promis outcome measures for yoga research · at the conclusion of this presentation, participants...
TRANSCRIPT
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PROMIS® Outcome Measures for Yoga Research
Alyson Ross PhD, RN
Nurse Researcher
Nursing Research and Translational Science
Nursing Department, National Institutes of Health
Clinical Center
Disclaimer: I have no conflicts of interest to report.
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Objectives
At the conclusion of this presentation,
participants will be able:
• To describe electronic PRO systems such a Patient-Reported Outcome Measurement Information System (PROMIS)
• To discuss the incorporation of patient reported outcomes (PRO) in yoga therapy
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Background
Yoga Therapy in the community
• Cross-sectional survey of 1,000+ IYNAUS
teachers
• 100% (n = 471) report modifying poses for
injuries, health conditions, or symptoms
• 57.3% do not keep any records/assessments
except attendance
• 84% assess effectiveness by “asking students”
• <2% utilize a standardized/validated
questionnaire to assess effectiveness
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What is a standardized/validated Patient Reported Outcome (PRO) measure? Validity and Reliability
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Why is it important to assess PROs
•Providers underestimate symptoms and overestimate function & quality of life
• Quantify change - worse, getting better, or staying about the same?
• Patients want to know how others feel while taking a new therapy.
Hendricks & Schouten, Euro J Int Med, 2002, Pakhomov et al., Am J Manag Care, 2008, Basch et al., J Natl Canc Inst, 2009
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Traditional Challenges Of Questionnaires
• Multiple measures of same health concept
• Quality varies
• Difficult to compare and combine data
. . . across studies
. . . across conditions
• Long and Complex
– Collecting, Storing and Scoring
• Limited use for practitioners in the
real world
Garcia, S.F. et al., J Clin Oncol, 2007, Guyatt et al., Mayo Clin Proc, 2007
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PROMIS ® : Patient-Reported Outcome Measurement Information System
A NIH Road Map Initiative
In September 2004, the NIH initiated a multicenter cooperative
group to develop a number of measurement initiatives including:
– NIH toolbox
– Neuro-QOL
– PROMIS
Goal: To develop psychometrically sound measures that:
– Are available at low or no cost.
– Utilized modern test development theory to develop
measures
– Improved measurement quality and precision
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Psycho-
metric
Testing
Item Bank (Items reviewed, analyzed, and refined)
0.0
0.5
1.0
1.5
2.0
2.5
-3 -2 -1 0 1 2 3
Theta
In
fo
rm
atio
n
0.0
0.2
0.4
0.6
0.8
1.0
-3 -2 -1 0 1 2 3
Theta
Pro
bab
ility o
f R
esp
onse
Short Form
Instruments
CAT
Items from
Instrument
A
Item Pool
Items from
Instrument
B
Items from
Instrument
C
New
Items
Tested General and
Clinical Populations
Cognitive
Interviews
Focus
Groups
Content Expert
Review
Cella, D., Yount, S., Rothrock, N., Gershon, R., Cook, K., Reeve, B., Rose, M. (2007)
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Domain Framework: Adult
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Value of PROMIS ®: Comparability
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PROMIS ®: Brief, flexible, inclusive & free
Short Form: Fatigue
Short Form: Emotional Distress – Depression
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PROMIS®
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Researcher Login Page
http://www.assessmentcenter.net/
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https://www.assessmentcenter.net/documents/InstrumentLibrary.pdf
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OUTPUT FROM PROMIS®
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Questions?
Alyson Ross PhD, RN
Nurse Researcher
Nursing Research and Translational Science
Nursing Department, National Institutes of Health
Clinical Center