Relationship Between Objective Performance and Patient‐Reported Outcomes Measurement Information System Physical Function in Patients With Stroke

Background The relationship between self‐reported physical function (PF) and objective performance in patients with stroke remains unclear. This study explored how various self‐reported health domains influence the correlation between Patient‐Reported Outcomes Measurement Information System (PROMIS)...

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Main Authors: Irene L. Katzan, Yadi Li, Maximos McCune, Brittany Lapin
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.039366
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author Irene L. Katzan
Yadi Li
Maximos McCune
Brittany Lapin
author_facet Irene L. Katzan
Yadi Li
Maximos McCune
Brittany Lapin
author_sort Irene L. Katzan
collection DOAJ
description Background The relationship between self‐reported physical function (PF) and objective performance in patients with stroke remains unclear. This study explored how various self‐reported health domains influence the correlation between Patient‐Reported Outcomes Measurement Information System (PROMIS) PF and the Timed Up and Go (TUG) test. Methods A retrospective cohort study examined patients with stroke who completed the TUG and PROMIS PF within 90 days post stroke. Correlations between these measures were analyzed, both overall and stratified by performance on other patient‐reported outcomes (Quality of Life in Neurological Disorders cognitive function, depression, and the following PROMIS scales: global health, social satisfaction, pain, sleep, and fatigue). Structural equation modeling assessed how these patient‐reported outcomes influenced the PROMIS PF‐TUG relationship. Results There were 432 patients with average age 63.7 (SD 13.5) years. Average TUG and PROMIS PF scores were 16.6 (SD 10.4) seconds and 36.8 (SD 8.5), respectively. TUG and PROMIS PF showed moderate correlation (r=−0.47 [95% CI, −0.54 to −0.40]). Fatigue (r=−0.53 [95% CI, −0.59 to −0.45]) and satisfaction with social roles (r=0.53 [95% CI, 0.45 to 0.60]) had the strongest correlations with PROMIS PF. Both social roles (estimate=0.08, SE=0.02, P=0.001) and fatigue (0.06, SE=0.02, P=0.001) demonstrated indirect effects on the TUG‐PROMIS PF relationship. Although not significant, correlations between PROMIS PF and TUG scores were consistently weaker in patients with poor scores in any patient‐reported outcome. Conclusions There is only moderate correlation between self‐reported PF and the performance measure TUG, which is mediated by fatigue and satisfaction with social roles. These findings highlight the importance of considering these broader dimensions of health in addition to physical capacity when interpreting patient‐reported PF scores.
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spelling doaj-art-05ac7152f5ad478f9951c092ac0bd0fd2025-08-20T01:54:08ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-05-01141010.1161/JAHA.124.039366Relationship Between Objective Performance and Patient‐Reported Outcomes Measurement Information System Physical Function in Patients With StrokeIrene L. Katzan0Yadi Li1Maximos McCune2Brittany Lapin3Center for Outcomes Research & Evaluation, Neurological Institute Cleveland Clinic Cleveland OH USACenter for Outcomes Research & Evaluation, Neurological Institute Cleveland Clinic Cleveland OH USACerebrovascular Center, Neurological Institute Cleveland Clinic Cleveland OH USACenter for Outcomes Research & Evaluation, Neurological Institute Cleveland Clinic Cleveland OH USABackground The relationship between self‐reported physical function (PF) and objective performance in patients with stroke remains unclear. This study explored how various self‐reported health domains influence the correlation between Patient‐Reported Outcomes Measurement Information System (PROMIS) PF and the Timed Up and Go (TUG) test. Methods A retrospective cohort study examined patients with stroke who completed the TUG and PROMIS PF within 90 days post stroke. Correlations between these measures were analyzed, both overall and stratified by performance on other patient‐reported outcomes (Quality of Life in Neurological Disorders cognitive function, depression, and the following PROMIS scales: global health, social satisfaction, pain, sleep, and fatigue). Structural equation modeling assessed how these patient‐reported outcomes influenced the PROMIS PF‐TUG relationship. Results There were 432 patients with average age 63.7 (SD 13.5) years. Average TUG and PROMIS PF scores were 16.6 (SD 10.4) seconds and 36.8 (SD 8.5), respectively. TUG and PROMIS PF showed moderate correlation (r=−0.47 [95% CI, −0.54 to −0.40]). Fatigue (r=−0.53 [95% CI, −0.59 to −0.45]) and satisfaction with social roles (r=0.53 [95% CI, 0.45 to 0.60]) had the strongest correlations with PROMIS PF. Both social roles (estimate=0.08, SE=0.02, P=0.001) and fatigue (0.06, SE=0.02, P=0.001) demonstrated indirect effects on the TUG‐PROMIS PF relationship. Although not significant, correlations between PROMIS PF and TUG scores were consistently weaker in patients with poor scores in any patient‐reported outcome. Conclusions There is only moderate correlation between self‐reported PF and the performance measure TUG, which is mediated by fatigue and satisfaction with social roles. These findings highlight the importance of considering these broader dimensions of health in addition to physical capacity when interpreting patient‐reported PF scores.https://www.ahajournals.org/doi/10.1161/JAHA.124.039366patient‐reported outcomeperformance measurestroke
spellingShingle Irene L. Katzan
Yadi Li
Maximos McCune
Brittany Lapin
Relationship Between Objective Performance and Patient‐Reported Outcomes Measurement Information System Physical Function in Patients With Stroke
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
patient‐reported outcome
performance measure
stroke
title Relationship Between Objective Performance and Patient‐Reported Outcomes Measurement Information System Physical Function in Patients With Stroke
title_full Relationship Between Objective Performance and Patient‐Reported Outcomes Measurement Information System Physical Function in Patients With Stroke
title_fullStr Relationship Between Objective Performance and Patient‐Reported Outcomes Measurement Information System Physical Function in Patients With Stroke
title_full_unstemmed Relationship Between Objective Performance and Patient‐Reported Outcomes Measurement Information System Physical Function in Patients With Stroke
title_short Relationship Between Objective Performance and Patient‐Reported Outcomes Measurement Information System Physical Function in Patients With Stroke
title_sort relationship between objective performance and patient reported outcomes measurement information system physical function in patients with stroke
topic patient‐reported outcome
performance measure
stroke
url https://www.ahajournals.org/doi/10.1161/JAHA.124.039366
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