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Barrett S. Boody, Surabhi Bhatt, Aditya S. Mazmudar, Wellington K. Hsu, Nan E. Rothrock and Alpesh A. Patel

spine treatments on other organ systems (e.g., musculoskeletal, cardiovascular, pulmonary), thereby allowing assessment of the fractional contribution of spine pathology and/or treatment on overall functioning and pain behaviors. The goal of the Patient-Reported Outcomes Measurement Information System (PROMIS) is to develop a psychometrically validated system of PRO measures in respondents with a wide range of chronic diseases and demographic characteristics. 19 The PROMIS PROs assess subjective experiences including symptom frequency and severity, emotional and

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Timothy J. Yee, Brandon W. Smith, Jacob R. Joseph, Yamaan S. Saadeh, Jay K. Nathan, Elyne N. Kahn, Siri S. Khalsa, Kelsey J. Fearer, Michael J. Kirsch, David R. Nerenz, Victor Chang, Jason M. Schwalb, Muwaffak M. Abdulhak and Paul Park

burdens has led to the development of shorter, more efficient PRO tools. 3 , 16 In 2004 the National Institutes of Health developed the Patient-Reported Outcomes Measurement Information System (PROMIS) for the assessment of physical, mental, and social health in a universal, rather than disease-specific, manner. PROMIS tools have been gaining popularity because of their accessibility and applicability across health domains, including spine surgery outcomes. 1 , 4 Both computer-adaptive testing (CAT) and short forms are available, the latter of which can be

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Robert J. Owen, Adam Z. Khan, Steven J. McAnany, Colleen Peters and Lukas P. Zebala

-specific PROMs, focusing on patient physical function and pain. 23 Despite their frequent use, the application of these measures creates a significant administrative burden on the patient, physician, and administrative staff due to the labor-intensive nature of many surveys. Furthermore, traditional legacy outcome measures suffer from concerns such as patient fatigue, moderator human error, and difficulty comparing outcomes across disparate populations. The Patient Reported Outcomes Measurement Information System (PROMIS) group is an NIH-funded initiative that developed a new

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Taylor E. Purvis, Brian J. Neuman, Lee H. Riley III and Richard L. Skolasky

National Institutes of Health encouraged researchers and clinicians to implement the Patient-Reported Outcomes Measurement Information System (PROMIS) to promote comparisons among multiple disease settings and across a range of populations. 10 , 12 , 27 Among other outcome variables, the PROMIS instrument generates anxiety and depression scores. 27 The raw scores for anxiety and depression are translated to standardized T-scores with a population mean of 50 ± 10. 11 , 37 The GAD-7 and PHQ-8 were developed using the classic test theory framework and require patients to

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Brittany E. Haws, Benjamin Khechen, Mundeep S. Bawa, Dil V. Patel, Harmeet S. Bawa, Daniel D. Bohl, Adam B. Wiggins, Kaitlyn L. Cardinal, Jordan A. Guntin and Kern Singh

populations or anatomical locations. Additionally, the administration of legacy measures can be time-consuming for patients and may lead to an additional administrative burden. The Patient-Reported Outcomes Measurement Information System (PROMIS) was developed as an effort to provide a standardized measure of clinical outcomes that is valid and reliable across a wide variety of patient populations. This instrument affords the accurate and efficient collection of PROs for multiple health domains, particularly with the use of computer adaptive testing (CAT). 13 PROMIS

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Brittany E. Haws, Benjamin Khechen, Jordan A. Guntin, Kaitlyn L. Cardinal, Daniel D. Bohl and Kern Singh

, physical function, and mental health. 4 , 16 , 17 Although these measures are of significant value, they can lead to significant administrative burden and can be time consuming for patients to complete. These inefficiencies often prove to be a barrier to data collection. The Patient-Reported Outcomes Measurement Information System (PROMIS) was developed to address these limitations. This tool uses computer-adaptive testing based on item response theory to enable accurate and efficient assessments of multiple health domains. 5 By reducing the number of questions posed

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Michael P. Kelly, Michael A. Kallen, Christopher I. Shaffrey, Justin S. Smith, Douglas C. Burton, Christopher P. Ames, Virginie Lafage, Frank J. Schwab, Han Jo Kim, Eric O. Klineberg, Shay Bess and the International Spine Study Group

test-retest reliability. 9 , 10 The Patient-Reported Outcomes Measurement Information System (PROMIS), funded by the National Institutes of Health (NIH), is a system of generic health measures and is available to clinicians and researchers alike for computer adaptive test (CAT) administration, a highly effective and efficient method of measure administration, based on detailed item performance parameters derived from supporting item response theory (IRT) analyses. In short, CATs allow for the collection of precise patient-centered outcome scores while minimizing

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Dil V. Patel, Mundeep S. Bawa, Brittany E. Haws, Benjamin Khechen, Andrew M. Block, Sailee S. Karmarkar, Eric H. Lamoutte and Kern Singh

P atient-reported outcomes (PROs) have historically been used by spine surgeons to gather clinical data before and after surgery. In recent years, the Patient-Reported Outcomes Measurement Information System (PROMIS) has emerged as a valuable instrument in evaluating patient health. 21 PROMIS is a time-efficient survey that dynamically modifies subsequent questions based on responses, potentially improving patient compliance with long-term data collection. The PROMIS domain Physical Function (PROMIS PF) may be particularly useful in relation to spine surgery

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Jared C. Tishelman, Dennis Vasquez-Montes, David S. Jevotovsky, Nicholas Stekas, Michael J. Moses, Raj J. Karia, Thomas Errico, Aaron J. Buckland and Themistocles S. Protopsaltis

often responsible for a significant burden to both the patient and the provider. The Patient-Reported Outcomes Measurement Information System (PROMIS) is a National Institutes of Health (NIH)–funded initiative to improve and streamline patient outcomes reporting. 6 , 15 PROMIS Physical Function (PF), PROMIS Pain Intensity, and PROMIS Pain Interference are 3 domains of the PROMIS instrument that test physical and psychosocial dimensions of a patient’s complaints. These PROMIS tools have demonstrated improved validity, reliability, and flexibility. 1 , 6 , 11 , 19

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Jawad M. Khalifeh, Christopher F. Dibble, Ammar H. Hawasli and Wilson Z. Ray

utilized and validated. However, they have significant psychometric shortcomings, particularly with disease bias, inefficiency in data collection, interpretability of survey results, and limited coverage (i.e., floor and ceiling effects). 5–7 , 14 , 16 , 17 The NIH initiated the Patient-Reported Outcomes Measurement Information System (PROMIS) network, a multicenter collaborative designed to develop, validate, and standardize a unified system of reliable PRO measures. 7 , 8 , 11 The goal of PROMIS is to improve reporting and communication of patient symptoms and health