Purpose
The Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity
Computer Adaptive Test (UE CAT) was recently updated to version 2.0 (v2.0). We hypothesized
that the PROMIS UE CAT v2.0 would exhibit improved performance characteristics compared
with the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) when administered to a nonshoulder upper extremity patient population.
Methods
The UE CAT v2.0, Physical Function (PF) CAT v2.0, and the QuickDASH were each prospectively administered via tablet computer to all patients presenting
to a tertiary hand and upper extremity clinic between April 2017 and October 2017.
Patient responses were analyzed, and the mean, range, floor and ceiling effect, and
correlations between instruments were calculated.
Results
Among 825 patients, the mean UE CAT v2.0 score was 38.3 (SD 10.7) with a range of
15 to 61 and interquartile range of 15.4. The UE CAT v2.0 had a strong correlation
with the QuickDASH (r = –0.749) and the PF CAT v2.0 (r = 0.719). No patient scored between 56 and
60, indicating a gap in scoring in that range. The UE CAT v2.0 demonstrated a floor
effect of 1%, a ceiling effect of 6.9%, and a high internal consistency with a Cronbach
alpha of 0.99.
Conclusions
The PROMIS UE CAT v2.0 demonstrated improved ceiling effects, range, and a decreased
gap in scoring compared with prior versions. Limitations of the PROMIS UE CAT v2.0
are still present, but updates have led to an incremental improvement over prior versions,
demonstrating the ability to influence PROMIS instrument performance through upgrades.
Clinical relevance
The updated PROMIS UE CAT v2.0 still demonstrates a ceiling effect and gap in scores
at the upper end of the instrument, both of which may limit discrimination between
different levels of upper extremity function for high-functioning patients.
Key words
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Article info
Publication history
Published online: February 25, 2019
Accepted:
January 4,
2019
Received:
March 21,
2018
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2019 by the American Society for Surgery of the Hand. All rights reserved.
