PROMIS CATs: AI Qualitative Analysis in Healthcare

According to the PLOS ONE study published on November 13, 2026, Dutch-Flemish PROMIS computerized adaptive tests were feasible and generally acceptable in primary care physical therapy, but simultaneous use of legacy questionnaires, portal problems, and uncertainty about score interpretation limited implementation.

• The 2026 mixed-methods study covered 14 physical therapy practices, 25 surveyed therapists, 10 interviewed therapists, and 9 interviewed patients.
• The study reported that 100% of surveyed therapists found PROMIS CATs easy to administer, while 72% rated them easy to use and 96% found them easy to locate in the electronic health record.
• Only 28% of surveyed therapists reported regular daily use, even though 80% expressed interest in using PROMIS CATs and 56% wanted to increase usage.
• PROMIS CATs required at least 4 and at most 12 items under the study’s stopping rules, which was intended to maintain approximately 0.95 reliability while limiting respondent burden.
• The researchers concluded on November 13, 2026, that sustainable adoption requires phasing out legacy PROMs, improving score-interpretation training, securing reimbursement, and incorporating PROMIS into clinical guidelines.

The 2026 PLOS ONE study found that PROMIS CATs were clinically useful but not fully embedded in routine physical therapy practice. Researchers combined a therapist survey with semi-structured interviews, then analyzed interview transcripts through hybrid inductive-deductive thematic analysis and mapped themes to Bowen’s feasibility domains: acceptability, demand, practicality, and implementation.

The study collected survey responses between May 2 and June 20, 2022, and conducted interviews between March 21 and November 23, 2022. The researchers integrated PROMIS CATs into electronic health records across 14 Dutch practices, allowing the feasibility assessment to reflect routine-care conditions rather than a controlled laboratory setting.

The researchers reported that therapists generally found PROMIS CATs easy to use and helpful for focused discussions about symptoms and functioning. Patients generally described the CATs as quick and relevant when clinicians used the results during consultations. However, the study also identified tension between perceived usefulness and operational adoption.

The study’s qualitative evidence explains that tension. One patient said, "Answering the questions made me reflect on my symptoms and what I want help with" (Patient #5). A physical therapist identified the central implementation problem by saying, "If the CAT can replace NPRS, PSFS, and Quebec while giving the same information, that’s a win-win" (PT #6). The findings indicate that PROMIS CATs were more attractive as replacements for legacy PROMs than as additional questionnaires.

The study also found a difference between therapist perceptions and patient accounts. Only 24% of surveyed therapists believed patients were satisfied with PROMIS CATs, while interviewed patients generally described the CATs as quick, simple, and relevant. The researchers interpreted this divergence as a reason to analyze quantitative and qualitative evidence together rather than relying on either data type alone.

The 2026 PROMIS CAT study shows why healthcare implementation research benefits from combining statistics with carefully analyzed qualitative evidence. PROMIS CATs were easy to administer and generally useful, but legacy questionnaires, interpretation challenges, and workflow conditions limited routine adoption.

AI qualitative analysis in healthcare can help research teams move from disconnected transcripts and survey comments to traceable themes, subgroup comparisons, and evidence-backed decisions. Researchers should validate AI-generated codes against source excerpts and preserve participant context, especially when working with sensitive patient data.

Healthcare researchers who want to analyze interviews, surveys, and documents in one workflow can try Evidano for free.