Lei D K, Yousaf M, Janmohamed S R, Vakharia P P, Chopra R, Sacotte R, Patel K R, Singam V, Immaneni S, Kantor R, Hsu D Y, Silverberg J I
Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Br J Dermatol. 2020 Nov;183(5):875-882. doi: 10.1111/bjd.18920. Epub 2020 Mar 5.
Sleep disturbances are common in adults with atopic dermatitis (AD). Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance (SD) and Sleep-Related Impairment (SRI) are validated questionnaires to assess sleep in adults. Little is known about their measurement properties in adults with AD.
To assess the measurement properties of the PROMIS SD and SRI eight-item short forms in AD.
We performed a prospective dermatology-practice-based study using questionnaires and evaluation by a dermatologist (n = 420).
PROMIS SD and SRI showed moderate correlations to each other (ρ = 0·67), and weak correlations with Patient-Oriented Eczema Measure (ρ = 0·43 and 0·39, respectively); average (ρ = 0·31/0·30) and worst numerical rating scale for itch (ρ = 0·32/0·30); Eczema Area and Severity Index (ρ = 0·41/0·31); and Scoring Atopic Dermatitis (SCORAD) (ρ = 0·44/0·30) (Spearman correlations, P < 0·001). PROMIS SD and SRI increased significantly and stepwise with more frequent sleep disturbance, severe itch and self-reported global AD severity (ancova, P < 0·001). PROMIS SD and SRI showed good internal consistency (Cronbach alpha 0·84 and 0·91). Changes from baseline in PROMIS SD and SRI were weakly to moderately correlated with each other and with changes of multiple patient-reported and clinician-reported AD outcomes. There were no floor or ceiling effects for PROMIS SD or SRI. The median completion time for PROMIS SD and SRI was 2 min.
PROMIS SD and SRI showed good construct validity, internal consistency, responsiveness and feasibility to assess sleep in adult patients with AD. What is already known about this topic? The Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance (SD) and Sleep-Related Impairment (SRI) scales were found to be valid in adults with chronic disease. However, the validity and feasibility of PROMIS SD and SRI in atopic dermatitis remain unknown. What does this study add? This study demonstrated that PROMIS SD and SRI had good content, concurrent, convergent and discriminant validity; feasibility; and responsiveness, with no floor or ceiling effects observed. What are the clinical implications of this work? The PROMIS SD and SRI eight-item bank short forms appear to have sufficient validity and feasibility to be used as assessments for burden of sleep in adults with atopic dermatitis in clinical practice.
睡眠障碍在特应性皮炎（AD）成人患者中很常见。患者报告结局测量信息系统（PROMIS）睡眠障碍（SD）和睡眠相关损害（SRI）是经过验证的用于评估成人睡眠的问卷。关于它们在AD成人患者中的测量特性知之甚少。
评估PROMIS SD和SRI八项简短形式在AD中的测量特性。
我们基于皮肤科实践进行了一项前瞻性研究，使用问卷并由皮肤科医生进行评估（n = 420）。
PROMIS SD和SRI彼此之间呈中度相关（ρ = 0·67），与以患者为导向的湿疹测量指标呈弱相关（分别为ρ = 0·43和0·39）；瘙痒的平均数值评定量表（ρ = 0·31/0·30）和最差数值评定量表（ρ = 0·32/0·30）；湿疹面积和严重程度指数（ρ = 0·41/0·31）；以及特应性皮炎评分（SCORAD）（ρ = 0·44/0·30）（斯皮尔曼相关性，P < 0·001）。随着睡眠障碍频率增加、瘙痒严重程度增加以及自我报告的AD总体严重程度增加，PROMIS SD和SRI显著且逐步升高（协方差分析，P < 0·001）。PROMIS SD和SRI显示出良好的内部一致性（Cronbach α分别为0·84和0·91）。PROMIS SD和SRI相对于基线的变化彼此之间以及与多个患者报告和临床医生报告的AD结局变化呈弱至中度相关。PROMIS SD或SRI没有地板效应或天花板效应。PROMIS SD和SRI的中位完成时间为2分钟。
PROMIS SD和SRI在评估AD成年患者睡眠方面显示出良好的结构效度、内部一致性、反应性和可行性。关于该主题已了解哪些内容？患者报告结局测量信息系统（PROMIS）睡眠障碍（SD）和睡眠相关损害（SRI）量表在患有慢性疾病的成人中被发现是有效的。然而，PROMIS SD和SRI在特应性皮炎中的有效性和可行性仍然未知。本研究补充了什么？本研究表明PROMIS SD和SRI具有良好的内容效度、同时效度、收敛效度和区分效度；可行性；以及反应性，未观察到地板效应或天花板效应。这项工作的临床意义是什么？PROMIS SD和SRI八项简短形式似乎具有足够的效度和可行性，可在临床实践中用作评估AD成年患者睡眠负担的工具。
