PROMIS-29 Profile v2.1: seven-domain health assessment

What this assessment is

The adult PROMIS-29 Profile v2.1 is a 29-item self-report measure of physical, mental, and social health.

It combines seven four-item PROMIS short forms with one separate rating of pain intensity.

The standard result is a health profile: seven domain T-scores and one pain-intensity rating. There is no standard total made by adding all 29 responses.

Keep the profile.

This page covers adult Profile v2.1. Other PROMIS profiles, earlier versions, pediatric forms, and computer-adaptive tests are not interchangeable with it.

The profile does not diagnose a condition.

Use the exact profile.

Who it was designed for

PROMIS was created to measure patient-reported health across diseases and care settings.

The adult 29-item profile is used when a broad but domain-specific view is more useful than one global score. It appears in clinical research, rehabilitation, chronic-disease care, and outcome monitoring.

The profile development study examined how fixed-length PROMIS profiles could represent multiple health domains while limiting respondent burden.

The adult form is completed by the person being assessed. Pediatric and proxy measures have their own item sets and calibrations.

How it is administered

The person answers 29 ratings using the exact adult Profile v2.1 form.

Completion usually takes several minutes. Disability, pain, fatigue, language, and the administration mode can affect the time needed.

Recall periods differ by domain. Some ratings concern recent symptoms, while some function ratings concern current ability. Keep the standard wording and time frame for every item.

Do not swap in a similar item from a PROMIS bank. Each domain score depends on the exact short form and version.

Use the same version, language, and mode when tracking change.

What it measures

The profile covers seven domains:

• physical function
• anxiety
• depression
• fatigue
• sleep disturbance
• ability to participate in social roles and activities
• pain interference

Each domain has four questions. The final rating records pain intensity on a 0-to-10 scale.

Domains stay separate.

Pain interference and pain intensity are different. Intensity concerns how strong the pain is. Interference concerns how pain affects life.

The domains can move independently. A person may report improved physical function while fatigue or sleep disturbance remains unchanged.

Differences matter.

Read the profile, not an invented total.

How scoring works

Score each four-item domain separately.

When all four responses are complete, their raw sum ranges from 4 to 20. Convert that sum with the table for the matching v2.1 short form, or use an approved response-pattern scoring service.

According to the adult PROMIS Profile scoring manual, each domain becomes a T-score with a reference mean of 50 and a standard deviation of 10.

Direction depends on the domain. Higher physical-function and social-participation scores indicate more function. Higher anxiety, depression, fatigue, sleep-disturbance, and pain-interference scores indicate more symptoms or difficulty.

Direction changes.

Report the separate pain-intensity rating from 0 to 10 without converting it into a domain T-score.

The manual prefers response-pattern scoring when responses are missing. Do not make a local prorating rule.

Do not guess.

Published methods can also estimate physical and mental health summary scores. Those summaries do not replace the seven domain results.

How to interpret a PROMIS-29 profile

Interpret each domain in its own direction.

A T-score of 50 is the reference mean, not a clinical cutoff. According to the official scoring manual, 10 points equal one reference standard deviation, but that difference does not have the same clinical meaning in every condition.

Fifty is descriptive.

There is no single set of mild, moderate, or severe bands for the whole profile. Domain-specific thresholds from one population should not be applied to another without evidence.

Look for the domains that are most different from their reference means and the domains that change over time. Then connect those results to the person's goals and clinical context.

For repeated assessment, keep the exact version and scoring method constant. Consider the score's standard error before treating a small change as meaningful.

What the scores cannot tell you

PROMIS-29 cannot diagnose depression, anxiety, a sleep disorder, chronic fatigue, or a pain condition.

It cannot identify why a domain score is high or low. Reduced physical function, for example, can arise from pain, weakness, breathlessness, fear, environment, or many other causes.

The profile cannot determine treatment or prove that a change resulted from an intervention.

A score close to the reference mean does not rule out an important individual problem. Four items give a useful summary, but they cannot cover every symptom or activity.

The result does not replace focused assessment when a domain raises concern.

Evidence and limitations

PROMIS domains were developed with item-response theory and tested across large, varied samples. Common T-score metrics make domain results easier to compare across studies that use the same calibrated measures.

Research on PROMIS-29 summary scoring found that physical and mental summary scores can add a broad view. The seven-domain profile still carries the detail needed to understand where health differs.

The fixed profile is more efficient than administering long measures for every domain. It is less precise than a longer short form or computer-adaptive test at some score levels.

Precision can differ.

Broad domains can miss condition-specific concerns. The measure also relies on self-report and can be influenced by health changes, expectations, support, and the environment.

Version and scoring errors are preventable limitations. Report the full instrument name, version, scoring method, domain direction, and assessment date beside every result.

Label every domain.