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Instead of a fixed questionnaire, PROMIS is a library of calibrated questions for things like fatigue, pain, anxiety, depression and physical function, built so that a computer can pick the next question based on the last answer and reach a precise score in a handful of items. Scores are set against the general population, not against other cancer patients.
The Patient-Reported Outcomes Measurement Information System was funded by the US National Institutes of Health to fix a specific problem, which its first-wave paper states plainly: existing measures "have been limited by a lack of precision, standardization, and comparability of scores across studies and diseases". Fourteen item pools were tested, 11 item banks were calibrated on a sample of 21,133 people using item response theory, alongside a 10-item global health scale.
What item response theory buys. Every item is calibrated on a common underlying scale, so a person's score does not depend on which items they were asked. That allows two things a fixed questionnaire cannot do: short forms of four to eight items that are as precise as a much longer legacy instrument, and computerised adaptive testing, where the next question is chosen by the answers already given and the test stops when the score is precise enough.
Scoring. PROMIS scores are reported as T-scores with a mean of 50 and a standard deviation of 10 in a US general population reference sample. A fatigue T-score of 60 is one standard deviation worse than the average American adult. This is a genuine difference from the cancer-specific instruments: a QLQ-C30 or FACT score is interpreted against other cancer populations, while a PROMIS score is interpreted against the general public, which is often the comparison a person recovering from treatment actually wants.
In cancer, PROMIS is used for the symptom domains (fatigue, pain interference, sleep disturbance, anxiety, depression, physical function, ability to participate in social roles) rather than as a quality-of-life profile, and PROMIS physical function is one of the instruments the US regulator's core outcomes framing points at for the physical function concept.
What it misses. It is generic by design, so it has no cancer-specific content: nothing on chemotherapy-induced neuropathy as such, nothing on hair, nothing on lymphoedema, nothing on the fear that the cancer comes back. The adaptive version needs software, and the reference population being American limits the interpretation of a T-score elsewhere. Comparability with the legacy instruments is approximate: linking tables exist between PROMIS and some older scales, but a converted score is an estimate, not the same measurement.
Item response theory calibrates every item in a bank onto one latent trait scale with known difficulty and discrimination. A score estimated from any subset of calibrated items is therefore on the same metric, which permits short forms and computerised adaptive testing without losing comparability.
Query for this technology: (TITLE:"PROMIS: the item banks that let a short questionnaire be precise" OR ABSTRACT:"PROMIS: the item banks that let a short questionnaire be precise") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about PROMIS: the item banks that let a short questionnaire be precise, not a curated reading list.
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