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克罗恩病患儿的患者报告结局测量信息系统

Patient-Reported Outcomes Measurement Information System in Children with Crohn's Disease.

作者信息

Arvanitis Marina, DeWalt Darren A, Martin Christopher F, Long Millie D, Chen Wenli, Jaeger Beth, Sandler Robert S, Kappelman Michael D

机构信息

University of North Carolina at Chapel Hill, Chapel Hill, NC.

University of North Carolina at Chapel Hill, Chapel Hill, NC.

出版信息

J Pediatr. 2016 Jul;174:153-159.e2. doi: 10.1016/j.jpeds.2016.03.069. Epub 2016 May 2.

Abstract

OBJECTIVES

To assess the criterion validity and responsiveness of Patient-Reported Outcomes Measurement Information System (PROMIS) in a web-based cohort of children with Crohn's disease.

STUDY DESIGN

We recruited children with Crohn's disease (ages 9-17 years) and their parents from the web-based Crohn's and Colitis Foundation of America Kids and Teens Study cohort. Upon entry into the cohort and 6 months later, children self-reported Crohn's disease activity, health-related quality of life, and PROMIS domains of pain interference, anxiety, depression, fatigue, and peer relationships.

RESULTS

Mean PROMIS scores for the 276 participating patients were worse among those with worse self-reported Crohn's disease activity (per Short Crohn's Disease Activity Index, P < .005 for all), Crohn's disease activity in the prior 6 months (per Manitoba Index, P < .01 for all), and health-related quality of life (per IMPACT-35, P < .001 for all). One hundred forty-three patients and their parents completed follow-up questionnaires, 75% of whom reported stable disease activity. Those with improved Crohn's disease activity reported improved PROMIS scores, and those with worsened Crohn's disease activity reported worse PROMIS scores for all domains except anxiety. All participants reported improved anxiety from baseline, but those with stable or worsened Crohn's disease activity reported less improvement (P = .07).

CONCLUSIONS

PROMIS scores were significantly associated with Crohn's disease activity in a linear and clinically meaningful manner, and responded to change in Crohn's disease activity over a 6-month period. This supports the criterion validity and responsiveness of pediatric PROMIS.

摘要

目的

评估患者报告结局测量信息系统(PROMIS)在基于网络的克罗恩病儿童队列中的标准效度和反应度。

研究设计

我们从美国克罗恩病和结肠炎基金会儿童与青少年研究队列中招募了患有克罗恩病的儿童(9 - 17岁)及其父母。在进入队列时和6个月后,儿童自行报告克罗恩病活动情况、健康相关生活质量以及PROMIS中疼痛干扰、焦虑、抑郁、疲劳和同伴关系等领域的情况。

结果

276名参与患者的PROMIS平均得分在自我报告的克罗恩病活动情况较差者(根据简化克罗恩病活动指数,所有项目P < 0.005)、前6个月的克罗恩病活动情况(根据马尼托巴指数,所有项目P < 0.01)以及健康相关生活质量较差者(根据IMPACT - 35,所有项目P < 0.001)中更低。143名患者及其父母完成了随访问卷,其中有75%报告疾病活动情况稳定。克罗恩病活动情况改善的患者报告PROMIS得分有所提高,而克罗恩病活动情况恶化的患者报告除焦虑外所有领域的PROMIS得分均更差。所有参与者报告焦虑较基线有所改善,但克罗恩病活动情况稳定或恶化的患者报告改善程度较小(P = 0.07)。

结论

PROMIS得分与克罗恩病活动情况以线性且具有临床意义的方式显著相关,并对6个月内克罗恩病活动情况的变化有反应。这支持了儿科PROMIS的标准效度和反应度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aca3/5157125/34f2ada25559/nihms774161f1.jpg

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