Reducing survey burden: feasibility and validity of PROMIS measures in multiple sclerosis

Mult Scler. 2014 Jul;20(8):1102-11. doi: 10.1177/1352458513517279. Epub 2014 Jan 8.


Background: Patient-reported outcomes are important for clinical research and care, yet administering and scoring the questionnaires requires considerable effort and time. The Patient Reported Outcomes Measurement Information System (PROMIS) could considerably reduce administrative obstacles and lessen survey burden for participants.

Objective: Assess the feasibility and validity of PROMIS, compared to commonly-used legacy measures for multiple sclerosis (MS).

Methods: In this cross-sectional survey, 133 participants with confirmed MS completed legacy surveys and PROMIS Computerized Adaptive Tests (CATs) for depression, anxiety, pain, fatigue and physical function. We conducted a multi-trait, multi-method analysis and verified results with confirmatory factor analysis.

Results: The correlations between PROMIS and the corresponding legacy measures were large (0.67 to 0.87). The multi-trait, multi-method criteria were generally well met, providing good evidence of the validity of PROMIS measures. PROMIS surveys asked fewer questions and required substantially less time to complete than the legacy scales.

Conclusions: Our results provide evidence of the construct validity of PROMIS for use with MS patients. Several aspects of the PROMIS CATs made them an important resource, including: (a) less time was required to complete them; (b) missing data was reduced; and (c) the automatic scoring referenced the general population. Our findings support the use of PROMIS in MS research and may have broader implications for clinical care, as well.

Keywords: Computerized Adaptive Test; PROMIS; multiple sclerosis; outcome measurement; self-reporting; survey design; validation.

Publication types

  • Comparative Study
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Anxiety / diagnosis
  • Anxiety / psychology
  • Cross-Sectional Studies
  • Depression / diagnosis
  • Depression / psychology
  • Feasibility Studies
  • Female
  • Health Care Surveys
  • Health Status
  • Humans
  • Male
  • Mental Health
  • Middle Aged
  • Multiple Sclerosis / diagnosis*
  • Multiple Sclerosis / physiopathology
  • Multiple Sclerosis / psychology
  • Multiple Sclerosis / therapy
  • Pain / diagnosis
  • Pain / psychology
  • Pain Measurement
  • Patient Reported Outcome Measures*
  • Predictive Value of Tests
  • Reproducibility of Results
  • Time Factors
  • Workflow