Article

PROMIS Pediatric Pain Interference Scale: An Item Response Theory Analysis of the Pediatric Pain Item Bank

Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, 3137 TAMU, College Station, Texas 77843-3137, USA.
The journal of pain: official journal of the American Pain Society (Impact Factor: 4.01). 11/2010; 11(11):1109-19. DOI: 10.1016/j.jpain.2010.02.005
Source: PubMed

ABSTRACT

An aim of the National Institutes of Health (NIH) Patient Reported Outcomes Measurement Information System (PROMIS) initiative is to develop item banks and computerized adaptive tests (CAT) that are applicable across a wide variety of chronic disorders. The PROMIS Pediatric Cooperative Group has concentrated on the development of pediatric self-report item banks for ages 8 through 17 years. The objective of the present study is to describe the Item Response Theory (IRT) analysis of the NIH PROMIS pediatric pain item bank and the measurement properties of the new unidimensional PROMIS Pediatric Pain Interference Scale. Test forms containing pediatric pain items were completed by a total of 3048 respondents. IRT analyses regarding scale dimensionality, item local dependence, and differential item functioning were conducted. A pain item pool was developed to yield scores on a T-score scale with a mean of 50 and standard deviation of 10. The recommended 8-item unidimensional short form for the PROMIS Pediatric Pain Interference Scale contains the item set which provides the maximum test information at the mean (50) on the T-score metric. A simulated CAT was computed that provides the most information at 5 possible score locations (30, 40, 50, 60, and 70 on the T-score metric). PERSPECTIVE: The present study provides initial calibrations of the NIH PROMIS pediatric pain item bank and the creation of the PROMIS Pediatric Pain Interference Scale. It is anticipated that this new scale will have application in pediatric chronic and recurrent pain.

  • Source
    • "In the first phase of PROMIS, 9 item banks were developed for measurement of child self-reported outcomes: depression, anxiety, social-peer relationships, pain interference, fatigue, mobility, upper extremity, anger, and asthma impact [8-13]. PROMIS pediatric measures were developed using qualitative and quantitative methods (focus groups, expert item review, cognitive interviewing, and item administration to a large population of children and adolescents) to create banks of items specific to selected symptoms and quality of life [11,14-17] for use in children 8 to 17 years of age [10,12,13]. PROMIS was developed in order to give researchers flexibility in selecting items or domains that are relevant to the disease of interest. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Nephrotic syndrome (NS) represents a common disease in pediatric nephrology typified by a relapsing and remitting course and characterized by the presence of edema that can significantly affect the health-related quality of life in children and adolescents. The PROMIS pediatric measures were constructed to be publically available, efficient, precise, and valid across a variety of diseases to assess patient reports of symptoms and quality of life. This study was designed to evaluate the ability of children and adolescents with NS to complete the PROMIS assessment via computer and to initiate validity assessments of the short forms and full item banks in pediatric NS. Successful measurement of patient reported outcomes will contribute to our understanding of the impact of NS on children and adolescents. This cross-sectional study included 151 children and adolescents 8-17 years old with NS from 16 participating institutions in North America. The children completed the PROMIS pediatric depression, anxiety, social-peer relationships, pain interference, fatigue, mobility and upper extremity functioning measures using a web-based interface. Responses were compared between patients experiencing active NS (n = 53) defined by the presence of edema and patients with inactive NS (n = 96) defined by the absence of edema. All 151 children and adolescents were successfully able to complete the PROMIS assessment via computer. As hypothesized, the children and adolescents with active NS were significantly different on 4 self-reported measures (anxiety, pain interference, fatigue, and mobility). Depression, peer relationships, and upper extremity functioning were not different between children with active vs. inactive NS. Multivariate analysis showed that the PROMIS instruments remained sensitive to NS disease activity after adjusting for demographic characteristics. Children and adolescents with NS were able to successfully complete the PROMIS instrument using a web-based interface. The computer based pediatric PROMIS measurement effectively discriminated between children and adolescents with active and inactive NS. The domain scores found in this study are consistent with previous reports investigating the health-related quality of life in children and adolescents with NS. This study establishes known-group validity and feasibility for PROMIS pediatric measures in children and adolescents with NS.
    Full-text · Article · Mar 2013 · Health and Quality of Life Outcomes
  • Source
    • "Additionally, current measures were primarily developed using classical test methods [16] and not modern test theory or advanced administration and scoring technology. PROMIS pediatric measures were developed using qualitative and quantitative methods (focus groups, expert item review, cognitive interviewing, and item administration to a large sample of children and adolescents) to create banks of items specific to selected domains and quality of life [9,17-20] for use in children 8- to 17- years of age [6,8,10]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Childhood obesity is a growing health concern known to adversely affect quality of life in children and adolescents. The Patient Reported Outcomes Measurement Information System (PROMIS) pediatric measures were developed to capture child self-reports across a variety of health conditions experienced by children and adolescents. The purpose of this study is to begin the process of validation of the PROMIS pediatric measures in children and adolescents affected by obesity. Methods The pediatric PROMIS instruments were administered to 138 children and adolescents in a cross-sectional study of patient reported outcomes in children aged 8–17 years with age-adjusted body mass index (BMI) greater than the 85th percentile in a design to establish known-group validity. The children completed the depressive symptoms, anxiety, anger, peer relationships, pain interference, fatigue, upper extremity, and mobility PROMIS domains utilizing a computer interface. PROMIS domains and individual items were administered in random order and included a total of 95 items. Patient responses were compared between patients with BMI 85 to < 99th percentile versus ≥ 99th percentile. Results 136 participants were recruited and had all necessary clinical data for analysis. Of the 136 participants, 5% ended the survey early resulting in missing domain scores at the end of survey administration. In multivariate analysis, patients with BMI ≥ 99th percentile had worse scores for depressive symptoms, anger, fatigue, and mobility (p < 0.05). Parent-reported exercise was associated with better scores for depressive symptoms, anxiety, and fatigue (p < 0.05). Conclusions Children and adolescents ranging from overweight to severely obese can complete multiple PROMIS pediatric measures using a computer interface in the outpatient setting. In the 5% with missing domain scores, the missing scores were consistently found in the domains administered last, suggesting the length of the assessment is important. The differences in domain scores found in this study are consistent with previous reports investigating the quality of life in children and adolescents with obesity. We show that the PROMIS instrument represents a feasible and potentially valuable instrument for the future study of the effect of pediatric obesity on quality of life.
    Full-text · Article · Mar 2013 · Health and Quality of Life Outcomes
  • Source
    • "It has been advocated that the measurement of HRQoL should be routine in pediatric outcomes research and clinical practice [1-5]. Specifically, the Pediatric Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (PedIMMPACT) [3] and the Patient-Reported Outcome Measurement Information System (PROMIS) have advocated the measurement of children's self-reported health, illness, well-being, and quality of life, including with a chronic pain conditions [2,6,7]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Previous pediatric studies have observed a cross-informant variance in patient self-reported health-related quality of life (HRQoL) versus parent proxy-reported HRQoL. This study assessed in older children and adolescents with a variety of chronic pain conditions: 1) the consistency and agreement between pediatric patients' self-report and their parents' proxy-report of their child's HRQoL; 2) whether this patient-parent agreement is dependent on additional demographic and clinical factors; and 3) the relationship between pediatric patient HRQoL and parental reported HRQoL. The 99 enrolled patients (mean age 13.2 years, 71% female, 81% Caucasian) and an accompanying parent completed the PedsQLTM 4.0 and 36-Item Short-Form Health Survey Version 2 (SF-36v2) at the time of their initial appointment in a pediatric chronic pain medicine clinic. Patients' and parents' total, physical, and psychosocial HRQoL scores were analyzed via an intra-class correlation coefficient, Spearman's correlation coefficient, Wilcoxon signed rank test, and Bland-Altman plot. A multivariable linear regression model was used to evaluate the association between clinical and demographic variables and the difference in patient and proxy scores for the Total Scale Score on the PedsQL™. With the exception of the psychosocial health domain, there were no statistically significant differences between pediatric patients' self-report and their parents' proxy-report of their child's HRQoL. However, clinically significant patient-parent variation in pediatric HRQoL was observed. Differences in patient-parent proxy PedsQL™ Total Scale Score Scores were not significantly associated with patient age, gender, race, intensity and duration of patient's pain, household income, parental marital status, and the parent's own HRQoL on the SF-36v2. No significant relationship existed among patients' self-reported HRQoL (PedsQL™), parental proxy-reports of the child's HRQoL, and parents' own self-reported HRQoL on the SF-36v2. We observed clinically significant variation between pediatric chronic pain patients' self-reports and their parents' proxy-reports of their child's HRQoL. While whenever possible the pediatric chronic pain patient's own perspective should be directly solicited, equal attention and merit should be given to the parent's proxy-report of HRQoL. To do otherwise will obviate the opportunity to use any discordance as the basis for a therapeutic discussion about the contributing dynamic with in parent-child dyad.
    Full-text · Article · Jul 2012 · Health and Quality of Life Outcomes
Show more