The DADOS team is excited to announce the launch of their newest feature, NIH’s PROMIS® (Patient-Reported Outcomes Measurement Information System).
Championed by Dr. Istvan Mucsi of the Multi-Organ Transplant Program at Toronto General Hospital, NIH’s PROMIS computer adaptive test (CAT) tools for patient-reported outcome measures (PROMs) are streamlined outcome measures that could be used in routine care of patients with chronic conditions (cancer, diabetes, heart failure, chronic kidney disease, arthritis, etc.) to screen for emotional distress, unmet supportive care needs, or social difficulties. Screening for distress among patients with cancer is part of a standard of care in Ontario, in the United States and globally. PROMs are also used as a performance metric for evaluating the quality of care on health outcomes.
Studies have shown that using appropriate PROMs helps physicians to determine whether a particular treatment option will be worthwhile for a given patient by enabling a better understanding of the patient’s expectations, their current functional status, and how much improvement the treatment can be expected to produce.
The implementation of the Application Programming Interface (API) to use computer adaptive test (CAT) based PROMIS tools will make regular monitoring of multiple PROM domains feasible, reliable and accurate by substantially reducing responder burden without loss of precision or reliability. Each question is selected using a patient’s previous responses. Patients answer an average of four to seven questions on a Wi-Fi-enabled tablet, and the system leverages a larger database – in the case of the physical function assessment, one with 121 validated items – to produce an accurate, reproducible score. There are currently over 50 PROMIS CATs available now within DADOS, including questionnaires to measure depression, anxiety, fatigue, physical function, pain, sleep, and social functioning.
PROMIS CAT tools are used in many large institutions throughout the US but have not seen the widespread uptake in Canada because there has not been a PROMIS server readily available. Now with the integration of CAT based PROMIS tools into DADOS Electronic Data Capture Platform, clinicians and researchers can enjoy a simple point-and-click solution that can be setup quickly. Unlike traditional PROMs, CAT based PROMIS tools for domains such as physical function, pain interference, and depression require 2-3 minutes to complete. If additional domains are needed, each additional domain increases completion time by approximately 1 minute.
In summary, a growing amount of research evidence indicates that patients and clinicians would benefit from PROMs that are accurate and reliable while not being burdensome. The measures developed by the NIH PROMIS provide a potential solution. The implementation of computer adaptive testing (CAT) based PROMIS tools into the library of outcome measures that can be used within the DADOS Electronic Data Capture Platform brings the latest innovations in outcomes measurement to clinicians and researchers across UHN and other institutions.