A Multinational Comparison Study of the Patient-Reported Outcomes Measurement Information System Anxiety, Depression, and Anger Item Bank in the General Population.

Objectives: This study aimed to compared Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety, depression, and anger item bank among Korean, US and Dutch general population.

Methods: Between December 2021 and January 2022, we surveyed representative Korean participants (N = 2699). Then we compared the mean T-scores of PROMIS anxiety, depression, and anger full items bank among Korean, US (N = 1696) and the Dutch (N = 1002) populations. Differential item-functioning (DIF) analyses were also performed. We also compared each score by age group, sex, presence of comorbidities, and general health status.

Results: In Korean, the mean T-scores for anxiety, depression, and anger were 45.3 (standard deviation [SD] = 11.6), 48.4 (SD = 11.2), and 44.9 (SD = 12.6), respectively. Among the general population in Korea, patients aged 35-44 years and those with comorbidities had higher anxiety, depression, and anger scores. In the DIF analyses between the US and Korean populations, 28%, 32%, and 45% were flagged for uniform or non-uniform DIF in anxiety, depression and anger, respectively.

Conclusions: Considering the cultural differences, we recommend using a harmonized approach that includes country-specific reference values while retaining a standardized core set of items to enable cross-country comparability.