PROMIS® Score Cut Points
General guidelines for interpreting PROMIS scores have been constructed using different methods.
PROMIS scores have a mean of 50 and standard deviation (SD) of 10 in a referent population.
Variation in Terminology and Cut Points
PROMIS domains use different terms to describe score ranges. For example, some domains use mild/moderate/severe whereas others use very high to very low. Cut points also vary. Below, each figure includes a list of domains that use the indicated terms and cut points. These can be applied to short forms and computer adaptive tests for a given domain.
- Note that for some domains (e.g., anxiety), terminology and cut points vary by respondent (early childhood parent-report, pediatric self-report, parent proxy report, adult self-report). Be sure to select the correct figure for the measure you are using.
Early Childhood Parent-Report Provisional Cut Points
PROMIS scientists constructed the interpretation of PROMIS scores graph for Profile domains (adult Anxiety, Depression, Fatigue, Pain Interference, Physical Function, Sleep Disturbance, and Ability to Participate in Social Roles & Activities) by reviewing the data collected in the large scale calibration testing data (Cella et al 2010, Rothrock et al 2010). They started by reviewing whether 0.5, 1.0, and 2.0 standard deviations were reasonable thresholds to use across domains. This was evaluated by looking at the percentage of participants from large scale calibration testing that would then fit into each category.
The cut points for PROMIS Adult Global Physical and Mental score categories of excellent, very good, good, fair, and poor were constructed by 1) creating groups based upon responses to Global01 “In general, would you say your health is excellent, very good, good, fair, or poor?”, 2) calculating mean scores for each group, and 3) identifying the midpoint between two adjacent means. For example, the mean Global Mental score for “Excellent” was 61 and the mean score for “Very Good” was 51. The midpoint between these scores is 56. Cut points are:
- Global Mental: 56, 48, 40, 29
- Global Physical: 58, 50, 42, 35
See Hays, Spritzer, Thompson & Cella (2015) for more information.
Standard Setting Using Bookmarking
Researchers have adopted a method applied in educational testing to identify thresholds for levels of academic outcomes (e.g., math proficiency levels). This method, called Bookmarking, has been used to establish thresholds for severity levels (e.g., no problems, mild problems, moderate problems, severe problems) in multiple patient populations. Learn more>>
Severity thresholds exist for:
- PROMIS Pain Interference, Fatigue, Anxiety, and Depression (Cella et al 2014) in cancer
- PROMIS Physical Function, Cognitive Function, and Sleep Disturbance (Rothrock et al 2019) in cancer
- PROMIS Pain Interference and Fatigue (Bingham et al 2021) in rheumatoid arthritis
- PROMIS Physical Function, Pain Interference, Sleep Disturbance, and Depression (Nagaraja et al 2018) in rheumatic conditions
- PROMIS Pediatric Mobility, Upper Extremity Function, Pain Interference, and Fatigue (Morgan et al 2017) in juvenile idiopathic arthritis
- PROMIS Pediatric Anxiety, Depressive Symptoms, Fatigue, and Mobility (Mann et al 2020) in juvenile idiopathic arthritis and childhood-onset systemic lupus erythematosus
Researchers have dichotomized responses to items and then used patterns of responses to determine no/mild, moderate, and severe score cut-points.
- PROMIS Pediatric Pain Interference and Pain Behavior (Singh & Panepinto 2019) in children with sickle cell disease.