Division of Rheumatology, Department of Internal Medicine, John P. and Kathrine G. McGovern School of Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Center for Clinical Research & Evidence-Based Medicine, Department of Pediatrics, John P. and Kathrine G. McGovern School of Medicine at The University of Texas Health Science Center at Houston, Houston, TX, USA.
Medicine (Baltimore). 2024 Mar 1;103(9):e37251. doi: 10.1097/MD.0000000000037251.
The Patient-Reported Outcomes Measurement Information System 29-Item Health Profile (PROMIS-29) is a generic measure of health-related quality of life that is not well-studied in Ankylosing Spondylitis (AS) patients. Our objective was to investigate the reliability and validity of the PROMIS-29 in AS. About 169 consecutive AS patients were enrolled from 2017 to 2022 with 167/169 patients fully completing the PROMIS-29 in this cross-sectional study. Test-retest reliability and internal consistency was assessed using intraclass correlation coefficients (ICC) and Cronbach alpha, respectively. We studied structural validity with confirmatory factor analysis (CFA) of our hypothesized and general population models. We evaluated model fit by Chi-squared goodness-of-fit-test (χ2), comparative fit index, and root mean square error of approximation. A χ2 test was used to compare nested models. PROMIS-29 convergent validity was studied by Spearman correlation coefficients with AS-legacy measures. PROMIS-29 domains showed good test-retest reliability (intraclass correlation coefficients (ICC) > 0.7) and excellent internal consistency with Cronbach alpha > 0.9 in all subscales. CFA of only the general population model met our model fit cutoffs (χ2 goodness-of-fit P-value of 0.21, comparative fit index of 0.99, and root mean square error of approximation of 0.05). Furthermore, a nested χ2 test was not significantly different between our hypothesized (full) and general (reduced) model [χ2 (1) = 0.754, P > .38]. AS legacy measures showed a strong correlation (rho > |0.7|) with the extracted physical health factor. The PROMIS-29 demonstrated good reliability and construct validity in AS patients with the general population model. Further study is required to determine its clinical and research utility in AS patients.
患者报告结局测量信息系统 29 项健康简表（PROMIS-29）是一种通用的健康相关生活质量测量方法，在强直性脊柱炎（AS）患者中研究较少。我们的目的是调查 PROMIS-29 在 AS 中的可靠性和有效性。本横断面研究共纳入了 2017 年至 2022 年间的 169 例连续 AS 患者，其中 167/169 例患者完整完成了 PROMIS-29 量表。采用组内相关系数（ICC）和克朗巴赫 α 分别评估测试-重测信度和内部一致性。我们通过假设和一般人群模型的验证性因子分析（CFA）研究结构效度。我们通过卡方拟合优度检验（χ2）、比较拟合指数和近似均方根误差评估模型拟合。使用卡方检验比较嵌套模型。通过与 AS 传统测量方法的斯皮尔曼相关系数研究 PROMIS-29 的收敛效度。在所有子量表中，PROMIS-29 各域的测试-重测信度（ICC＞0.7）良好，内部一致性极好（克朗巴赫 α＞0.9）。仅一般人群模型的 CFA 符合我们的模型拟合标准（χ2 拟合优度 P 值为 0.21，比较拟合指数为 0.99，近似均方根误差为 0.05）。此外，假设的（完整）和一般的（简化）模型之间的嵌套卡方检验差异无统计学意义[χ2（1）=0.754，P＞.38]。AS 传统测量方法与提取的身体健康因素呈强相关（rho＞|0.7|）。在一般人群模型中，PROMIS-29 在 AS 患者中表现出良好的可靠性和结构有效性。需要进一步研究确定其在 AS 患者中的临床和研究应用价值。
