Assessment of Patient-Reported Physical Function in Persons With Upper Extremity Amputation: Comparison of Short Form Instruments

Am J Phys Med Rehabil. 2023 Feb 1;102(2):120-129. doi: 10.1097/PHM.0000000000002044. Epub 2022 Jun 11.

Abstract

Objective: The aim of the study was to compare psychometric properties of the Patient-Reported Outcomes Measurement Information System upper extremity measure (PROMIS UE) 7-item short form with 6- and 13-item versions for persons with upper limb amputation.

Design: The study used a telephone survey of 681 persons with upper limb amputation. Versions were scored two ways: PROMIS health measure scoring (PROMIS UE HMSS) and sample-specific calibration (PROMIS UE AMP). Factor analyses and Rasch analyses evaluated unidimensionality, monotonicity, item fit, differential item functioning, and reliability. Known group validity was compared for all versions.

Results: Model fit was acceptable for PROMIS-6 UE AMP and marginally acceptable for PROMIS-13 UE AMP and PROMIS-7 UE AMP. Item response categories were collapsed because of disordered categories. A total of 91.4% of participants had PROMIS-13 UE AMP scores with reliability greater than 0.8, compared with 70.4% for PROMIS-7 UE AMP, and 72.1% for PROMIS-6 UE AMP versions. No differences were observed by prosthesis use. Scores differed by amputation for all measures except the HMSS scored 13- and 7-item versions.

Conclusions: The PROMIS-13 UE AMP short form was superior to the health measures scoring system scored PROMIS-7 UE or PROMIS-6 UE, and to the PROMIS-7 UE AMP and PROMIS-6 UE AMP. Issues with known group validation suggest a need for a population-specific measure of upper extremity function for persons with upper limb amputation.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Amputation, Surgical
  • Humans
  • Patient Reported Outcome Measures*
  • Psychometrics
  • Reproducibility of Results
  • Upper Extremity* / surgery