Item banks for alcohol use from the Patient-Reported Outcomes Measurement Information System (PROMIS®): Use, consequences, and expectancies
Introduction
The Patient-Reported Outcomes Measurement Information System (PROMIS®) is an NIH Roadmap initiative designed to improve self-reported outcomes using state-of-the-art psychometric methods (for detailed information, see http://www.nihpromis.org/). PROMIS has developed and calibrated item banks assessing physical, mental, and social health, consistent with the World Health Organization's tripartite framework (Cella et al., 2007). For example, there are item banks assessing physical functioning, pain, fatigue, sleep disturbance, emotional distress (depression, anxiety, and anger), and social participation, providing a comprehensive profile of health status (Buysse et al., 2010, Cella et al., 2007, Cella et al., 2010, Fries et al., 2009, Pilkonis et al., 2011, Revicki et al., 2009). PROMIS is the most ambitious attempt to date to apply models from item response theory (IRT) to health-related assessment. The PROMIS methodology involves iterative steps of comprehensive literature searches; item pooling; development of conceptual frameworks; qualitative assessment of items using expert review, focus groups, and cognitive interviewing; and quantitative evaluation of items using techniques from both classical test theory (CTT) and IRT (Cella et al., 2007, Cella et al., 2010, Hilton, 2011, Reeve et al., 2007). We report here on the development and calibration of five item banks capturing prominent aspects of alcohol use (consumption, craving, efforts at control, internal and external triggers for drinking), negative and positive consequences of alcohol use, and negative and positive expectancies regarding drinking.
There is informative previous work using IRT models for the scaling and calibration of criteria for substance abuse and dependence, including those for alcohol (Krueger et al., 2004, Langenbucher et al., 2004, Martin et al., 2006, Saha et al., 2006). These criteria are sufficiently unidimensional for calibration with IRT models, but they are high-threshold items most appropriate for clinical samples. The use of such items results in “tests” with narrow bandwidth relevant only at the severe end of the continuum of alcohol use and consequences. From a psychometric perspective, our goal was to identify items that were more normally distributed and less positively skewed in a sample that included both members of the general population who used alcohol as well as alcohol abusers. Such items will provide more information across a broader range of the continuum of alcohol use, and for this reason, they will constitute more sensitive measures of treatment outcome and result in a single metric that could be used across treatment, observational, and epidemiological settings. Thus, we were interested in alcohol use not only at the level of clinical disorders but also at lower levels of consumption, where alcohol use may still be an important health-related behavior (or risk factor) relevant to a wide range of medical and psychiatric conditions.
Section snippets
Comprehensive literature searches
The Pittsburgh PROMIS research site developed a methodology for performing comprehensive literature searches to ensure content validity and broad coverage of the alcohol domain. We performed searches in the MEDLINE, PsycINFO, and Health and Psychosocial Instruments (HaPI) databases. Details of the methodology are reported in Klem et al. (2009), and all search algorithms are available upon request. The searches generated 785 abstracts that could be linked to more than 200 unique measures of
Alcohol, drug, and tobacco use in the two samples
The most stable estimates of alcohol use came from the NIAAA questions for the past 12 months (2003), given that shorter term patterns of drinking were influenced by the recent decision to seek treatment among members of the clinical sample. Table 2 summarizes these data. Frequency of drinking did not distinguish the community and clinical samples, with “once a week” being the median for both groups over the past year. (In this context, please note that members of the clinical sample sought
Discussion
Compared with existing alcohol use instruments (which typically cover the higher end of the severity spectrum, 1–2 SDs above the mean), the PROMIS item bank for alcohol use provides more information in a range from −1 to +3 SDs among people who have had some exposure to alcohol in the past month. The item banks for negative and positive consequences and negative and positive expectancies also provide broad coverage of these constructs. The item banks for use and consequences (both positive and
Role of funding source
The Patient-Reported Outcomes Measurement Information System (PROMIS®) is a National Institutes of Health (NIH) Roadmap initiative to develop a computerized system measuring patient-reported outcomes in respondents with a wide range of chronic diseases and demographic characteristics. PROMIS was funded initially by cooperative agreements to a Statistical Coordinating Center (Evanston Northwestern Healthcare, PI: David Cella, PhD, U01AR52177) and six Primary Research Sites (Duke University, PI:
Contributors
Paul A. Pilkonis, PhD, contributed to study conception and design and took responsibility for drafting the manuscript. Lan Yu, PhD, provided data analysis and interpretation. Jason B. Colditz, BS, Nathan Dodds, BS, Kelly L. Johnston, MPH, Catherine Maihoefer, MS, LSW, Angela M. Stover, MA, Dennis C. Daley, PhD, and Dennis McCarty, PhD, contributed to study implementation (literature reviews, conceptual organization of items, item and intellectual property reviews) and data collection (focus
Conflict of interest
No conflict declared.
Acknowledgements
We acknowledge the work of our colleagues within the two research nodes (the Tri-State Appalachian node and the Western States node) affiliated with the NIDA Clinical Trials Network that collaborated in this work. Dennis Daley, PhD, is the principal investigator of the Tri-State Appalachian node, and clinical data from this node were collected in Pittsburgh, PA, where we are grateful for the help of Dorothy Sandstrom, MS, and Janis McDonald. Dennis McCarty, PhD, is the principal investigator of
References (46)
- et al.
Alcohol expectancies: integrating cognitive science and psychometric approaches
Addict. Behav.
(2003) - et al.
The patient-reported outcomes measurement information system (PROMIS) developed and tested its first wave of adult self-reported health outcome item bank: 2005–2008
J. Clin. Epidemiol.
(2010) - et al.
The latent structure of alcohol use pathology in an epidemiological sample
J. Psychiatr. Res.
(2011) - et al.
Development and psychometric analysis of the PROMIS pain behavior item bank
Pain
(2009) - et al.
The role of alcohol consumption in future classification of alcohol use disorders
Drug Alcohol Depend.
(2007) Scales, norms and equivalent scores
- et al.
Intellectual property considerations in the development and use of HRQL measures for clinical trial research
Qual. Life Res.
(1994) - et al.
Development and validation of patient-reported outcome measures for sleep disturbance and sleep-related impairments
Slee
(2010) - et al.
Content validity in the PROMIS social health domain: a qualitative analysis of focus group data
Qual. Life Res.
(2008) - et al.
The future of outcomes measurement: item banking, tailored short forms, and computerized adaptive assessment
Qual. Life Res.
(2007)
Firestar: computerized adaptive testing simulation program for polytomous item response theory models
Appl. Psychol. Meas.
Efficiency of static and computer adaptive short forms compared to full-length measures of depressive symptoms
Qual. Life Res.
Evaluation of item candidates: the PROMIS qualitative item review
Med. Care
Progress in assessing physical function in arthritis: PROMIS short forms and computerized adaptive testing
J. Rheumatol.
The promise of PROMIS® for addiction
Drug Alcohol Depend.
A rationale and test for the number of factors in factor analysis
Psychometrika
A review of expectancy theory and alcohol consumption
Addiction
Describing depression: congruence between patient experiences and clinical assessments
Br. J. Clin. Psychol.
Building PROMIS item banks: librarians as co-investigators
Qual. Life Res.
Test Equating, Scaling and Linking: Methods and Practices
Using latent trait modeling to conceptualize an alcohol problems continuum
Psychol. Assess.
An application of item response theory analysis to alcohol, cannabis, and cocaine criteria in DSM-IV
J. Abnorm. Psychol.
Linking results of distinct assessments
Appl. Measure. Educ.
Cited by (54)
An Open Trial of Skills for Psychological Recovery for Sudden Loss Survivors
2024, Cognitive and Behavioral PracticePatient Reported Outcome and Experience Measures (PROMs and PREMs) in substance use disorder treatment services: A scoping review
2023, Drug and Alcohol DependenceLong-Term Effects of Cognitive-Behavioral Therapy and Yoga for Worried Older Adults
2022, American Journal of Geriatric PsychiatryCitation Excerpt :Internal consistency reliability ranged from good to excellent (α = 0.89 at baseline, α = 0.92 at Week 37). Anxiety symptoms were assessed with two measures: 1) the Patient Reported Outcomes Measurement Information System (PROMIS) Short Form v1.0 - Anxiety 8a,5,28 an eight-item measure of fear, anxious misery, and hyperarousal. Responses were converted to t-scores with a mean of 50 and standard deviation of 10 (secondary outcome).
Evidence-Based Assessment of Substance Use Disorder
2024, Assessment