使用计算机自适应测试评估晚期慢性肾脏病患者的患者报告结局测量信息系统（PROMIS®）的有效性和可靠性。
Validity and reliability of the Patient-Reported Outcomes Measurement Information System (PROMIS®) using computerized adaptive testing in patients with advanced chronic kidney disease.
机构信息
Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands.
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
出版信息
Nephrol Dial Transplant. 2023 May 4;38(5):1158-1169. doi: 10.1093/ndt/gfac231.
BACKGROUND
The Patient-Reported Outcomes Measurement Information System (PROMIS®) has been recommended for computerized adaptive testing (CAT) of health-related quality of life. This study compared the content, validity, and reliability of seven PROMIS CATs to the 12-item Short-Form Health Survey (SF-12) in patients with advanced chronic kidney disease.
METHODS
Adult patients with chronic kidney disease and an estimated glomerular filtration rate under 30 mL/min/1.73 m2 who were not receiving dialysis treatment completed seven PROMIS CATs (assessing physical function, pain interference, fatigue, sleep disturbance, anxiety, depression, and the ability to participate in social roles and activities), the SF-12, and the PROMIS Pain Intensity single item and Dialysis Symptom Index at inclusion and 2 weeks. A content comparison was performed between PROMIS CATs and the SF-12. Construct validity of PROMIS CATs was assessed using Pearson's correlations. We assessed the test-retest reliability of all patient-reported outcome measures by calculating the intraclass correlation coefficient and minimal detectable change.
RESULTS
In total, 207 patients participated in the study. A median of 45 items (10 minutes) were completed for PROMIS CATs. All PROMIS CATs showed evidence of sufficient construct validity. PROMIS CATs, most SF-12 domains and summary scores, and Dialysis Symptom Index showed sufficient test-retest reliability (intraclass correlation coefficient ≥ 0.70). PROMIS CATs had a lower minimal detectable change compared with the SF-12 (range, 5.7-7.4 compared with 11.3-21.7 across domains, respectively).
CONCLUSION
PROMIS CATs showed sufficient construct validity and test-retest reliability in patients with advanced chronic kidney disease. PROMIS CATs required more items but showed better reliability than the SF-12. Future research is needed to investigate the feasibility of PROMIS CATs for routine nephrology care.
背景
患者报告结局测量信息系统（PROMIS®）已被推荐用于健康相关生活质量的计算机自适应测试（CAT）。本研究比较了 7 种 PROMIS CAT 与 12 项简明健康调查（SF-12）在晚期慢性肾脏病患者中的内容、效度和信度。
方法
未接受透析治疗且估计肾小球滤过率低于 30ml/min/1.73m2的慢性肾脏病成年患者完成了 7 种 PROMIS CAT（评估身体功能、疼痛干扰、疲劳、睡眠障碍、焦虑、抑郁和参与社会角色和活动的能力）、SF-12、PROMIS 疼痛强度单项和透析症状指数，纳入时和 2 周时。对 PROMIS CAT 和 SF-12 进行了内容比较。采用 Pearson 相关系数评估 PROMIS CAT 的结构效度。通过计算组内相关系数和最小可检测变化来评估所有患者报告结局测量的测试-重测信度。
结果
共有 207 名患者参与了研究。完成 PROMIS CAT 的中位数为 45 项（10 分钟）。所有 PROMIS CAT 均具有足够的结构效度。PROMIS CAT、大多数 SF-12 领域和总分以及透析症状指数均具有足够的测试-重测信度（组内相关系数≥0.70）。与 SF-12 相比，PROMIS CAT 的最小可检测变化较小（范围分别为 5.7-7.4 与 11.3-21.7）。
结论
PROMIS CAT 在晚期慢性肾脏病患者中具有足够的结构效度和测试-重测信度。PROMIS CAT 需要更多的项目，但比 SF-12 具有更好的可靠性。需要进一步研究 PROMIS CAT 在常规肾脏病护理中的可行性。
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