • Pain Measurement
  • Population Surveillance
  • Psychometrics* / methods
  • Quality of Life
  • Self Report*
  • United States
  • Young Adult