Extending the Patient-Reported Outcomes Measurement Information System Pain Item Banks: Pain Self-Efficacy and Pain Catastrophizing [Methods Study], United States, 2014-2018 (ICPSR 39507)
Version Date: Oct 9, 2025 View help for published
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Dagmar Amtmann, University of Washington
https://doi.org/10.3886/ICPSR39507.v1
Version V1
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Chronic pain, which lasts for months or even years, can disturb people's daily lives and their relationships with others. Doctors want to measure how chronic pain affects people's lives so they can help their patients manage pain.
In this study, the research team wanted to measure two aspects of living with and managing chronic pain:
- Pain appraisal describes how people think about their pain. It measures how much people worry about their pain and how well they cope with pain or distract themselves from thinking about it.
- Pain-related self-efficacy describes how confident a person is that they can live well with pain.
The research team created two pools of questions, called item banks, to measure each of the two aspects of living with chronic pain. From these larger item banks, the team created and tested brief versions using two and six questions. These brief versions take people less time to finish than the full item banks.
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Study Purpose View help for Study Purpose
To develop brief, flexible, and sound measures of pain catastrophizing and pain-related self-efficacy for people living with chronic pain.
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An item bank is a set of items calibrated using Item Response Theory (IRT) that ask about a specific topic. Users can create custom short forms by picking sets of questions from an item bank or by using computerized adaptive testing. In this study, researchers developed separate item banks to measure pain catastrophizing and pain-related self-efficacy. Pain catastrophizing is a tendency to worry excessively about pain and to feel helpless about coping with it. Pain-related self-efficacy is the belief of people living with chronic pain that they can live well despite that pain. Existing measures of pain catastrophizing and pain-related self-efficacy were created using older methodology requiring all respondents to answer the same items. In this study, patient advisors, pain researchers, and clinicians guided item-bank development and provided feedback throughout the study.
The researchers developed the new item banks using qualitative and quantitative methodologies from the Patient-Reported Outcomes Measurement Information System (PROMIS), including IRT, which result in flexible, brief, and clinically meaningful measures. To define the two aspects of living with chronic pain, the researchers worked with patient advisors, pain researchers, and clinicians. Then, focus group participants living with chronic pain provided feedback on the definitions and the items used to measure pain catastrophizing and pain-related self-efficacy. Using this feedback, the researchers developed items and tested them in interviews with people living with chronic pain.
Finally, the researchers conducted a field test of the item banks with 795 people living with chronic pain across the country. Of these people, 86% were white, 9% were African American, and 5% were other races. The average age was 55 and 64% were female. Respondents had a variety of chronic pain conditions such as low back pain and pain from multiple sclerosis.
To develop a scoring system and evaluate the reliability and validity of the scores, researchers conducted psychometric analyses. After finalizing the item banks, the team developed two- and six-question short forms for both pain catastrophizing and pain-related self-efficacy and calculated the correlations between the short forms and the full item banks. To evaluate test-retest reliability, the researchers examined the correlations between the scores of respondents who completed the measure a second time 40 to 80 hours later.
Universe View help for Universe
Patients living with chronic pain
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Item bank and short form development: patient advisors and expert panel; 19 focus group participants living with chronic pain; 22 cognitive-interview participants living with chronic pain
Item scoring: 795 field test respondents living with chronic pain
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This study is maintained and distributed by the Patient-Centered Outcomes Data Repository (PCODR). PCODR is the official data repository of the Patient-Centered Outcomes Research Initiative (PCORI).