Content validity of the patient-reported outcomes measurement information system in chronic skin disease

While patient-reported outcome measures (PROMs) provide valuable clinical insights and can complement clinician-reported outcome measures, their use can be limited by completion time and integration barriers. Although item response theory-based Patient-Reported Outcomes Measurement Information System (PROMIS) measures offer advantages, their content validity in skin disease remains unclear. This study evaluates the content validity (i.e. relevance, comprehensibility, and comprehensiveness) of a profile of PROMIS scales among patients with acne, atopic dermatitis, psoriasis, hidradenitis suppurativa, and alopecia areata. Cognitive debriefing interviews were conducted among English-speaking adults with dermatologist-confirmed acne, atopic dermatitis, psoriasis, hidradenitis suppurativa, or alopecia areata. Participants were recruited from Brigham and Women’s Hospital dermatology clinic and National Eczema Association from January 5, 2024, to July 19, 2024. Among 30 participants, mean age was 37.3 years. PROMIS scales ‘Anxiety’, ‘Satisfaction with Participation in Discretionary Social Activities’, ‘Ability to Participate in Social Roles and Activities’, ‘Satisfaction with Social Roles and Activities’, ‘Pain Intensity’ demonstrated sufficient relevance (> 85% items relevant). Scales for ‘General Life Satisfaction’ (77.3%), ‘Depression’ (84.4%), ‘Social Isolation’ (80.0%), ‘Itch Severity’ (83.3%) did not meet this threshold. Comprehensibility and comprehensiveness were high across scales. Some reported seven-day recall may not capture disease fluctuations; and insufficient coverage of romantic relationships, body image, and treatment satisfaction. In this cohort of participants with chronic skin disease, several PROMIS scales demonstrated acceptable content validity, providing insight into suitability for use. Further research evaluating additional measurement properties (e.g., construct validity, responsiveness) is needed.