Boston Children's Hospital, Department of Orthopaedic Surgery, Boston, MA.
Harvard Medical School, Boston, MA; and.
J Orthop Trauma. 2024 Aug 1;38(8):e295-e301. doi: 10.1097/BOT.0000000000002842.
The efficiency and validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) surveys were determined for pediatric orthopaedic trauma patients with posttraumatic stress disorder (PTSD) symptoms in a clinic setting.
Prospective cohort study.
Single-institution, Level I trauma center.
All consecutive children aged 8-18 years undergoing procedures or surgery for orthopaedic trauma.
The convergent, divergent, and discriminant validity of the PROMIS Anger and Anxiety computerized adaptive tests (CATs) were evaluated and compared with the previously validated Child PTSD Symptom Scale (CPSS). The efficiency in time to completion of the outcome measures was compared between the CPSS and PROMIS surveys. Cutoffs for increased likelihood of PTSD were established for the PROMIS questionnaires.
A total of 233 subjects were included in this study (mean age 13.1 years with SD 2.8 years, 71% male). The majority (51%) of injuries were related to sports, and most (60%) involved the upper extremity. Of those included, 41 patients had high levels of PTSD symptoms on the CPSS (18%; 95% CI, 13.1-23.2%). The CPSS took 182 (interquartile range [IQR] 141-228) seconds versus 52 (IQR 36-84) and 52 (IQR 36-70) seconds for PROMIS Anger and Anxiety CATs, respectively. Convergent validity showed patient scores on both PROMIS instruments significantly correlated with CPSS scores (Anger: P < 0.001, r = 0.51; Anxiety: P < 0.001, r = 0.41). Neither PROMIS score correlated with University of California Los Angeles Activity Score (Anger: r = -0.26; Anxiety: r = -0.22), a functional outcome measure, demonstrating divergent validity. Both PROMIS instruments sufficiently discriminated across PTSD risk groups (Anger P < 0.001; Anxiety P < 0.001). A score of at least 53 on PROMIS Anger or at least 48 on PROMIS Anxiety indicated an increased likelihood of PTSD risk.
PROMIS Anger and Anxiety CATs are efficient and valid for evaluating posttraumatic stress in children following orthopaedic trauma procedures.
Diagnostic Level I. See Instructions for Authors for a complete description of levels of evidence.
在诊所环境下，确定用于评估患有创伤后应激障碍（PTSD）症状的儿科骨科创伤患者的患者报告结局测量信息系统（PROMIS）量表的效率和有效性。
前瞻性队列研究。
单机构、一级创伤中心。
所有连续接受骨科创伤手术或手术的 8-18 岁儿童。
评估并比较了 PROMIS 愤怒和焦虑计算机自适应测试（CAT）的收敛性、发散性和判别有效性，并与先前经过验证的儿童 PTSD 症状量表（CPSS）进行了比较。比较了 CPSS 和 PROMIS 调查在完成结果测量方面的效率。为 PROMIS 问卷确定了 PTSD 可能性增加的截止值。
PROMIS 愤怒和焦虑 CAT 可有效且有效地评估骨科创伤手术后儿童的创伤后应激。
诊断水平 I. 有关证据水平的完整说明，请参见作者说明。
