Responsiveness of Pediatric and Parent-Proxy PROMIS Mobility and PROMIS Pain Interference: Comparing Versions 2.0 and 3.0

Abstract Objective To support clinical decision-making and treatment evaluation, outcome measures need to accurately detect changes in patient health. As such, we aim to assess and compare the responsiveness of the v2.0 and v3.0 self- and proxy-reported PROMIS® Item Banks for Mobility, Pain Interference and Upper Extremity in the context of pediatric physical therapy (PPT). Methods Children (8-17 years), and parents (of children aged 5-17 years), completed three pediatric PROMIS® item banks v2.0 (Mobility, Pain Interference, Upper Extremity) while following PPT treatment (baseline) and six months later (follow-up). Eligible participants expected to progress between baseline and follow-up. Responsiveness was evaluated by hypotheses testing for four multimethod approaches: (1) comparison of PROMIS and two legacy instruments; (2) known-group responsiveness, based on physical complaints of the child, and (3) based on focus of PPT intervention; (4) anchor-based method, based on ratings of change. Instruments were deemed responsive if ≥75% of results were in line with hypotheses. To compare v2.0 and v3.0, data reported on v2.0 were collapsed/recalculated to match v3.0. Subsequently, all above hypotheses were investigated for v3.0. Versions were compared on number of hypotheses met. Results Follow-up was completed by 63 children and 80 parents. Sufficient responsiveness was observed for the pediatric Mobility, and pediatric and parent-proxy Pain Interference item banks, in v2.0 and v3.0. The parent-proxy Mobility v2.0 and v3.0 item banks showed 70.0% of results in line with hypotheses. V2.0 and v3.0 did not differ in responsiveness. Due limited reported change, it was not possible to perform the analyses for Upper Extremity. Conclusion The PROMIS pediatric Mobility, pediatric Pain Interference and parent-proxy Pain Interference item banks, in both v2.0 and v3, demonstrate sufficient responsiveness in PPT, supporting their use for reliably capturing change over time in clinical practice. The parent-proxy Mobility v2.0 and v3.0 showed promising indications of responsiveness. Impact statement This study demonstrates that PROMIS pediatric Mobility, as well as the pediatric and parent-proxy Pain Interference, v2.0 and v3.0 item banks are effective tools for detecting change over time in children in pediatric physical therapy. This supports their use in clinical research and practice to enhance treatment evaluation and patient care.