Appendix 1. Identified Patient Reported Outcome Measures, by Domain
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Appendix 1. Identified Patient Reported Outcome Measures, by Domain.
PAIN
1. PROMIS-Pain Intensity SF 3a
2. PROMIS-Pain Interference SF 6b
3. PROMIS-Pain Interference SF 8a (alternative to 6b)
4. PROMIS Pain Behavior SF 7a
5. PROMIS PAIN Behavior
6. Visual Analog Scale for Pain (VAS Pain)
7. Numeric Rating Scale for Pain (NRS Pain)
8. McGill Pain Questionnaire (MPQ)
9. McGill Pain Questionnaire (MPQ) Short Form
10. SF-36 Bodily Pain
11. Measure of Intermittent and Constant Arthritis (ICOAP) – KNEE
12. Measure of Intermittent and Constant Arthritis (ICOAP) – HIP
13. KOOS-Pain subscale
14. HOOS-Pain subscale
15. WOMAC-Pain subscale
16. BRFSS Pain question
17. AIMS2-Pain subscale
18. Brief Pain Inventory (BPI) -- Short Form
19. Chronic Pain Grade Scale – public domain
20. Lequesne Index of Severity for OA of the Hip (LISOH)
21. Lequesne Index of Severity for OA of the Knee (LISOK)
22. Oxford Knee Score-Pain subscale 23. Oxford Hip Score-Pain subscale
24. Harris Hip Score – SA and IA
25. Nottingham Health Profile pain scale
26. Knee Pain Screening Tool
FUNCTION
1. PROMIS Mobility
2. PROMIS Function SF
3. PROMIS Physical Functioning SF 10a
4. PROMIS Physical Functioning SF 20a
5. KOOS-PS
6. KOOS Knee Survey
7. HOOS Hip Survey
8. HOOS-PS
9. IKDC Subjective Knee Evaluation Form
10. KOS-ADL
11. Lysholm Knee Scoring Scale
12. Oxford Knee Score
13. WOMAC
14. Activity Rating Scale
15. Tegner Activity Scale
16. HAQ-20
17. MHAQ
18. SF-36 Physical Function subscale fee required 19. Lequesne Index of Severity for OA of the Hip (LISOH)
20. AIMS2
21. AIMS2 SF
22. MMWR NRS
23. Lequesne Index of Severity for OA of the Hip (LISOH)
24. AAOS Hip and Knee Outcomes Questionnaire
25. Oxford Hip Score
26. Lower Extremity Functional Scale
27. EQ-5D-3L fee required
FATIGUE
1. PROMIS Fatigue Short Form 8a
2. PROMIS Fatigue Short Form 7a
3. Bristol RA Fatigue Scale Multi-Dimensional Questionnaire (BRAF MDQ)
4. Bristol RA Fatigue Numerical Rating Scales (BRAF NRS)
5. Checklist Individual Strength Therapy (CI20R) -- 20 item
6. Checklist Individual Strength Therapy (CIS8R) -- 8 item
7. Fatigue Severity Scale (FSS)
8. Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F)
9. Multidimensional Assessment of Fatigue (MAF)
10. Multidimensional Fatigue Inventory (MFI-20)
11. Profile of Fatigue (ProF)
12. Short Form 36 Vitality (SF 36 VT)
13. Visual Analog Scale (VAS) – Fatigue 14. Numerical (10com) 0-10 scale (Stanford)
SLEEP
1. PROMIS Sleep Disturbance SF 8a
2. PROMIS Sleep Disturbance SF 8b
3. PROMIS Sleep Related Impairment SF 8a
4. Medical Outcome Study (MOS) Sleep scale
5. Epworth Sleepiness Scale (ESS)
6. Functional Outcome of Sleep Questionnaire (FOSQ)
7. Functional Outcome of Sleep Questionnaire Short Form (FOSQ-SF)
8. Insomnia Severity Index
9. Pittsburgh Sleep Quality Index (PSQI)
10. Berlin Questionnaire (for sleep apnea)
11. STOP-BANG Sleep Apnea Questionnaire
12. General Sleep Disturbance Scale
13. Leeds Evaluation Questionnaire
14. VAS sleep
15. Chronic Pain Sleep Inventory (CPSI)
16. Poor Sleep Quality
17. Sleep Impairment Index (SII)
18. Nottingham Health Profile sleep subscale
19. BPI interference with sleep item Appendix 2. Contact websites for Reviewed Patient Report Outcome Measures, by
Domain.
PAIN
1. PROMIS-Pain Intensity SF 3a – contact the PCORI website for access to short forms
https://www.assessmentcenter.net/PromisForms.aspx
2. PROMIS-Pain Interference SF 6b – contact the PCORI website for access to short forms
https://www.assessmentcenter.net/PromisForms.aspx
3. PROMIS-Pain Interference SF 8a (alternative to 6b) – contact the PCORI website for access to short
forms https://www.assessmentcenter.net/PromisForms.aspx
4. Numeric Rating Scale for Pain (NRS Pain) – Stanford Patient Education Research Center
http://patienteducation.stanford.edu/research/
5. Measure of Intermittent and Constant Arthritis (ICOAP) KNEE – available through OARSI website
http://www.oarsi.org/index2.cfm?section=Publications_and_Newsroom&content=Indexes
6. Measure of Intermittent and Constant Arthritis (ICOAP) HIP – available through OARSI website
http://www.oarsi.org/index2.cfm?section=Publications_and_Newsroom&content=Indexes
7. KOOS-Pain subscale -- http://www.koos.nu/ (click on KOOS under “Questionnaires, user’s guides
and scoring files – click on English to secure the pdf -- go to the 9-item Pain scale)
8. HOOS-Pain subscale -- http://www.koos.nu/ (click on HOOS under “Questionnaires, user’s guides
and scoring files – click on English to secure the pdf -- go to the 9-item Pain scale)
9. AIMS2-Pain scale --
http://www.proqolid.org/instruments/arthritis_impact_measurement_scales_aims2?
private=yes&fromSearch= (under “Copy of the original questionnaire”, click on “AIMS2 in English for
the USA – go to the 5-item Pain scale, questions 38-42) FUNCTION
10. PROMIS Mobility – contact the PCORI website for access to short forms
https://www.assessmentcenter.net/PromisForms.aspx
11. PROMIS Function SF – contact the PCORI website for access to short forms
https://www.assessmentcenter.net/PromisForms.aspx
12. KOOS-PS -- http://www.koos.nu/ (click on KOOS-PS under “Questionnaires, user’s guides and
scoring files – click on English to secure the pdf)
13. HOOS-PS -- http://www.koos.nu/ (click on HOOS-PS under “Questionnaires, user’s guides and
scoring files – click on English to secure the pdf)
14. MHAQ – www.iche.edu/newsletter/MHAQ.pdf
15. MMWR NRS (Cheng) -- yes/no question “Have you ever been told by a doctor or other health
professional that you have some form of arthritis, rheumatoid arthritis, gout, lupus, or
fibromyalgia?” http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5939a1.htm
16. AAOS Hip and Knee Outcomes Questionnaire – www.aaos.org/research/outcomes/Hip_Knee.pdf
FATIGUE
15. PROMIS Fatigue Short Form 8a – contact the PCORI website for access to short forms
https://www.assessmentcenter.net/PromisForms.aspx
16. PROMIS Fatigue Short Form 7a – contact the PCORI website for access to short forms
https://www.assessmentcenter.net/PromisForms.aspx
17. Bristol RA Fatigue Numerical Rating Scales (BRAF NRS) -- available from the developer
http://www1.uwe.ac.uk/hls/research/healthandclinicalresearch/researchareas/longtermconditions/
fatiguescales/brafscales.aspx 18. Fatigue Severity Scale (FSS) – requires permission from the author (Lauren B Krupp, MD) email
19. Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F) – access through the FACIT.org
website http://www.facit.org/FACITOrg/Questionnaires
20. Multidimensional Assessment of Fatigue (MAF) – register at the author’s website
http://www.son.washington.edu/research/maf/
21. Numeric Rating Scale – Stanford Patient Education Research Center
http://patienteducation.stanford.edu/research/
SLEEP
20. PROMIS Sleep Disturbance SF 8a – contact the PCORI website for access to short forms
https://www.assessmentcenter.net/PromisForms.aspx
21. PROMIS Sleep Disturbance SF 8b – contact the PCORI website for access to short forms
https://www.assessmentcenter.net/PromisForms.aspx
22. PROMIS Sleep Related Impairment SF 8a – contact the PCORI website for access to short forms
https://www.assessmentcenter.net/PromisForms.aspx
23. Medical Outcome Study (MOS) Sleep scale --
http://www.rand.org/health/surveys_tools/mos/mos_sleep.html
24. Insomnia Severity Index (ISI) -- contact Charles M. Morin, PhD for permission
25. Pittsburgh Sleep Quality Index (PSQI) -- permission for use from Daniel J. Buysse, MD
26. Berlin Questionnaire (for sleep apnea) -- http://www.google.com/url?
sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CC8QFjAA&url=http%3A%2F %2Fwww.commondataelements.ninds.nih.gov%2FCRFs%2FBerlin%2520Questionnaire.pdf%3FCrfId
%3DF0781&ei=jE3pUaTnFdWv4AOC4YHgCg&usg=AFQjCNE9en_t7wqzwFa7q8l9qkRN_xf-
3w&sig2=VGetAhBmT0tarJWdtlgVmA&bvm=bv.49478099,d.dmg
27. STOP-BANG Sleep Apnea Questionnaire -- http://www.google.com/url?
sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CC8QFjAA&url=http%3A%2F
%2Fwww.sleepapnea.org%2Fassets%2Ffiles%2Fpdf%2FSTOP-BANG
%2520Questionnaire.pdf&ei=y03pUe3iOJXj4AOL14GoAg&usg=AFQjCNEX3ODJ4A1xbWgSLKw-
o9s47mnlFg&sig2=WDh7peKIfQ_6gHWuO14bRg&bvm=bv.49478099,d.dmg