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  2. PROMIS Pediatric - Anxiety

PROMIS Pediatric - Anxiety

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Purpose

Domain focused, self-reported and parent-reported measures of global, physical, mental, and social health for adults and children in the general population and those living with a chronic condition.

Link to Instrument

Instrument Details

Area of Assessment

Mental Health

Assessment Type

Patient Reported Outcomes

Cost

Free

Actual Cost

$0.00

Cost Description

Free for short forms, $499.99 for annual subscription to NIH Toolbox

CDE Status

Availability

The instrument is freely available here: PROMIS website.

See General Page for currently available PROMIS Bank CDE Details.

Classification

Supplemental - Highly Recommended: Stroke, Congenital Muscular Dystrophy (CMD) in studies of psychosocial functioning, quality-of-life, outcome, and long-term adjustment studies.

 Supplemental: Traumatic Brain Injury (TBI), Amyotrophic Lateral Sclerosis (ALS), Chiari I Malformation (CM), Epilepsy, Friedreich's Ataxia (FA), Headache, Huntington's Disease (HD), Mitochondrial Disease (Mito), Multiple Sclerosis (MS), Myasthenia Gravis (MG), Neuromuscular Diseases (NMD), Duchenne/Becker Muscular Dystrophy (DMD/BMD), Spinal Muscular Atrophy (SMA), Parkinson's Disease (PD), Stroke, and Spinal Cord Injury (SCI), and Unruptured Cerebral Aneurysms and Subarachnoid Hemorrhage (SAH)

Exploratory: Cerebral Palsy (CP) Myotonic Muscular Dystrophy (DM) and Facioscapulohumeral Muscular Dystrophy (FSHD) and Sport-Related Concussion (SRC)

*Headache specific subtest recommendations : Anxiety (Adult/Pediatric), Depression (Adult/Pediatric), Sleep (Adult)

Populations

Pediatric Disorders

Key Descriptions

  • Options for administration: Short Form, CAT, or Profile)
  • Minimum and maximum scores depends on the form being used
  • Scoring: Item-levels are scored numerically for an individual's response to each question. PROMIS recommends the best way to find the total raw score is using the free HealthMeasures Scoring Service
    (https://www.assessmentcenter.net/ac_scoringservice) or a tool that can automatically calculate scores. Scores can also be added up by hand to find the total raw score. Then the raw score is converted to a T-score using the table in the Appendix of the link below. This standardizes the score with a mean of 50 and standard deviation of 10. Being above or below the standard deviation could be desirable or undesirable based on the domain being measured.
  • Higher scores means more of the concept being measured. Example = more anxiety

Number of Items

Pediatric
• Item bank: 15
• Short form: 8
Parent proxy report for pediatric patients
• Item bank: 13
• Short form: 8

Time to Administer

5 minutes

Required Training

No Training

Age Ranges

Preschool Children

2 - 5

years

Child

5 - 12

years

Adolescent

13 - 17

years

Instrument Reviewers

Holly O’Hearn, SPT

Jensyn Bradley SPT, ATC, LAT

Chi-Lun Chiao, SPT

Holt McPherson, SPT

Kenna Peters, SPT

Corinne Woodbine, SPT

Duke University, School of Medicine, Division of Physical Therapy

Measurement Domain

Emotion

Considerations

  • PROMIS measures can be used in pediatric populations with a chronic condition(s)
  • PROMIS measures have a larger range of measurement than most conventional measures, decreasing floor and ceiling effects as a result
  • PROMIS measures have fewer items than conventional measures, thereby decreasing respondent burden. When used as computer adaptive tests, PROMIS measures usually require 4-6 items for precise measurement of health-related constructs
  • Translations: The assessments are available via PDF in Spanish and can be obtained in other languages by contacting translations@Healthmeasures.net

Pediatric Disorders

back to Populations

Minimally Clinically Important Difference (MCID)

Nephrotic Syndrome: Selewski et al, 2017; n=127; Age Range=8-17; Severity= active nephrotic syndrome

  • MID = 3

Normative Data

Nephrotic Syndrome: Selewski et al, 2017; n=127; Age Range=8-17; Severity= active nephrotic syndrome

  • Baseline
    • Mean score (n=127): 49.4 (10.6)
  • Event visit [occurred after remission or 3-months post baseline]
    • Mean score (n=112): 43.2 (11.5)
  • Final visit [12-months post-baseline]
    • Mean score (n=90): 44.5 (10.7)

Test/Retest Reliability

General population: (Varni et al, 2014; n=331; age= 12.1; General Pediatrics)

  • Excellent test-retest Reliability for short form (ICC = .74)
  • Excellent test-retest Reliability for CAT (ICC = .74)

Internal Consistency

General population: (Varni et al, 2014; n=331; age= 12.1; General Pediatrics)

  • Excellent internal consistency (α=.83-.84)

 

Childhood-Onset Systemic Lupus Erythematosus (SLE)

Jones, 2017; n=100 (at visit baseline); Age=15.8 (2.2)

  • Excellent internal consistency for PROMIS-Short Form pooled across all visits: (Cronbach’s Alpha = 0.91)

Construct Validity

Pediatric Traumatic Brain Injury(Bertisch, et. al, 2017.,n=115 children, range= 8-18)

Child Version: Convergent:

  • Excellent PedsQL Emotional: r = -0.82
  • Poor correlation with SDQ Hyperactivity: r = 0.40
  • Adequate correlation with SDQ Emotional: r = 0.76

Child Version: Discriminant:

  • Poor correlation with PedsQL Physical: r = -0.50

 

Childhood‐Onset Systemic Lupus Erythematosus Jones, et. al, (2017)

r-pool between PROMIS-SF and legacy measure subscales

Legacy Measures

PROMIS-SF Anxiety

SLEDAI-2K

0.06

BILAG

0.07

MD-Global

0.09

SDI

-0.06

Functional Disability Inventory

0.48

PedsQL-GC: Summary Score

-0.68

Physical Function

-0.53

Emotional Function

-0.73

Social Function

-0.50

School Function

-0.58

PedsQL-RM: Summary

Score

-0.66

Pain and Hurt

-0.52

Daily Activity

-0.43

Treatment

-0.54

Worry

-0.52

Communication

-0.50

SMILEY: Summary Score

0.26

Effect on Self

0.34

Limitations

0.07

Social

-0.50

Burden of Childhood Onset SLE

0.33

C-HAQ: Summar Score

0.28

Dressing/Grooming

0.31

Arising

0.28

Eating

0.25

Walking

0.29

Hygiene

0.26

Reach

0.28

Play

0.37

Grip

0.33

CHQ-PF50: PsychosocialbSummary

-0.32

Physical Summary Score

-0.26

Physical Functioning

-0.26

Bodily Pain

-0.29

General Health Perception

-0.27

Role/Social-Physical

-0.20

Role/Social-Emotional/Behavioral

-0.25

Self-Esteem

-0.32

Mental Health

-0.37

Behavior

-0.19

Mental Health

-0.37

 

 

Nephrotic Syndrome: Selewski et al, 2017; n=127; Age Range=8-17; Severity= active nephrotic syndrome

    • Adequate correlation with Peds QL Physical Functioning (ρ=-.51)
    • Adequate correlation with Peds QL Emotional Functioning (ρ=-.68)
    • Poor correlation with Peds QL Social Functioning (ρ=-.35)
    • Adequate correlation with Peds QL School Functioning (ρ=-.51)

Adequate correlation with overall health-related QOL (ρ=-.64)

Responsiveness

General population: (Varni et al, 2014; n=331; age= 12.1; General Pediatrics)

  • Effect size: .01 to .02

 

 Childhood‐Onset Systemic Lupus Erythematosus (Jones, et. al, 2017)

   - Low‐to‐fair correlation (rpool ≤ 0.42) of change of the legacy measure summary scores (FDI, C‐HAQ, CHQ‐psychosocial summary, CHQ‐ physical summary, PedsQL‐GC, PedsQL‐RM, and SMILEY) with the change of the scores of the PROMIS‐SFs 

   - Strong support for the usefulness of PROMIS-SFs to capture clinically relevant changes in HRQoL in patients with childhood-onset SLE

Bibliography

Bertisch, H., Rivara, F. P., Kisala, P. A., Wang, J., Yeates, K. O., Durbin, D., Zonfrillo M.R., Bell, M. J., Temkin, N., Tulsky, D. (2017).  Psychometric evaluation of the pediatric and parent-proxy Patient-Reported Outcomes Measurement Information System and the Neurology and Traumatic Brain Injury Quality of Life measurement item banks in pediatric traumatic brain injury. Quality of Life Research, 26(7), 1887-1899. doi:10.1007/s11136-0171524-6

Jones, J.T., Carle, A.C., Wootton, J., Liberio, B., Lee, J., Schanberg, L.E., Ying, J.,  Dewitt, E.M., Brunner, H.I. (2017). Validation of Patient-Reported Outcomes Measurement Information System Short Forms for Use in Childhood-Onset Systemic Lupus Erythematosus. Arthritis care & research, 69(1), 133–142. doi:10.1002/acr.22927

Selewski, D. T., Troost, J. P., Cummings, D., Massengill, S. F., Gbadegesin, R. A.,  Greenbaum, L. A.,Shatat, I.F., Cai, Y., Kapur, G., Herbert, D., Somers, M.J., Trachtman, H., Pais, P., Seifert, M.E., Goebel, J., Sethna, C.B., Mahan, J.D., Gross, H.E., Herreschoff, E. Liu, Y., Carlozzi, N.E., Reeve, B.B., Dewalt, D. A.,  Gipson, D. S. (2017). Responsiveness of the PROMIS® measures to changes in disease status among pediatric nephrotic syndrome patients: a Midwest pediatric nephrology consortium study. Health and Quality of Life Outcomes, 15(1), 166. doi:10.1186/s12955-017-0737-2

Varni, J. W., Magnus, B., Stucky, B. D., Liu, Y., Quinn, H., Thissen, D., Gross, H.E., Huang, I.C.,Dewalt, D. A. (2014). Psychometric properties of the PROMIS pediatric scales: Precision, stability, and comparison of different scoring and administration options. Quality of Life Research, 23(4), 1233-43. doi:http://dx.doi.org.proxy.lib.duke.edu/10.1007/s11136-013-0544-0

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