Division of Nephrology, Department of Pediatrics, University of Michigan, CS Mott Children's Hospital Room 12-250, 1540 E Hospital Drive, SPC 4297, Ann Arbor, MI 48109-4297, USA.
Health Qual Life Outcomes. 2013 Mar 1;11:29. doi: 10.1186/1477-7525-11-29.
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.
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.
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).
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.
儿童肥胖是一个日益严重的健康问题，已知会对儿童和青少年的生活质量产生不利影响。患者报告的结果测量信息系统（PROMIS）儿科措施旨在捕捉儿童在儿童和青少年经历的各种健康状况下的自我报告。本研究的目的是开始验证受肥胖影响的儿童和青少年的 PROMIS 儿科措施。
在一项横断面研究中，对 138 名 8-17 岁儿童和青少年进行了儿科 PROMIS 仪器测试，这些儿童和青少年的年龄调整体重指数（BMI）大于第 85 百分位数，设计目的是建立已知组有效性。儿童使用计算机界面完成抑郁症状、焦虑、愤怒、同伴关系、疼痛干扰、疲劳、上肢和移动性 PROMIS 领域。PROMIS 领域和个别项目随机分配，共包括 95 个项目。患者的反应在 BMI 85 到<99 百分位与≥99 百分位的患者之间进行比较。
共招募了 136 名参与者，他们都有进行分析所需的所有临床数据。在 136 名参与者中，5%的人提前结束了调查，导致在调查结束时出现域得分缺失。在多变量分析中，BMI≥99 百分位的患者在抑郁症状、愤怒、疲劳和移动性方面的评分更差（p<0.05）。父母报告的锻炼与抑郁症状、焦虑和疲劳的评分改善有关（p<0.05）。
从超重到严重肥胖的儿童和青少年可以在门诊环境中使用计算机接口完成多项 PROMIS 儿科措施。在 5%有缺失域评分的患者中，缺失评分始终出现在最后进行的域中，这表明评估的长度很重要。本研究中发现的域评分差异与之前调查肥胖儿童和青少年生活质量的研究结果一致。我们表明，PROMIS 仪器代表了未来研究儿科肥胖对生活质量影响的一种可行且有潜在价值的仪器。
