Quach Caroleen W, Langer Michelle M, Chen Ronald C, Thissen David, Usinger Deborah S, Emerson Marc A, Reeve Bryce B
Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Qual Life Res. 2016 Nov;25(11):2811-2823. doi: 10.1007/s11136-016-1325-3. Epub 2016 May 30.
To evaluate the reliability and validity of six PROMIS measures (anxiety, depression, fatigue, pain interference, physical function, and sleep disturbance) telephone-administered to a diverse, population-based cohort of localized prostate cancer patients.
Newly diagnosed men were enrolled in the North Carolina Prostate Cancer Comparative Effectiveness and Survivorship Study. PROMIS measures were telephone-administered pre-treatment (baseline), and at 3-months and 12-months post-treatment initiation (N = 778). Reliability was evaluated using Cronbach's alpha. Dimensionality was examined with bifactor models and explained common variance (ECV). Ordinal logistic regression models were used to detect potential differential item functioning (DIF) for key demographic groups. Convergent and discriminant validity were assessed by correlations with the legacy instruments Memorial Anxiety Scale for Prostate Cancer and SF-12v2. Known-groups validity was examined by age, race/ethnicity, comorbidity, and treatment.
Each PROMIS measure had high Cronbach's alpha values (0.86-0.96) and was sufficiently unidimensional. Floor effects were observed for anxiety, depression, and pain interference measures; ceiling effects were observed for physical function. No DIF was detected. Convergent validity was established with moderate to strong correlations between PROMIS and legacy measures (0.41-0.77) of similar constructs. Discriminant validity was demonstrated with weak correlations between measures of dissimilar domains (-0.20--0.31). PROMIS measures detected differences across age, race/ethnicity, and comorbidity groups; no differences were found by treatment.
This study provides support for the reliability and construct validity of six PROMIS measures in prostate cancer, as well as the utility of telephone administration for assessing HRQoL in low literacy and hard-to-reach populations.
评估通过电话向不同的、基于人群的局限性前列腺癌患者队列进行六种患者报告结果测量信息系统（PROMIS）测量（焦虑、抑郁、疲劳、疼痛干扰、身体功能和睡眠障碍）的可靠性和有效性。
新诊断的男性纳入北卡罗来纳州前列腺癌比较疗效与生存研究。PROMIS测量在治疗前（基线）以及治疗开始后3个月和12个月通过电话进行（N = 778）。使用克朗巴赫α系数评估可靠性。用双因素模型和解释共同方差（ECV）检验维度。采用有序逻辑回归模型检测关键人口统计学组的潜在差异项目功能（DIF）。通过与传统工具前列腺癌纪念焦虑量表和SF - 12v2的相关性评估聚合效度和区分效度。通过年龄、种族/民族、合并症和治疗情况检验已知群体效度。
每种PROMIS测量的克朗巴赫α系数值都很高（0.86 - 0.96），且维度足够单一。焦虑、抑郁和疼痛干扰测量观察到地板效应；身体功能测量观察到天花板效应。未检测到DIF。PROMIS与类似结构的传统测量之间存在中度至强相关性（0.41 - 0.77），从而确立了聚合效度。不同领域测量之间的相关性较弱（-0.20 - -0.31），证明了区分效度。PROMIS测量检测到年龄、种族/民族和合并症组之间的差异；未发现治疗情况导致的差异。
本研究为六种PROMIS测量在前列腺癌中的可靠性和结构效度提供了支持，也为电话管理在低文化水平和难以接触人群中评估健康相关生活质量的效用提供了支持。
