Károly Rácz Doctoral School of Clinical Medicine, Semmelweis University, Budapest, Hungary.
Department of Health Policy, Corvinus University of Budapest, 8 Fővám tér, Budapest, 1093, Hungary.
Eur J Health Econ. 2024 Jun;25(4):549-562. doi: 10.1007/s10198-023-01610-w. Epub 2023 Jun 28.
Patient-Reported Outcomes Measurement Information System-Global Health (PROMIS-GH) is a widely used generic measure of health status. This study aimed to (1) assess the psychometric properties of the Hungarian PROMIS-GH and to (2) develop general population reference values in Hungary.
An online cross-sectional survey was conducted among the Hungarian adult general population (n = 1700). Respondents completed the PROMIS-GH v1.2. Unidimensionality (confirmatory factor analysis and bifactor model), local independence, monotonicity (Mokken scaling), graded response model fit, item characteristic curves and measurement invariance were examined. Spearman's correlations were used to analyse convergent validity of PROMIS-GH subscales with SF-36v1 composites and subscales. Age- and gender-weighted T-scores were computed for the Global Physical Health (GPH) and Global Mental Health (GMH) subscales using the US item calibrations.
The item response theory assumptions of unidimensionality, local independence and monotonicity were met for both subscales. The graded response model showed acceptable fit indices for both subscales. No differential item functioning was detected for any sociodemographic characteristics. GMH T-scores showed a strong correlation with SF-36 mental health composite score (r = 0.71) and GPH T-scores with SF-36 physical health composite score (r = 0.83). Mean GPH and GMH T-scores of females were lower (47.8 and 46.4) compared to males (50.5 and 49.3) (p < 0.001), and both mean GPH and GMH T-scores decreased with age, suggesting worse health status (p < 0.05).
This study established the validity and developed general population reference values for the PROMIS-GH in Hungary. Population reference values facilitate the interpretation of patients' scores and allow inter-country comparisons.
患者报告结局测量信息系统-全球健康（PROMIS-GH）是一种广泛使用的健康状况通用衡量标准。本研究旨在：（1）评估匈牙利语 PROMIS-GH 的心理测量特性；（2）在匈牙利制定一般人群参考值。
采用在线横断面调查的方法，对匈牙利成年一般人群（n=1700）进行调查。受访者完成了 PROMIS-GH v1.2 量表。对单维性（验证性因子分析和双因子模型）、局部独立性、单调性（Mokken 量表）、等级反应模型拟合、项目特征曲线和测量不变性进行了检验。使用 Spearman 相关分析评估了 PROMIS-GH 分量与 SF-36v1 综合评分和分量的聚合效度。使用美国项目标定，计算了全球生理健康（GPH）和全球心理健康（GMH）分量的年龄和性别加权 T 评分。
两个分量的维度性、局部独立性和单调性的项目反应理论假设均成立。等级反应模型对两个分量的拟合指数均表现出可接受的水平。未发现任何社会人口学特征的差异项目功能障碍。GMH T 评分与 SF-36 心理健康综合评分呈强相关（r=0.71），GPH T 评分与 SF-36 生理健康综合评分呈强相关（r=0.83）。女性的 GPH 和 GMH 平均 T 评分（分别为 47.8 和 46.4）低于男性（分别为 50.5 和 49.3）（p<0.001），且 GPH 和 GMH 平均 T 评分随年龄的增加而降低，表明健康状况较差（p<0.05）。
本研究确立了匈牙利语 PROMIS-GH 的有效性，并制定了一般人群参考值。人群参考值有助于解释患者的分数，并允许进行跨国比较。
