Division of Nephrology, BC Children's Hospital, Vancouver, British Columbia, Canada.
Department of Paediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Clin J Am Soc Nephrol. 2024 Jul 1;19(7):851-859. doi: 10.2215/CJN.0000000000000467. Epub 2024 Jun 11.
PRO-Kid is a patient-reported outcome measure of the frequency and burden of symptoms. Higher PRO-Kid scores are associated with lower Pediatric Quality of Life Inventory scores.
Measuring the burden of symptoms that matter most to children and adolescents with CKD is essential for optimizing patient-centered care. We developed a novel CKD-specific patient-reported outcome measure (PRO-Kid) to assess both frequency and impact of symptoms in children. In this study, we further assessed the validity and internal consistency of PRO-Kid.
In this multicenter study, children age 8–18 years with stages 3–5 CKD, including those on dialysis, were recruited from five pediatric centers. Children completed the 14-item PRO-Kid questionnaire and the validated Pediatric Quality of Life Inventory (PedsQL 4.0). We explored the dimensionality of the PRO-kid scale using exploratory and confirmatory factor analysis, to either establish that it is a unidimensional construct or identify evidence of subfactors. We then assessed internal consistency (Cronbach alpha) and construct validity (Pearson correlations).
In total, 100 children were included. The median eGFR was 27.4 ml/min per 1.73 m (7.43–63.4), and 26 children (26%) were on dialysis. Both the PRO-Kid frequency and the impact scales were unidimensional. Cronbach alpha was high for both the PRO-Kid frequency and impact scales, 0.83 (95% confidence interval [CI], 0.78 to 0.88) and 0.84 (95% CI, 0.80 to 0.89), respectively, showing strong internal consistency. Pearson correlations between PRO-Kid and PedsQL scores were also strong: −0.78 (95% CI, −0.85 to −0.70) for the frequency score and −0.69 (95% CI, −0.78 to −0.56) for the impact score, reflecting the association between poorer quality of life and higher symptom burden.
PRO-Kid is a novel patient-reported symptom burden tool for children age 8–18 years with CKD that correlates strongly in the expected direction with PedsQL, supporting its validity. Future work will evaluate changes in PRO-Kid score with progression of CKD and implementation of the tool into clinical care.
PRO-Kid 是一种评估症状频率和负担的患者报告结局测量工具。较高的 PRO-Kid 评分与较低的儿童生活质量量表（PedsQL）评分相关。
测量对患有 CKD 的儿童和青少年最重要的症状负担对于优化以患者为中心的护理至关重要。我们开发了一种新的 CKD 特异性患者报告结局测量工具（PRO-Kid），以评估儿童的症状频率和影响。在这项研究中，我们进一步评估了 PRO-Kid 的有效性和内部一致性。
在这项多中心研究中，招募了来自五个儿科中心的年龄在 8-18 岁、患有 3-5 期 CKD 的儿童，包括接受透析治疗的儿童。儿童完成了 14 项 PRO-Kid 问卷和经过验证的儿童生活质量量表（PedsQL 4.0）。我们使用探索性和验证性因素分析来研究 PRO-kid 量表的维度，以确定它是否是一个单一维度的结构，或确定存在亚因素的证据。然后，我们评估了内部一致性（克朗巴赫 alpha）和结构效度（皮尔逊相关系数）。
共纳入 100 名儿童。中位 eGFR 为 27.4 ml/min per 1.73 m（7.43-63.4），26 名儿童（26%）接受透析治疗。PRO-Kid 的频率和影响量表均为单维度。PRO-Kid 频率和影响量表的克朗巴赫 alpha 均较高，分别为 0.83（95%置信区间 [CI]，0.78 至 0.88）和 0.84（95% CI，0.80 至 0.89），显示出很强的内部一致性。PRO-Kid 和 PedsQL 评分之间的皮尔逊相关也很强：频率评分为-0.78（95% CI，-0.85 至 -0.70），影响评分为-0.69（95% CI，-0.78 至 -0.56），反映了生活质量较差与更高的症状负担之间的关联。
PRO-Kid 是一种用于 8-18 岁患有 CKD 的儿童的新型患者报告症状负担工具，与 PedsQL 的相关性很强，在预期方向上支持其有效性。未来的工作将评估随着 CKD 的进展和该工具在临床护理中的实施，PRO-Kid 评分的变化。
Zotero 插件