Stefan Schneider PhD and Colleagues Advance the Use of Daily Diaries to Measure Patient Reported Health Status

imageThe National Institutes of Health (NIH) have set national standards for measuring patient-reported health outcomes such as pain, fatigue and depression with their Patient Reported Outcomes Measurement Information System (PROMIS). When PROMIS validated its assessment tools, it used a 7-day recall format to ask respondents about their health status. Several researchers have identified the advantages of using a 1-day recall format, pointing out the daily dairies yield information that is more accurate and sensitive to daily fluctuations. But before results obtained with daily diaries can be compared with nationally established norms, the psychometric characteristics of the daily recall method need to be established. In an article published in the journal Quality of Life Research, Stefan Schneider PhD and colleagues took a major step in that direction.
Funded by a grant from the NIH, Dr. Schneider and associates administered daily diary versions of three PROMIS measures (pain interference, fatigue and depression) to 100 healthy volunteers over a period of 28 days. Using the same statistical models as PROMIS they demonstrated that the daily recall method “captures comparable constructs with comparable metrics.”

Howerver, the daily recall method yielded lower mean symptom ratings than the 7-day recall period, perhaps because people tend to be more influenced by peak symptoms when using longer recall methods. Therefore, the national norms established by PROMIS are no longer valid when the recall period is modified from a 7-day recall to a daily diary version. The authors also noted that day to day fluctuations in reports of depression may involve a secondary factor, other than depression, reflecting transient changes in mood.

Dr. Schneider is Clinical Instructor of Psychiatry in the Department of Psychiatry and Behavioral Science at Stony Brook University. The paper, which is titled Psychometric characteristics of daily diaries for Patient-Reported Outcomes Measurement System (PROMIS): a preliminary investigation, was co-authored by Seung Choi PhD from Northwestern University and Doerte Junghaenel PhD, Joseph Schwartz PhD, and Arthur Stone PhD, all from Stony Brook University.