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.