Use of the PROMIS-10 global health in patients with chronic low back pain in outpatient physical therapy: a retrospective cohort study

Implementation of a value-based approach for older people who have suffered an acute myocardial infarction: study protocol

Introduction

Due to the rapid aging of the global population, new approaches are required to improve the quality of life of older people and to reduce healthcare system expenditures. One of the approaches that can be used is value-based healthcare. This article describes a value-based solution for older people who have suffered a myocardial infarction.

Methods

This solution combines the work of healthcare professionals and informal caregivers and the use of modern and user-friendly technologies to support the achievement of patients' values. Patients older than 65 years who have suffered a myocardial infarction will be divided into control and intervention groups within a pre-post-controlled design research study. Members of the intervention group will be provided with a personalized plan developed by healthcare professionals and based on the results from the baseline questionnaire.

Discussion

Two ValueCare digital solution components will be developed: a mobile application for the participants and a web platform for the professionals, researchers, and informal caregivers. Together with smartwatches, which will track important health aspects, and applications, this approach would enable older people to improve their health through correct lifestyle choices and their professional and informal caregivers to track their progress. With the use of the described technology and the multidisciplinary approach, the unmet needs and values of participants could be achieved. Using this approach, it could be possible to reduce overall healthcare expenses through the active involvement of both older people and their informal caregivers through a shared decision-making process with healthcare professionals.

Clinical trial registration

The ISRCTN registry number is 25089186. The date of trial registration is 16/11/2021.

Scoping Review: Anesthesiologist Involvement in Alternative Payment Models, Value Measurement, and Nonclinical Capabilities for Success in the United States of America

The US healthcare sector is undergoing significant payment reforms, leading to the emergence of Alternative Payment Models (APMs) aimed at improving clinical outcomes and patient experiences while reducing costs. This scoping review provides an overview of the involvement of anesthesiologists in APMs as found in published literature. It specifically aims to categorize and understand the breadth and depth of their participation, revolving around 3 main axes or "Aims": (1) shaping APMs through design and implementation, (2) gauging the value and quality of care provided by anesthesiologists within these models, and (3) enhancing nonclinical abilities of anesthesiologists for promoting more value in care. To map out the existing literature, a comprehensive search of relevant electronic databases was conducted, yielding a total of 2173 articles, of which 24 met the inclusion criteria, comprising 21 prospective or retrospective cohort studies, 2 surveys, and 1 case-control cohort study. Eleven publications (45%) discussed value-based, bundled, or episode-based payments, whereas the rest discussed non-payment-based models, such as Enhanced Recovery After Surgery (7 articles, 29%), Perioperative Surgical Home (4 articles, 17%), or other models (3 articles, 13%).The review identified key themes related to each aim. The most prominent themes for aim 1 included protocol standardization (16 articles, 67%), design and implementation leadership (8 articles, 33%), multidisciplinary collaboration (7 articles, 29%), and role expansion (5 articles, 21%). For aim 2, the common themes were Process-Based & Patient-Centric Metrics (1 article, 4%), Shared Accountability (3 articles, 13%), and Time-Driven Activity-Based Costing (TDABC) (3 articles, 13%). Furthermore, we identified a wide range of quality metrics, spanning 8 domains that were used in these studies to evaluate anesthesiologists' performance. For aim 3, the main extracted themes included Education on Healthcare Transformation and Policies (3 articles, 13%), Exploring Collaborative Leadership Skills (5 articles, 21%), and Embracing Advanced Analytics and Data Transparency (4 articles, 17%).Findings revealed the pivotal role of anesthesiologists in the design, implementation, and refinement of these emerging delivery and payment models. Our results highlight that while payment models are shifting toward value, patient-centered metrics have yet to be widely accepted for use in measuring quality and affecting payment for anesthesiologists. Gaps remain in understanding how anesthesiologists assess their direct impact and strategies for enhancing the sustainability of anesthesia practices. This review underscores the need for future research contributing to the successful adaptation of clinical practices in this new era of healthcare delivery.

Enhancing representativeness of patient-reported outcomes in routine radiation oncology care: a quality improvement protocol to address non-response

INTRODUCTION

Non-response significantly undermines the representativeness of patient-reported outcome (PRO) data, thereby compromising its utility for facilitating high-value, equitable, patient-centred care in cancer clinics. Quality improvement studies are needed to assess the representativeness of PRO data collected in routine care, identify the underlying causes of non-response and develop novel methods to ensure data representativeness. Using a multilevel framework and a mixed-methods approach, we have three aims: (1) characterise the non-response of the Global-10 across clinic, provider and patient levels; (2) identify multilevel causes of non-response and potential strategies to improve representativeness in PRO collection; and (3) develop effective modifications to missing-data methods to enhance the representativeness of pre-existing PRO data.

METHODS AND ANALYSIS

Our primary data source is the Patient Reported Outcomes Measurement Information System Global-10, collected as part of routine care at the Radiation Oncology clinics within the Mass General Brigham (MGB) healthcare system. Other sources include (1) Harvard Catalyst for provider-specific data, (2) MGB administrative data, (3) public Centers for Medicare & Medicaid Services data and (4) the National Plan and Provider Enumeration System. We will conduct quantitative analyses to assess variations in Global-10 non-response across multilevel factors. Additionally, we will use qualitative interviews with patients and clinical professionals to understand the causes of non-response and to formulate strategies to expand the reach of PRO collection to underrepresented cancer patients, improve their completions and enhance overall data representativeness. Finally, we will integrate implementation science knowledge and findings from the first two aims into missing-data methods to manage non-response in the pre-existing Global-10 data and to evaluate their performance in preserving representativeness.

ETHICS AND DISSEMINATION

The study protocol was reviewed and approved by the Institutional Review Board at the Dana-Farber/Harvard Cancer Center (24-225). Written informed consent will be obtained from participants. Study findings will be disseminated through peer-reviewed publications and presentations at national and international conferences.

An observational study: Correlation between self-perceived readiness and physical performance in healthy individuals

INTRODUCTION

In complex environments, individuals need to anticipate and react to stimuli by integrating complex systems and skills. Identifying the perceptual-cognitive, physical, and health characteristics that afford effective performance is necessary for developing training and readiness strategies. Measuring readiness by establishing a relationship between the Acute Readiness Monitoring Scale (ARMS) and performance during perceptual-cognitive tasks is essential. Therefore, this study aimed to determine the relationship between self-perceived readiness, physical performance, and perceptual-cognitive performance in healthy young adults.

MATERIALS AND METHODS

Cross-sectional design with healthy and physically active young adults (n = 35). Participants completed a measure of self-perceived readiness (the ARMS), physical performance (i.e., Vertical Jump (VJ) and Ballistic Push-Up), and perceptual-cognitive exercises (i.e., Single Leg Memory Hop (SLMH), Reactive VJ, Reactive Ballistic Push-Up, Reactive Agility Run Decide, and Upper and Lower Extremity Reaction Tests). Data was analyzed using Pearson's r (r) correlation to identify associations.

RESULTS

Statistically significant moderate correlations were detected between ARMS Total and VJ (Peak Power Normalized and Flight Time) (r = 0.434, p = 0.010) and (r = 0.420, p = 0.013), and SLMH Distance Normalized (r = 0.409, p = 0.016). Moderate negative correlations between the ARMS Total and Reactive VJ Reaction Time (r = -0.473, p = 0.005).

CONCLUSION

The ARMS can be an effective tool for measuring acute self-perceived readiness. This suggests that individuals who work in dynamic environments may benefit from training that targets perceptual-cognitive skills. Although moderate, self-perceived readiness was associated with better resilience, health, and performance exercises. Results highlight the importance of protocols targeting populations who work in complex environments for increased performance.

Associations between physical activity, long COVID symptom intensity, and perceived health among individuals with long COVID

Introduction

Physical activity (PA) is associated with better perceived health among individuals with chronic conditions. However, PA's relationship with perceived health in people with long COVID is unclear and may be modified by long COVID symptom burden.

Methods

Participants with self-reported long COVID (N = 379) responded to an online survey cross-sectionally assessing PA levels, perceived physical and mental health, and intensity of CDC-defined long COVID symptoms on a 0-100 scale. Linear regression analyses assessed the associations between PA and perceived physical and mental health, after accounting for sociodemographic, health behavior, and long COVID intensity variables, with post-hoc analyses comparing health across PA levels.

Results

Increasing levels of PA were associated with increases in perceived physical health (β = 0.27, p < 0.001) and mental health (β = 0.19, p < 0.001) after accounting for sociodemographic and health behavior variables. PA remained significantly associated with perceived physical health (β = 0.15, p < 0.001) but not perceived mental health (β = 0.09, p = 0.067) after the adding long COVID intensity to the model. Insufficiently active and active groups reported significant better physical and mental health than the inactive group (ps < 0.05), while the highly active group did not significantly differ from any other group on perceived physical or mental health (ps > 0.05). Inactive individuals reported significantly greater long COVID symptom burden compared to each other PA level (ps < 0.05).

Conclusion

Higher levels of PA may be associated with better physical health among individuals with long COVID, even after accounting for symptom intensity. However, long COVID symptom intensity may confound the relationship between PA and mental health among individuals with long COVID.

Relationships Between Socioecological Factors and Self-Efficacy to Participate in Physical Activity for Adults With Chronic Musculoskeletal Pain: An Integrative Review

OBJECTIVE

Self-efficacy for leisure-time or health-promoting physical activity (SEPA) is a psychosocial determinant of physical activity. The socioecological model can provide a robust perspective of SEPA. The objective of this study was to synthesize the evidence on multilevel correlates of SEPA among individuals with chronic musculoskeletal pain. The second aim examined the extent to which socioecological disparities are associated with SEPA among individuals with chronic musculoskeletal pain.

METHODS

An integrative review was conducted. Included studies needed to investigate the relationship between SEPA and socioecological factors at the interpersonal, institutional, community, and/or macrosystem level among adults with chronic musculoskeletal pain (≥3 months). Searches in PubMed, EMBASE, PsycINFO, and CINAHL were performed (December 30, 2020, and October 12, 2022), yielding 4047 records after duplicates were removed. Two independent reviewers completed screening, full-text reviews, and data extraction. After title and abstract screening and full-text reviews, 17 studies were included. The constant comparison method included: data reduction, data display, data comparison, and conclusion drawing/verification. Quality of evidence was assessed using the Joanna Briggs Institute appraisal tools.

RESULTS

Five themes emerged with respect to relationships between SEPA and socioecological factors: social relations, social comparisons, patient-provider relationship, organizational resources, and accessibility to physical activity. Relationships between interpersonal factors and SEPA were most prominently studied. One study examined and addressed potential disparities in SEPA at the macrosystem level.

CONCLUSION

A spectrum of relationships from supporting to straining SEPA were found at the interpersonal level. Relationships between institutional, community, and macrosystem factors and SEPA were comparably sparse. Gaps in the literature were identified regarding how health disparities present across the socioecological model with respect to SEPA.

IMPACT

Clinicians can use this review to evaluate how SEPA can be supported or threatened by factors across the socioecological model. This may be a preliminary step towards examining and addressing health disparities in SEPA.

Racial Differences in Movement-Related Appraisals and Pain Behaviors Among Adults With Chronic Low Back Pain

Research documents racial disparities in chronic low back pain (CLBP). Few studies have examined racial disparities in movement-related appraisals and no studies have examined anticipatory appraisals prior to or pain behaviors during functional activities among individuals with CLBP. This cross-sectional study examined racial differences in anticipatory appraisals of pain, concerns about harm, and anxiety, appraisals of pain and anxiety during movement, and observed pain behaviors during 3 activities of daily living (supine-to-standing bed task, sitting-to-standing chair task, floor-to-waist lifting task) in a sample (N = 126) of non-Hispanic Black (31.0%), Hispanic (30.2%), and non-Hispanic White (38.9%) individuals with CLBP. Hispanic participants reported more expected pain, concerns about harm, and pre-movement anxiety prior to the bed and chair tasks compared to non-Hispanic White participants. Hispanic participants reported more pain during the bed task and more anxiety during the bed and chair tasks compared to non-Hispanic White participants. Non-Hispanic Black participants reported more expected pain, concerns about harm, and pre-movement anxiety prior to the bed task and more pre-movement anxiety prior to the chair task compared to non-Hispanic White participants. Non-Hispanic Black participants reported more anxiety during the bed and chair tasks compared to non-Hispanic White participants. Non-Hispanic Black participants were observed to have significantly more verbalizations of pain during the bed task compared to non-Hispanic White participants. Current findings identify racial disparities in important cognitive-behavioral and fear-avoidance mechanisms of pain. Results indicate a need to revisit traditional theoretical and treatment models in CLBP, ensuring racial disparities in pain cognitions are considered. PERSPECTIVE: This study examined racial disparities in anticipatory and movement-related appraisals, and pain behaviors during activities of daily living among Non-Hispanic Black, Non-Hispanic White, and Hispanic individuals with CLBP. Racial disparities identified in the current study have potentially important theoretical implications surrounding cognitive-behavioral and fear-avoidance mechanisms of pain.

Matched vs Nonmatched Placebos in a Randomized Trial of COVID-19 Treatments

Importance

Matched placebo interventions are complex and resource intensive. Recent evidence suggests matched placebos may not always be necessary. Previous studies have predominantly evaluated potential bias of nonmatched placebos (ie, differing on dose, frequency of administration, or formulation) in pain and mental health, but to date no systematic examination has been conducted in infectious disease.

Objective

To test for differences between nonmatched and matched placebo arms with respect to clinical outcome measures across multiple therapeutics for COVID-19.

Design, Setting, and Participants

In a comparative effectiveness research study, a post hoc analysis was conducted of data on individual patients enrolled in a large, multiarm, platform randomized clinical trial in symptomatic adult outpatients with COVID-19 between January 15, 2021, to September 28, 2023, in which the outcomes of both matched and nonmatched placebo groups were reported. Bayesian and frequentist covariate-adjusted techniques were compared with 7 intervention-placebo pairs.

Exposures

Seven matched and nonmatched placebo pairs (for a total of 7 comparisons) were evaluated throughout the primary platform trial. Comparisons were made between treatment and its associated matched (concurrent) placebo, as well as with nonmatched placebo (alone and in combination) assessed at a similar time point.

Main Outcomes and Measures

Outcomes assessed included hospitalizations, EuroQol 5-Dimension 5-level scores, and PROMIS Global-10 scores.

Results

A total of 7 intervention-control pairs (N = 2684) were assessed, including 1620 (60.4%) women, with mean (SD) age, 47 (15.2) years; the most common comorbidities were obesity (41.9%) and hypertension (37.9%). In a meta-analysis with decoupled SEs, accounting for overlapping placebo patients, the overall odds ratio (OR) of nonmatched compared with matched placebo was 1.01 (95% credible interval, 0.77-1.32), with posterior probability of equivalence, defined as 0.8 ≤ OR ≤ 1.2 (a deviation from perfect equivalence ie, OR = 1, by no more than 0.2) of 85.4%, implying no significant difference. Unadjusted analysis of the event rate difference between all nonmatched and matched placebo groups did not identify any notable differences across all 7 treatment-placebo combinations assessed. Similar analysis that was conducted for patient-reported quality of life outcomes did not yield statistically significant differences.

Conclusions and Relevance

In this post hoc study of a randomized clinical platform trial, pooling matched and nonmatched placebo patient data did not lead to inconsistencies in treatment effect estimation for any of the investigational drugs. These findings may have significant implications for future platform trials, as the use of nonmatched placebo may improve statistical power, or reduce barriers to placebo implementation.

Functional medicine health coaching improved elimination diet compliance and patient-reported health outcomes: Results from a randomized controlled trial

BACKGROUND

The objective of this study was to determine whether an elimination diet with virtually provided functional medicine health coaching support would be more effective than a typical self-guided elimination diet with respect to dietary compliance and patient-reported health and quality of life.

METHODS

A parallel arm, randomized controlled trial was conducted among a sample of healthcare professionals. Participants were randomized to either an elimination diet with 5 sessions of functional medicine health coaching support (intervention arm) or a self-guided elimination diet (control arm). Outcomes assessed at baseline and at the conclusion of the 10-week study included PROMIS Global Health (GH) and medical symptoms questionnaire (MSQ). Compliance with the elimination diet was assessed at the conclusion of the study. Baseline and end of study outcomes were compared within study arms via paired t tests and between study arms with unpaired t tests. Subgroup analysis of symptomatology at baseline was performed.

RESULTS

125 randomized participants (n = 64 intervention, n = 61 control) provided baseline outcomes data. There were statistically and clinically significant within-group improvements in patient-reported outcomes in both the intervention arm (PROMIS GH-physical = 4.68, PROMIS GH-mental = 3.53, MSQ = 28.9) and control arm (PROMIS GH-physical = 48.4, PROMIS GH-mental = 3.18, MSQ = 24.1). There were no between-group differences in the primary analysis (P > .1). However, participants with more symptoms at baseline had statistically and clinically significant between-group differences in PROMIS GH-mental health (3.90, P = .0038) and MSQ (12.3, P = .047) scores that favored the functional medicine health coaching arm.

CONCLUSIONS

An elimination diet, whether self-guided or with functional medicine health coaching support, may improve patient-reported health outcomes among relatively healthy healthcare professionals. While studies in more diverse samples are needed, functional medicine health coaching support appears to be superior to a self-guided approach with regard to both dietary compliance and improving health outcomes among those with greater symptomatology.

Predictive Criterion Validity of the Parsley Symptom Index Against the Patient-Reported Outcomes Measurement Information System-10 in a Chronic Disease Cohort: Retrospective Cohort Study

BACKGROUND

Approximately 60% of US adults live with chronic disease, imposing a significant burden on patients and the health care system. With the rise of telehealth, patient-reported outcomes measures (PROMs) have emerged as pivotal tools for managing chronic disease. While numerous PROMs exist, few have been designed explicitly for telehealth settings. The Parsley Symptom Index (PSI) is an electronic patient-reported outcome measure (ePROM) developed specifically for telehealth environments.

OBJECTIVE

Our aim is to determine whether the PSI predicts changes in the established Patient-Reported Outcomes Measurement Information System-10 (PROMIS-10) Global Health, a 10-question short form.

METHODS

We conducted a retrospective cohort study using data from 367 unique patients, amassing 1170 observations between August 30, 2017, and January 30, 2023. Patients completed the PSI and the PROMIS-10 multiple times throughout the study period. Using univariate regression models, we assess the predictive criterion validity of the PSI against PROMIS-10 scores.

RESULTS

This study revealed significant relationships between the PSI and PROMIS-10 physical and mental health scores through comprehensive univariate analyses, thus establishing support for the criterion validity of the PSI. These analyses highlighted the PSI's potential as an insightful tool for understanding and predicting both mental and physical health dimensions.

CONCLUSIONS

Our findings emphasize the importance of the PSI in capturing the nuanced interactions between symptomatology and health outcomes. These insights reinforce the value of the PSI in clinical contexts and support its potential as a versatile tool in both research and practice.

Telemedical Interdisciplinary Care Team Evaluation and Treatment of People With Low Back Pain: A Retrospective Observational Study

Objective

To evaluate the effects of an interdisciplinary care team (ICT) model delivered by telemedicine on patients with low back pain (LBP).

Design

Retrospective analysis of deidentified pre-existing data.

Setting

Retrospective observational study of patients presenting with LBP to a nationwide telemedicine practice using an ICT model.

Participants

Over a 9-month period all patients with a diagnosis related to LBP and who had an ICT evaluation (medical doctor, advanced practice provider, health coach, and physical therapist) were included in the study (n=36). A minimum of 2 follow-up physical therapy visits were required for inclusion.

Interventions

Patients were evaluated for LBP, received a diagnosis, and were offered a multidisciplinary treatment plan. Additional real-time audio visual medical, health coaching, registered dietician, and physical therapy services were received as deemed clinically appropriate.

Main Outcome Measures

Baseline, 30 day, and final pain (mean 81 day) measurements via numerical pain rating scale (NPRS). Baseline and final Patient-Reported Outcomes Measurement Information System (PROMIS)-10 Global Mental/Physical domains.

Secondary Outcome Measures

Use of prescription medication, referral for imaging, need for injections, or surgery.

Results

36 patients met criteria. Pain levels included mild (n=6, 16.7%), moderate (n=19, 52.8%), and severe (n=11, 30.6%). Clinically significant pain improvements were noted in 83.3% (n=25) of those with moderate or severe pain. PROMIS Mental and Physical Health categorization from Fair/Poor to Good/Excellent significantly improved over time. The initial 20% (n=7) in Fair/Poor Mental Health improved to 6.3% (n=2) at finish, while the 80% (n=28) in Good/Excellent Mental Health at start improved to 93.8% (n=30) at finish. Regarding Physical Health, 51.4% (n=18) rated Fair/Poor at start and 31.3% (n=10) at finish, while the 48.6% (n=17) rated Good/Excellent at start improved to 68.8% (n=22) at finish. The need for prescription medication was low (n=6, 16.7%) and spinal imaging orders were negligible (n=1, 2.8%). Injections were warranted in 11.4% (n=4) of patients and surgical referral with operative treatment in 2.8% (n=1).

Conclusion

Interdisciplinary care delivered through telemedicine can significantly improve pain and support improved health-related quality of life in patients with LBP, with low rates of imaging, prescription, and interventional use.

Woman-Centered Care: Standardized Outcomes Measure

Background and Objectives: Patient- or woman-centered care, prioritizing women's perspectives, needs, and preferences, is a widely recommended approach to enhance the quality of maternity care services. It aligns with the broader principles of patient-centered care, emphasizing the importance of a collaborative and respectful relationship between healthcare providers and women. This study evaluates low-risk pregnancies managed by midwives and obstetrician-gynecologists in Lithuania using patient-reported outcome measures and patient-reported experience measures. Materials and Methods: A prospective cohort study was conducted between September 2022 and April 2023. Data were collected through patient-reported questionnaires. Results: A total of 153 pregnant women who had singleton, low-risk pregnancies participated in the study, of whom 24.8% had their pregnancies supervised by a midwife, and 75.2% of the participants had their pregnancies supervised by an obstetrician-gynecologist. The study found no statistically significant differences in assessed patient-reported outcome measures and patient-reported experience measures between both models of care. Conclusions: Adopting patient-centered approaches enables healthcare systems to understand and address women's specific needs and preferences, fostering high-quality and woman-centered care. This research adds to the growing evidence supporting midwife-led care and emphasizes the importance of personalized, woman-centered approaches in maternity care, ultimately enhancing maternal health outcomes and promoting positive experiences for low-risk pregnant women. The quality of care provided by midwives remains uncompromised and equivalently proficient compared to the care provided by collaborative teams.

Childhood Adversity among Adults with Chronic Pain: Prevalence and Association with Pain-Related Outcomes

OBJECTIVES

Adverse childhood experiences (ACEs) have been linked to the development and impact of chronic pain in adulthood. The goal of this study was to investigate the prevalence of ACEs in a treatment-seeking sample of adults with chronic pain and the relationship between number and type(s) of ACEs and pain-related outcomes.

METHODS

Adults (N=1794) presenting for treatment at a multidisciplinary pain management center completed self-report measures of childhood adversity, pain, functioning, emotional distress, and adjustment to pain.

RESULTS

Participants endorsing ≥4 ACEs had significantly worse pain-related outcomes and lower quality of life compared to individuals reporting fewer ACEs. Having ≥3 ACEs was associated with higher anxiety and depression levels. Experiences of childhood neglect negatively affected mental health-related outcomes independent of number of ACEs. Significant sex differences were found in the number and type of ACEs reported, but not in the relationship between ACEs and outcome variables.

CONCLUSION

Findings suggest that the number and type of self-reported ACE(s) are associated with pain-related variables and psychosocial functioning in adults with chronic pain. Results highlight the importance of assessment of ACEs and trauma-informed care with patients with chronic pain.

Patient-reported outcomes and quality of life in PMM2-CDG

Patient-reported outcomes (PROs) measure important aspects of disease burden, however they have received limited attention in the care of patients with Congenital Disorders of Glycosylation (CDG). We evaluated the PROs and correlation between clinical disease severity scoring and reported quality of life (QoL) in a PMM2-CDG patient cohort. Twenty-five patients with diagnosis of PMM2-CDG were enrolled as part of the Frontiers in Congenital Disorders of Glycosylation Consortium (FCDGC) natural history study. Patient- Reported Outcomes Measurement Information System (PROMIS) was completed by caregivers to assess health-related QoL. Clinical disease severity was scored by medical providers using the Nijmegen Progression CDG Rating Scale (NPCRS). The domains such as physical activity, strength impact, upper extremity, physical mobility, and a satisfaction in social roles (peer relationships) were found to be the most affected in the PMM2-CDG population compared to US general population. We found a strong correlation between NPCRS 1 (current functional ability) and three out of ten PROMIS subscales. NPCRS 2 (laboratory and organ function) and NPCRS 3 (neurological involvement) did not correlate with PROMIS. Mental health domains, such as anxiety, were positively correlated with depressive symptoms (r = 0.76, p = 0.004), fatigue (r = 0.67, p = 0.04). Surprisingly, patients with severely affected physical mobility showed low anxiety scores according to PROMIS (inverse correlation, r = -0.74, p = 0.005). Additionally, there was a positive correlation between upper extremity and physical mobility (r = 0.75, p = 002). Here, we found that PROMIS is an informative additional tool to measure CDG disease burden, which could be used as clinical trial outcome measures. The addition of PROMIS to clinical follow-up could help improve the quality of care for PMM2-CDG by facilitating a holistic approach for clinical decision-making. SYNOPSIS: We recommend PROMIS as an informative tool to measure disease burden in PMM2-CDG in addition to traditional CDG disease severity scores.