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 language | English (US) |
|---|---|
| Pages (from-to) | 1452-1458 |
| Number of pages | 7 |
| Journal | Journal of general internal medicine |
| Volume | 34 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 15 2019 |
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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
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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 journal › Article
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 -