Wang Suwei, Arizmendi Cara J, Chen Dandan, Lin Li, Blalock Dan V, Huang I-Chan, Thissen David, DeWalt Darren A, Pan Wei, Reeve Bryce B
Center for Health Measurement, Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
J Biopharm Stat. 2023 May 14:1-14. doi: 10.1080/10543406.2023.2210684.
The impact of chronic diseases on health-related quality of life (HRQOL) in adolescents and young adults (AYAs) is understudied. Latent profile analysis (LPA) can identify profiles of AYAs based on their HRQOL scores reflecting physical, mental, and social well-being. This paper will (1) demonstrate how to use LPA to identify profiles of AYAs based on their scores on multiple HRQOL indicators; (2) explore associations of demographic and clinical factors with LPA-identified HRQOL profiles of AYAs; and (3) provide guidance on the selection of adult or pediatric versions of Patient-Reported Outcomes Measurement Information System® (PROMIS®) in AYAs. A total of 872 AYAs with chronic conditions completed the adult and pediatric versions of PROMIS measures of anger, anxiety, depression, fatigue, pain interference, social health, and physical function. The optimal number of LPA profiles was determined by model fit statistics and clinical interpretability. Multinomial regression models examined clinical and demographic factors associated with profile membership. As a result of the LPA, AYAs were categorized into 3 profiles: Minimal, Moderate, and Severe HRQOL Impact profiles. Comparing LPA results using either the pediatric or adult PROMIS T-scores found approximately 71% of patients were placed in the same HRQOL profiles. AYAs who were female, had hypertension, mental health conditions, chronic pain, and those on medication were more likely to be placed in the Severe HRQOL Impact Profile. Our findings may facilitate clinicians to screen AYAs who may have low HRQOL due to diseases or treatments with the identified risk factors without implementing the HRQOL assessment.
慢性病对青少年和青年（AYA）健康相关生活质量（HRQOL）的影响尚未得到充分研究。潜在类别分析（LPA）可以根据反映身体、心理和社会福祉的HRQOL分数识别AYA的类别。本文将（1）展示如何使用LPA根据AYA在多个HRQOL指标上的得分来识别其类别；（2）探讨人口统计学和临床因素与LPA识别的AYA的HRQOL类别之间的关联；以及（3）为AYA选择成人版或儿童版患者报告结果测量信息系统（PROMIS®）提供指导。共有872名患有慢性病的AYA完成了PROMIS关于愤怒、焦虑、抑郁、疲劳、疼痛干扰、社会健康和身体功能的成人版和儿童版测量。通过模型拟合统计和临床可解释性确定LPA类别的最佳数量。多项回归模型检验了与类别归属相关的临床和人口统计学因素。作为LPA的结果，AYA被分为3个类别：最小、中度和严重HRQOL影响类别。使用儿童版或成人版PROMIS T分数比较LPA结果发现，约71%的患者被归入相同的HRQOL类别。女性、患有高血压、心理健康问题、慢性疼痛以及正在服药的AYA更有可能被归入严重HRQOL影响类别。我们的研究结果可能有助于临床医生在不进行HRQOL评估的情况下，筛查出因疾病或治疗而可能具有低HRQOL且具有已识别风险因素的AYA。
