This project's goal is to improve medical care processes and patient outcomes in clinical practice settings using routine collection of patient-reported outcomes (PROs) administered by computerized adaptive tests (CATs). The research team will integrate PROMIS data with other data captured during clinical care to deliver clinically useful information to the provider at the point of care in real time. The team will evaluate PROs in a nationally distributed consortium of HIV clinics. This project will leverage extensive resources from the Centers for AIDS Research (CFAR) Network of Integrated Cohort Studies (CNICS);a consortium of 9 clinical research sites providing care for a well-characterized and demographically heterogeneous cohort of >20,000 HIV-infected individuals. CNICS has committed to collection of PRO data. The study's aims include: 1. Develop and assess PROMIS short forms and hybrid CATs for patients with HIV. The team will evaluate five PROMIS I domains in Spanish and English selected by HIV-infected patients, providers, and researchers and will develop and evaluate the two new domains of perceived stigma and positive affect. The team will use high quality mixed qualitative and quantitative methods, modify standard CAT algorithms to ensure that items patients and providers deem important are administered, and analyze PROMIS items for differential item functioning (DIF) and individual- and group-level DIF impact. 2. Determine the effect on care processes and patient outcomes of integrating routine PROMIS CAT PRO data with individually tailored treatment recommendations using a comprehensive health improvement model in nine HIV clinics. The team will engage in quality improvement initiatives to involve stakeholders and overcome barriers to routine PRO collection with PRO and clinical data and tailored recommendations delivered to providers in real time at the point of care. The team will use a randomized controlled trial to determine the intervention's impact on process outcomes, clinical outcomes, and satisfaction with care. 3. Collaborate with the PROMIS Network to add value to the PROMIS initiative. The team will contribute patients, data, and software tools. The team will develop and evaluate techniques to analyze DIF in data collected by CATs.

Public Health Relevance

This project will evaluate the validity of PROMIS domains in patients infected with HIV, making PROMIS applicable to this large, underserved population. The project addresses critical limitations of prior research integrating PRO data into routine clinical care. If successful, this project may influence the shape and content of routine clinical care for patients with HIV.

National Institute of Health (NIH)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Research Project--Cooperative Agreements (U01)
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Special Emphasis Panel (ZRG1-RPHB-A (54))
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Serrate-Sztein, Susana
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University of Washington
Schools of Public Health
United States
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Crane, Heidi M; Fredericksen, Rob J; Church, Anna et al. (2016) A Randomized Controlled Trial Protocol to Evaluate the Effectiveness of an Integrated Care Management Approach to Improve Adherence Among HIV-Infected Patients in Routine Clinical Care: Rationale and Design. JMIR Res Protoc 5:e156
Solorio, R; Ayala, N C; Paez, E et al. (2016) Use of Cognitive Interviews to Adapt PROMIS Measurement Items for Spanish Speakers Living with HIV. AIDS Res Treat 2016:8340863
Cook, Karon F; Jensen, Sally E; Schalet, Benjamin D et al. (2016) PROMIS measures of pain, fatigue, negative affect, physical function, and social function demonstrated clinical validity across a range of chronic conditions. J Clin Epidemiol 73:89-102
Edwards, Todd C; Fredericksen, Rob J; Crane, Heidi M et al. (2016) Content validity of Patient-Reported Outcomes Measurement Information System (PROMIS) items in the context of HIV clinical care. Qual Life Res 25:293-302
Kashikar-Zuck, Susmita; Carle, Adam; Barnett, Kimberly et al. (2016) Longitudinal evaluation of patient-reported outcomes measurement information systems measures in pediatric chronic pain. Pain 157:339-47
Dampier, Carlton; Barry, Vaughn; Gross, Heather E et al. (2016) Initial Evaluation of the Pediatric PROMIS® Health Domains in Children and Adolescents With Sickle Cell Disease. Pediatr Blood Cancer 63:1031-7
Schalet, Benjamin D; Pilkonis, Paul A; Yu, Lan et al. (2016) Clinical validity of PROMIS Depression, Anxiety, and Anger across diverse clinical samples. J Clin Epidemiol 73:119-27
Gibbons, Laura E; Fredericksen, Rob; Merrill, Joseph O et al. (2016) Suitability of the PROMIS alcohol use short form for screening in a HIV clinical care setting. Drug Alcohol Depend 164:113-9
Li, Zheng; Thompson, Lindsay A; Gross, Heather E et al. (2016) Longitudinal associations among asthma control, sleep problems, and health-related quality of life in children with asthma: a report from the PROMIS(®) Pediatric Asthma Study. Sleep Med 20:41-50
Thissen, David; Liu, Yang; Magnus, Brooke et al. (2016) Estimating minimally important difference (MID) in PROMIS pediatric measures using the scale-judgment method. Qual Life Res 25:13-23

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