Use of PROMIS-29® in US Veterans: Diagnostic Concordance and Domain Comparisons with the General Population

Sherri L LaVela*, Bella Etingen, Scott Miskevics, David Cella

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background: PROMIS® items have not been widely or systematically used within the Veterans Health Administration (VA). Objective: To examine the concordance of PROMIS-29® scores and medical record diagnosis in US Veterans and to compare Veteran scores relative to US population norms. Design/Participants: Cross-sectional multi-site survey of Veterans (n = 3221) provided sociodemographic and PROMIS-29® domain data. Electronic medical records provided health condition (depression, anxiety, sleep disorders, pain disorders) diagnosis data. Main Measures: For each domain, we calculated PROMIS® standardized T scores and used t tests to compare PROMIS® scores for Veterans diagnosed with each targeted health condition vs. those without that documented clinical diagnosis and compare mean Veterans’ PROMIS-29® with US adult population norms. Key Results: Veterans with (vs. without) a depression diagnosis reported significantly higher PROMIS® depression scores (60.3 vs. 49.6, p <.0001); those with an anxiety diagnosis (vs. without) reported higher average PROMIS® anxiety scores (62.7 vs. 50.9, p <.0001). Veterans with (vs. without) a pain disorder reported higher pain interference (65.3 vs. 57.7, p <.0001) and pain intensity (6.4 vs. 4.4, p <.0001). Veterans with (vs. without) a sleep disorder reported higher sleep disturbance (55.8 vs. 51.2, p <.0001) and fatigue (57.5 vs. 51.8, p <.0001) PROMIS® scores. Compared with the general population norms, Veterans scored worse across all PROMIS-29® domains. Conclusions: We found that PROMIS-29® domains are selectively sensitive to expected differences between clinically-defined groups, suggesting their appropriateness as indicators of condition symptomology among Veterans. Notably, Veterans scored worse across all PROMIS-29(R) domains compared with population norms. Taken collectively, our findings suggest that PROMIS-29® may be a useful tool for VA providers to assess patient’s physical and mental health, and because PROMIS® items are normed to the general population, this offers a way to compare the health of Veterans with the adult population at large and identify disparate areas for intervention.

Original languageEnglish (US)
Pages (from-to)1452-1458
Number of pages7
JournalJournal of general internal medicine
Volume34
Issue number8
DOIs
StatePublished - Aug 15 2019

Fingerprint

Veterans
Population
Veterans Health
United States Department of Veterans Affairs
Somatoform Disorders
Depression
Anxiety
Pain
Electronic Health Records
Health
Anxiety Disorders
Medical Records
Fatigue
Mental Health
Sleep

Keywords

  • PROMIS
  • Veterans
  • health-related quality of life
  • mental health
  • patient-reported outcomes
  • physical health
  • social role

ASJC Scopus subject areas

  • Internal Medicine

Cite this

@article{d70e05b8446646ac865efd95353e1934,
title = "Use of PROMIS-29{\circledR} in US Veterans: Diagnostic Concordance and Domain Comparisons with the General Population",
abstract = "Background: PROMIS{\circledR} items have not been widely or systematically used within the Veterans Health Administration (VA). Objective: To examine the concordance of PROMIS-29{\circledR} scores and medical record diagnosis in US Veterans and to compare Veteran scores relative to US population norms. Design/Participants: Cross-sectional multi-site survey of Veterans (n = 3221) provided sociodemographic and PROMIS-29{\circledR} domain data. Electronic medical records provided health condition (depression, anxiety, sleep disorders, pain disorders) diagnosis data. Main Measures: For each domain, we calculated PROMIS{\circledR} standardized T scores and used t tests to compare PROMIS{\circledR} scores for Veterans diagnosed with each targeted health condition vs. those without that documented clinical diagnosis and compare mean Veterans’ PROMIS-29{\circledR} with US adult population norms. Key Results: Veterans with (vs. without) a depression diagnosis reported significantly higher PROMIS{\circledR} depression scores (60.3 vs. 49.6, p <.0001); those with an anxiety diagnosis (vs. without) reported higher average PROMIS{\circledR} anxiety scores (62.7 vs. 50.9, p <.0001). Veterans with (vs. without) a pain disorder reported higher pain interference (65.3 vs. 57.7, p <.0001) and pain intensity (6.4 vs. 4.4, p <.0001). Veterans with (vs. without) a sleep disorder reported higher sleep disturbance (55.8 vs. 51.2, p <.0001) and fatigue (57.5 vs. 51.8, p <.0001) PROMIS{\circledR} scores. Compared with the general population norms, Veterans scored worse across all PROMIS-29{\circledR} domains. Conclusions: We found that PROMIS-29{\circledR} domains are selectively sensitive to expected differences between clinically-defined groups, suggesting their appropriateness as indicators of condition symptomology among Veterans. Notably, Veterans scored worse across all PROMIS-29(R) domains compared with population norms. Taken collectively, our findings suggest that PROMIS-29{\circledR} may be a useful tool for VA providers to assess patient’s physical and mental health, and because PROMIS{\circledR} items are normed to the general population, this offers a way to compare the health of Veterans with the adult population at large and identify disparate areas for intervention.",
keywords = "PROMIS, Veterans, health-related quality of life, mental health, patient-reported outcomes, physical health, social role",
author = "LaVela, {Sherri L} and Bella Etingen and Scott Miskevics and David Cella",
year = "2019",
month = "8",
day = "15",
doi = "10.1007/s11606-019-05011-9",
language = "English (US)",
volume = "34",
pages = "1452--1458",
journal = "Journal of General Internal Medicine",
issn = "0884-8734",
publisher = "Springer New York",
number = "8",

}

Use of PROMIS-29® in US Veterans : Diagnostic Concordance and Domain Comparisons with the General Population. / LaVela, Sherri L; Etingen, Bella; Miskevics, Scott; Cella, David.

In: Journal of general internal medicine, Vol. 34, No. 8, 15.08.2019, p. 1452-1458.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Use of PROMIS-29® in US Veterans

T2 - Diagnostic Concordance and Domain Comparisons with the General Population

AU - LaVela, Sherri L

AU - Etingen, Bella

AU - Miskevics, Scott

AU - Cella, David

PY - 2019/8/15

Y1 - 2019/8/15

N2 - Background: PROMIS® items have not been widely or systematically used within the Veterans Health Administration (VA). Objective: To examine the concordance of PROMIS-29® scores and medical record diagnosis in US Veterans and to compare Veteran scores relative to US population norms. Design/Participants: Cross-sectional multi-site survey of Veterans (n = 3221) provided sociodemographic and PROMIS-29® domain data. Electronic medical records provided health condition (depression, anxiety, sleep disorders, pain disorders) diagnosis data. Main Measures: For each domain, we calculated PROMIS® standardized T scores and used t tests to compare PROMIS® scores for Veterans diagnosed with each targeted health condition vs. those without that documented clinical diagnosis and compare mean Veterans’ PROMIS-29® with US adult population norms. Key Results: Veterans with (vs. without) a depression diagnosis reported significantly higher PROMIS® depression scores (60.3 vs. 49.6, p <.0001); those with an anxiety diagnosis (vs. without) reported higher average PROMIS® anxiety scores (62.7 vs. 50.9, p <.0001). Veterans with (vs. without) a pain disorder reported higher pain interference (65.3 vs. 57.7, p <.0001) and pain intensity (6.4 vs. 4.4, p <.0001). Veterans with (vs. without) a sleep disorder reported higher sleep disturbance (55.8 vs. 51.2, p <.0001) and fatigue (57.5 vs. 51.8, p <.0001) PROMIS® scores. Compared with the general population norms, Veterans scored worse across all PROMIS-29® domains. Conclusions: We found that PROMIS-29® domains are selectively sensitive to expected differences between clinically-defined groups, suggesting their appropriateness as indicators of condition symptomology among Veterans. Notably, Veterans scored worse across all PROMIS-29(R) domains compared with population norms. Taken collectively, our findings suggest that PROMIS-29® may be a useful tool for VA providers to assess patient’s physical and mental health, and because PROMIS® items are normed to the general population, this offers a way to compare the health of Veterans with the adult population at large and identify disparate areas for intervention.

AB - Background: PROMIS® items have not been widely or systematically used within the Veterans Health Administration (VA). Objective: To examine the concordance of PROMIS-29® scores and medical record diagnosis in US Veterans and to compare Veteran scores relative to US population norms. Design/Participants: Cross-sectional multi-site survey of Veterans (n = 3221) provided sociodemographic and PROMIS-29® domain data. Electronic medical records provided health condition (depression, anxiety, sleep disorders, pain disorders) diagnosis data. Main Measures: For each domain, we calculated PROMIS® standardized T scores and used t tests to compare PROMIS® scores for Veterans diagnosed with each targeted health condition vs. those without that documented clinical diagnosis and compare mean Veterans’ PROMIS-29® with US adult population norms. Key Results: Veterans with (vs. without) a depression diagnosis reported significantly higher PROMIS® depression scores (60.3 vs. 49.6, p <.0001); those with an anxiety diagnosis (vs. without) reported higher average PROMIS® anxiety scores (62.7 vs. 50.9, p <.0001). Veterans with (vs. without) a pain disorder reported higher pain interference (65.3 vs. 57.7, p <.0001) and pain intensity (6.4 vs. 4.4, p <.0001). Veterans with (vs. without) a sleep disorder reported higher sleep disturbance (55.8 vs. 51.2, p <.0001) and fatigue (57.5 vs. 51.8, p <.0001) PROMIS® scores. Compared with the general population norms, Veterans scored worse across all PROMIS-29® domains. Conclusions: We found that PROMIS-29® domains are selectively sensitive to expected differences between clinically-defined groups, suggesting their appropriateness as indicators of condition symptomology among Veterans. Notably, Veterans scored worse across all PROMIS-29(R) domains compared with population norms. Taken collectively, our findings suggest that PROMIS-29® may be a useful tool for VA providers to assess patient’s physical and mental health, and because PROMIS® items are normed to the general population, this offers a way to compare the health of Veterans with the adult population at large and identify disparate areas for intervention.

KW - PROMIS

KW - Veterans

KW - health-related quality of life

KW - mental health

KW - patient-reported outcomes

KW - physical health

KW - social role

UR - http://www.scopus.com/inward/record.url?scp=85066790851&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85066790851&partnerID=8YFLogxK

U2 - 10.1007/s11606-019-05011-9

DO - 10.1007/s11606-019-05011-9

M3 - Article

C2 - 31144276

AN - SCOPUS:85066790851

VL - 34

SP - 1452

EP - 1458

JO - Journal of General Internal Medicine

JF - Journal of General Internal Medicine

SN - 0884-8734

IS - 8

ER -