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Patient-reported outcome measure

PROMIS Global-10 Calculator

PROMIS Global Health Short Form (Global-10)

The PROMIS Global-10 is a 10-item general health questionnaire that yields two four-item summary scores — Global Physical Health and Global Mental Health — each reported as a T-score calibrated to the United States general population, where 50 is the population mean, 10 points is one standard deviation, and higher scores indicate better health.

Free to use10 items~2 min16.2–67.7, higher is better

General ratings

Please respond to each question or statement by marking one box per row.

1In general, would you say your health is:

Reported as a single item. It is not part of either summary score.

2In general, would you say your quality of life is:
3In general, how would you rate your physical health?
4In general, how would you rate your mental health, including your mood and your ability to think?
5In general, how would you rate your satisfaction with your social activities and relationships?
6In general, please rate how well you carry out your usual social activities and roles. (This includes activities at home, at work and in your community, and responsibilities as a parent, child, spouse, employee, friend, etc.)

Reported as a single item. It is not part of either summary score.

7To what extent are you able to carry out your everyday physical activities such as walking, climbing stairs, carrying groceries, or moving a chair?

In the past 7 days

These three questions ask about the past 7 days rather than about your health in general.

8In the past 7 days, how often have you been bothered by emotional problems such as feeling anxious, depressed or irritable?
9In the past 7 days, how would you rate your fatigue on average?

0 is no pain and 10 is the worst pain imaginable. The whole numbers 0 to 10 are recoded onto the 1–5 scale used by the other items before the physical health summary is calculated.

What the PROMIS Global-10 score means

PROMIS Global-10 scores run from 16.2 to 67.7, where a higher score is better. The bands below are conventional reporting categories, not diagnostic cut-offs.

  • Severe impairment16–29.9

    More than two standard deviations below the United States general population mean.

  • Moderate impairment30–39.9

    One to two standard deviations below the general population mean.

  • Mild impairment40–44.9

    Half a standard deviation to one standard deviation below the general population mean.

  • Within normal limits45–55

    Within half a standard deviation of the general population mean of 50.

  • Better than the population average55.1–68

    More than half a standard deviation above the general population mean.

How the score is calculated

Stated in full so the calculation can be independently checked, and reproduced by hand if needed.

Nine items are scored 1 to 5, with 5 always the healthiest response. The 0–10 pain item is first recoded onto the same metric: 0 becomes 5, 1–3 become 4, 4–6 become 3, 7–9 become 2 and 10 becomes 1. The Global Physical Health raw score is the sum of four items — general physical health, everyday physical activities, the recoded pain rating and fatigue — giving 4 to 20. The Global Mental Health raw score is the sum of four different items — quality of life, mental health, satisfaction with social activities and relationships, and emotional problems — also giving 4 to 20. Each raw sum is then converted to a T-score using the conversion table published in the PROMIS Global Health scoring manual, so that 50 is the mean of the United States general population and 10 points is one standard deviation. The remaining two items, self-rated general health and usual social activities and roles, are administered but are not included in either summary score.

Missing data

The published raw-score-to-T-score table is defined only for a complete four-item sum, so a summary score with any of its four items missing is not converted to a T-score here. The other summary score is unaffected and is still reported. PROMIS itself offers response-pattern (item response theory) scoring, which can handle missing items, but it requires the full item calibrations rather than the summed-score table.

Instrument profile

Developer
Ron D. Hays, David Cella and the PROMIS Cooperative Group
Institution
National Institutes of Health PROMIS initiative; Northwestern University
First published
2009
Custodian
HealthMeasures, Northwestern University
Items
10
Response format
Nine 5-point verbal rating scales plus one 0–10 pain numeric rating scale
Score range
16.2 to 67.7
Direction
Higher score = better
Recall period
Seven items ask "in general"; the pain, fatigue and emotional-problems items ask about the past 7 days
Completion time
About 2 minutes
Age range
Adults 18 and over (a separate PROMIS paediatric global health form exists)
Regions
General Health
Conditions
Any musculoskeletal condition, Osteoarthritis, Chronic pain, Post-operative recovery, Multimorbidity
Procedures
Total knee arthroplasty, Total hip arthroplasty, Spine surgery, Shoulder arthroplasty
Languages
English, Spanish, French, German, Dutch, Chinese, Japanese, Many further translations through the PROMIS translation programme
Internal consistency
Cronbach's alpha of roughly 0.8 for the physical health summary and roughly 0.9 for the mental health summary in the development sample.
Validity
The two summary scores correlate strongly with the corresponding SF-36 and EQ-5D summary indices, and with the longer PROMIS Physical Function and Depression item banks.
Responsiveness
Responsive to change in chronic disease and after major surgery, but less responsive than a joint-specific measure for a single-joint problem, because a knee that hurts affects only part of a global health rating. No minimal important difference has been published for either summary score in a defined population, so a change should be read against the metric itself — 10 T-score points is one standard deviation of the United States general population — and not against a threshold borrowed from another PROMIS domain.
Ceiling effect
A pronounced ceiling in healthy and young populations: several items saturate at "Excellent" long before physical performance is normal.

Normative values

Reference values from published cohorts, for comparison against the score you calculated.

PopulationAgeMeanSD
United States general population (the calibration sample that defines the metric)—5010

When to use the PROMIS Global-10

Well suited to

  • As the general-health companion to a joint-specific measure, so that a change in knee or hip score can be read against overall health.
  • Registry and value-based care reporting, where a single short instrument must cover every condition in the service.
  • Case-mix adjustment and comparison across specialties, since the T-score metric is common to every PROMIS instrument.
  • Screening for a mental health burden that would otherwise go unrecorded in an orthopaedic clinic.

Limitations and poor fits

  • As the primary endpoint for a single-joint intervention — it is far less responsive than KOOS, HOOS or a shoulder-specific measure.
  • Where a preference-based health utility is required for cost-effectiveness analysis; use the EQ-5D-5L, or a validated PROMIS-to-utility crosswalk rather than the T-scores directly.
  • In children and adolescents — use the PROMIS Paediatric Global Health form instead.
  • When a summary score is incomplete: do not prorate the raw sum, because the conversion table assumes four answered items.
  • To declare a responder. There is no published minimal important difference for the Global Physical Health or Global Mental Health summary in a defined population, and the 2–6 point figures quoted for "PROMIS" belong to the Physical Function, Pain Interference and Depression banks, not to this scale.

Copyright and permitted use

Published openly because it is the question every clinician and researcher asks before using an instrument, and almost nobody answers it.

Free to useRights holder: PROMIS Health Organization / Northwestern University (HealthMeasures)

PROMIS instruments were developed with United States National Institutes of Health funding and are distributed free of charge by HealthMeasures for clinical, research and commercial use. The item wording and the scoring manual are published openly. PROMIS is a registered trademark of the US Department of Health and Human Services, so the name may not be used to imply endorsement.

Rights holder’s own page

References

  1. Hays RD, Bjorner JB, Revicki DA, Spritzer KL, Cella D. Development of physical and mental health summary scores from the patient-reported outcomes measurement information system (PROMIS) global items. Quality of Life Research. 2009.doi:10.1007/s11136-009-9496-9
  2. Cella D, Riley W, Stone A, et al.. The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005–2008. Journal of Clinical Epidemiology. 2010.doi:10.1016/j.jclinepi.2010.04.011
  3. PROMIS Health Organization and PROMIS Cooperative Group. PROMIS Scale v1.2 – Global Health: scoring manual (raw score to T-score conversion tables). HealthMeasures, Northwestern University. 2021.

Editorial status

Not yet reviewedQueued for clinical review by Sam Tuffun, PT, DPT. Sign-off has not taken place — this is a placeholder assignment, not a completed review.