Item banks for measuring emotional distress from the Patient-Reported Outcomes Measurement Information System (PROMIS®): depression, anxiety, and anger

Abstract

The authors report on the development and calibration of item banks for depression, anxiety, and anger as part of the Patient-Reported Outcomes Measurement Information System (PROMIS®). Comprehensive literature searches yielded an initial bank of 1,404 items from 305 instruments. After qualitative item analysis (including focus groups and cognitive interviewing), 168 items (56 for each construct) were written in a first person, past tense format with a 7-day time frame and five response options reflecting frequency. The calibration sample included nearly 15,000 respondents. Final banks of 28, 29, and 29 items were calibrated for depression, anxiety, and anger, respectively, using item response theory. Test information curves showed that the PROMIS item banks provided more information than conventional measures in a range of severity from approximately -1 to +3 standard deviations (with higher scores indicating greater distress). Short forms consisting of seven to eight items provided information comparable to legacy measures containing more items.

Figure 1

Flowchart illustrating the PROMIS methodology Note. PROMIS = Patient-Reported Outcomes Measurement Information System.

Figure 2

Test information curves for depression: Full bank, short form, and the CES-D Note. CES-D = Center for Epidemiologic Studies Depression Scale.

Figure 3

Test information curves for anxiety: Full bank, short form, and the general distress (anxiety) scale from the MASQ Note. MASQ = Mood and Anxiety Symptom Questionnaire.

Figure 4

Test information curves for anger: Full bank, short form, and the combined subscales for anger and verbal aggression from the AQ Note. AQ = Aggression Questionnaire.