Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA.
Department of Physical Medicine and Rehabilitation, Rehabilitation Outcomes Center (ROC) Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts , USA.
J Burn Care Res. 2023 Nov 2;44(6):1419-1427. doi: 10.1093/jbcr/irad061.
This study examined the reliability and validity of the Patient Reported Outcomes Measurement System (PROMIS)-25, a profile instrument consisting of four-item fixed short forms for six health domains, in children living with burn injury. Data were provided by children participating in a multi-center longitudinal study of outcomes after burn injury. Floor and ceiling effects, unidimensionality, internal consistency, reliability, and differential item functioning (DIF) of the PROMIS-25 Profile v.2.0 were examined. Correlations with other established measures were calculated to assess concurrent validity. Children (n = 256) between the ages of 8-18 years with moderate to severe injury provided responses on PROMIS-25 domains. All PROMIS-25 domains showed high internal consistency. Substantial portions of the sample reported no symptoms (anxiety [58.2%], depressive symptoms [54.6%], fatigue [50.8%], pain [60.1%]). There was a large ceiling effect on peer relationships (46.8%) and physical function mobility (57.5%). One-factor confirmatory factor analyses supported unidimensionality for all domains. Reliability was sufficient for group mean comparisons (>0.8) across at least some trait levels for most domains except fatigue and anxiety. No DIF with respect to burn status was detected when comparing the burn sample to the PROMIS pediatric general U.S. population testing sample. These results provide evidence of reliability and validity of PROMIS-25 scores among children living with burn injury. Reliability of domains was low to moderate and would likely be improved, and ceiling effects reduced for some domains, by administering the PROMIS-37, which includes six items per domain.
本研究考察了患者报告结局测量系统(PROMIS)-25 的可靠性和有效性,该系统是一种由六个健康领域的四项固定简短形式组成的简表工具,用于评估患有烧伤的儿童。数据来自参与烧伤后多中心纵向研究的儿童。检查了 PROMIS-25 简表 v.2.0 的地板效应和天花板效应、单维性、内部一致性、可靠性和项目间差异功能(DIF)。计算了与其他已建立的测量方法的相关性,以评估同时效度。8-18 岁、中度至重度烧伤的儿童提供了 PROMIS-25 各领域的回答。所有 PROMIS-25 领域的内部一致性均较高。大量样本报告没有症状(焦虑[58.2%]、抑郁症状[54.6%]、疲劳[50.8%]、疼痛[60.1%])。同伴关系(46.8%)和身体功能移动性(57.5%)存在较大的天花板效应。所有领域的单因素验证性因子分析均支持单维性。除了疲劳和焦虑,大多数领域的组间平均比较的可靠性都足够高(>0.8)。在将烧伤样本与 PROMIS 儿科普通美国人群测试样本进行比较时,没有发现与烧伤状态有关的 DIF。这些结果提供了 PROMIS-25 评分在患有烧伤的儿童中的可靠性和有效性的证据。各领域的可靠性为低至中度,如果每个领域都采用包含六个项目的 PROMIS-37 进行评估,某些领域的可靠性和天花板效应可能会提高。