Assessment of a Nine-Item Patient-Reported Outcomes Measurement Information System Upper Extremity Instrument Among Individuals With Upper Limb Amputation

Objective The aim of the study was to assess the validity of a customized nine-item Patient-Reported Outcomes Measurement Information System Upper Extremity instrument being used with individuals with upper extremity amputation to inform potential modifications for clinical efficiency. Design A sample of 239 adults with upper extremity amputation (mean age = 48 +/- 16 yrs; female = 69; prosthesis users = 150) were included. After clinical implementation of the nine-item Patient-Reported Outcomes Measurement Information System Upper Extremity, the following psychometric properties were examined: structural and known-groups validity, differential item functioning, and reliability. Results The nine-item Patient-Reported Outcomes Measurement Information System Upper Extremity short form demonstrated satisfactory psychometric properties. Convincing evidence of structural validity included no violation of unidimensionality, local independence (all local dependence chi(2) < 10), monotonicity (Hij > 0, Hi > 0.3, and H = 0.57), and adequate model fit (P > 0.006). Known-groups analysis demonstrated that the nine-item Patient-Reported Outcomes Measurement Information System Upper Extremity instrument was able to discriminate between prosthesis users and nonprosthesis users and amputation level. The Cronbach's alpha and item response theory reliability at the selected range of T scores were greater than 0.9 indicating high reliability. No items were flagged for age in differential item functioning. Conclusions The customized nine-item Patient-Reported Outcomes Measurement Information System Upper Extremity met the minimum criteria, according to the Patient-Reported Outcomes Measurement Information System plan, for psychometric validity supporting its use within the population of individuals with upper extremity amputation.