Psychometric Properties of the Pediatric Patient-Reported Outcomes Measurement Information System (PROMIS®) Item Banks in a Dutch Clinical Sample of Children with Juvenile Idiopathic Arthritis

Michiel Luijten ¹, Caroline Terwee ², Hedy van Oers ², Mala Joosten ³, Merlijn van den Berg ², Dieneke Schonenberg-Meinema ², Koert Dolman ⁴, Rebecca Ten Cate ⁵, Leo Roorda ⁶, Martha Grootenhuis ³, Marion van Rossum⁷ and Lotte Haverman ², ¹Amsterdam University Medical Centers, Amsterdam, Noord-Holland, Netherlands, ²Amsterdam University Medical Centers, Amsterdam, Netherlands, ³Princess Maxima Centre for Pediatric Oncology, Utrecht, Netherlands, ⁴Onze Lieve Vrouwe Gasthuis West, Amsterdam, Netherlands, ⁵Leiden University Medical Centre, Leiden, Netherlands, ⁶Amsterdam Rehabilitation Research Center | Reade, Amsterdam, Netherlands, ⁷Amsterdam University Medical Centers, Amsterdam

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: patient-reported outcome measures, pediatric rheumatology and juvenile idiopathic arthritis (JIA)

Session Information

Date: Sunday, November 10, 2019

Title: Patient Outcomes, Preferences, & Attitudes Poster I: Patient Reported Outcomes

Session Type: Poster Session (Sunday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Patient-reported outcome measures (PROMs) are often used to include the patients perspective on treatment (outcome). However, the choice of PROMs is difficult, as there are multiple PROMs available to measure a single construct. These PROMs differ in psychometric properties, length and scoring methods and often suffer from ceiling effects. To improve measurements the National Institute of Health (NIH) initiated the development of the Patient Reported Outcomes Measurement Information System (PROMIS®), which contains multiple item banks to assess different construct of Health-Related Quality of Life (HRQoL), symptoms and psychosocial functioning.The purpose of this study was to assess the psychometric properties of eight pediatric PROMIS item banks in a clinical sample of children with Juvenile Idiopathic Arthritis (JIA).

Methods: 154 Dutch children (8-18 years, mean=14.4, SD=3.0) with JIA completed eight pediatric v1.0 PROMIS item banks (Anger, Anxiety, Depressive Symptoms, Fatigue, Pain Interference, Peer Relationships, Physical Function Mobility, Physical Function Upper Extremity) twice and the Pediatric Quality of Life Inventory (PedsQL) and the Childhood Health Assessment Questionnaire (CHAQ) once. Structural validity of the item banks was assessed by fitting a Graded Response Model (GRM) and inspecting GRM fit (CLI, TLI, RMSEA) and item fit (S-X²). Convergent validity (with PedsQL/CHAQ subdomains) and discriminative validity (active/inactive disease) were assessed. Reliability of the item banks, short-forms and CATs was expressed as standard error of theta (SE(θ)). Test-retest reliability was assessed using intraclass correlation coefficients (ICC) and Smallest Detectable Change (SDC).

Results: All item banks had sufficient overall GRM fit (CFI >.95, TLI >.95, RMSEA< .08) and no item misfit (all S-X2 p >.001). High correlations ( >.70) were found between most PROMIS T-scores and hypothesized PedsQL/CHAQ (sub)domains. Mobility, Pain Interference and Upper Extremity item banks were able to discriminate between patients with active and inactive disease. Regarding reliability PROMIS item banks outperformed legacy instruments. Post-hoc CAT simulations outperformed short-forms. Test-retest reliability was strong (ICC >.70) for all full-length item banks and short-forms, except for Peer Relationships.

Conclusion: The pediatric PROMIS item banks displayed sufficient psychometric properties in children with JIA. CATs outperformed short-forms in terms of test length and amount of patients reliably estimated. PROMIS item banks are ready for use in clinical research and practice in children with JIA.

Reliability and test-retest reliability of measurements for the full-length -FL- item banks, short-forms -SF- and computerized adaptive test -CAT-s of the pediatric PROMIS item banks in a sample of children with juvenile idiopathic arthritis -n = 155-.

Reliability of measurement -expressed as SE of the theta- plots for the PROMIS item banks: Anger, Anxiety Depressive Symptoms and Fatigue and their associated PedsQL subscale across the range of theta.

Reliability of measurement -expressed as SE of the theta- plots for the PROMIS item banks: Mobility Pai Interference, Peer Relationships and Upper Extremity and their associated PedsQL subscale across the range of theta.

Disclosure: M. Luijten, None; C. Terwee, None; H. van Oers, None; M. Joosten, None; M. van den Berg, None; D. Schonenberg-Meinema, None; K. Dolman, None; R. Ten Cate, None; L. Roorda, None; M. Grootenhuis, None; M. van Rossum, None; L. Haverman, None.

To cite this abstract in AMA style:

Luijten M, Terwee C, van Oers H, Joosten M, van den Berg M, Schonenberg-Meinema D, Dolman K, Ten Cate R, Roorda L, Grootenhuis M, van Rossum M, Haverman L. Psychometric Properties of the Pediatric Patient-Reported Outcomes Measurement Information System (PROMIS®) Item Banks in a Dutch Clinical Sample of Children with Juvenile Idiopathic Arthritis [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/psychometric-properties-of-the-pediatric-patient-reported-outcomes-measurement-information-system-promis-item-banks-in-a-dutch-clinical-sample-of-children-with-juvenile-idiopathic-arthritis/. Accessed .

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