1037 — Using PROMIS/NeuroQol Methods to Build Measures of the Impact of Deployment-Related PTSD on Health-Related Quality of Life

Luther SL, Center for Innovation on Disabilities and Rehabilitation Research; Lind JD, Center of Innovations on Disabilities and Rehabilitation Research (CINDRR), James A. Haley Veterans Hospital; Haun JN, Center of Innovations on Disabilities and Rehabilitation Research (CINDRR), James A. Haley Veterans Hospital; Marx B, VA Boston Healthcare System; Erbes CR, Minneapolis VAMC; Schwartzberg R, Center of Innovations on Disabilities and Rehabilitation Research (CINDRR), James A. Haley Veterans Hospital; Kisala P, University of Deleware; Tulsky D, University of Deleware;

Objectives:
Develop new and/or adapt existing item banks that measure the impact of deployment-related post-traumatic stress disorder (PTSD) on health-related quality of life (HRQOL).

Methods:
Veteran and provider focus groups were conducted at three VA medical centers to identify HRQOL issues relevant to deployment-related PTSD. Transcripts of the focus groups were analyzed to identify potential domains. The domains were compared with existing item banks developed by the Patient-Reported Outcomes Measurement Information System (PROMIS) and Neuro-QOL. Item pools, including new and existing items, were created and iteratively refined by the research team. Cognitive testing was conducted for all new items. Field testing of the new items and computer adaptive testing or short form versions of the existing items was conducted using the PROMIS Assessment Center with a minimum of 500 respondents completing each item.

Results:
A total of 8 Veteran (n = 58) and 4 professional (n = 23) focus groups were conducted. Based on the results of the focus groups, potential domains identified included Anger, Violence/Aggression, Avoidance/Isolation, Control Over the Environment, Social Roles, Task Performance, Sleep Interference and Hypervigilance. The Task Performance domain, which emphasized items related to the impact of PTSD on employment, was dropped from field test because of concerns that the targeted cohort would not support the planned psychometric analysis. Some of the domains identified currently exist in the PROMIS/NeuroQOL (e.g. Anger, Social Roles) while others describe constructs unique to deployment-related HRQOL (e.g. Avoidance/Isolation, Control Over the Environment). A small number of items in each pool were re-worded or dropped based on results of cognitive testing. A total of 178 new items were field tested along with relevant PROMIS/NeuroQOL items. Total number of new items ranged from 7 for the Anger domain to 39 for the for the Social Roles domain.

Implications:
The domains identified and the resultant field test of the items pools provide the foundation upon which to build psychometrically sound item banks to measure HRQOL in Veterans with deployment-related PTSD.

Impacts:
Improved measures of HRQOL for Veterans with deployment-related PTSD can facilitate improved research, program evaluation, and clinical practice.