PROMIS Pediatric – Depressive Symptoms

Last Updated

November 01, 2018

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Center for Smart Use of Technologies to Assess Real World Outcomes (C-STAR)

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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

Depression

Assessment Type

Patient Reported Outcomes

Cost

Free

Actual Cost

$0.00

Cost Description

Free for short form, $499.99 annual subscription for 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)

Pediatric Disorders

Usually 4-12 items for each section domain depending on which type of test is being
performed (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 depressive symptoms.

Number of Items

Pediatric
• Item bank: 14
• Short form: 8
Parent proxy report for pediatric patients
• Item bank: 13
• Short form: 6
Computer adaptive tests (CAT)
Items dynamically selected for administration from the item bank based on respondent’s previous answer. Usually between 4-12 items or questions.

5 minutes

Required Training

No Training

Preschool Children

2 - 5

years

Child

6 - 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.

Considerations

PROMIS measures can be used in the general population and with adults and 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

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): 49.7 (9.3)
Event visit [occurred after remission or 3-months post baseline]
- Mean score (n=112): 45.2 (9.9)
Final visit [12-months post-baseline]
- Mean score (n=90): 46.2 (9.6)

Test/Retest Reliability

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

Excellent test-retest Reliability for short form (ICC = .76)
Excellent test-retest Reliability for CAT (ICC = .77)

Internal Consistency

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

Excellent internal consistency (α=.85-.86)

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 = 0.96)

Construct Validity

Pediatric Traumatic Brain Injury

(Bertisch et al, 2017)

Child Version: Convergent

PedsQL Emotional r=−0.81

PROMIS ratings strongly correlated

SDQ Hyperactivity r=0.53

PROMIS ratings strongly correlated

SDQ Emotional r= 0.73

PROMIS ratings strongly correlated

Child Version: Discriminant

PedsQL Physical r= −0.55

PROMIS ratings strongly correlated

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

- Poor correlation with Peds QL Physical Functioning (ρ=-.46)
- Adequate correlation with Peds QL Emotional Functioning (ρ=-.55)
- Poor correlation with Peds QL Social Functioning (ρ=-.44)
- Poor correlation with Peds QL School Functioning (ρ=-.39)
- Adequate correlation with overall health-related QOL (ρ=-.57)

Childhood-Onset Systemic Lupus Erythematosus (SLE)

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

Bivariate correlation (r_pool) between pediatric PROMIS short forms and legacy measure subscalesa

Legacy measures	Depressive symptoms
SLEDAI‐2K	0.03
BILAGb	−0.03
MD‐globalc	0.07
SDId	−0.07
Functional Disability Inventory	0.42e
PedsQL‐GC
-Summary score	−0.64e
-Physical function	−0.48e
-Emotional function	−0.72e
-Social function	−0.49e
-School function	−0.53e
PedsQL‐RM
-Summary score	−0.62e
-Pain and hurt	−0.47e
-Daily activity	−0.41e
-Treatment	−0.56e
-Worry	−0.43e
-Communication	−0.45e
SMILEY
-Summary score	0.25
-Effect on self	0.34e
-Limitations	0.06
-Social	−0.49e
-Burden of childhood‐onset SLE	0.28
C‐HAQ
-Summary score	0.28
-Dressing/grooming	0.28
-Arising	0.27
-Eating	0.22
-Walking	0.24
-Hygiene	0.31e
-Reach	0.29
-Play	0.34e
-Grip	0.31e
CHQ‐PF50
-Psychosocial summary score	−0.34e
-Physical summary score	−0.21
-Physical functioning	−0.22
-Bodily pain	−0.25
-General health perception	−0.18
-Role/social‐physical	−0.27
-Role/social‐emotional/behavioral	−0.25
-Self‐esteem	−0.35e
-Mental health	−0.40e
-Behavior	−0.23
-Mental health	−0.40e

^a Values are the pooled correlation coefficients (r_pool) across visits (n = 280 patient visits). PROMIS = Patient‐Reported Outcomes Measurement Information System; SLEDAI‐2K = Systemic Lupus Erythematosus Disease Activity Index 2000; BILAG = British Isles Lupus Assessment Group index; MD‐global = physician global disease assessment; SDI = Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index; PedsQL‐GC = Pediatric Quality of Life Generic Core Scale 4.0; PedsQL‐RM = Pediatric Quality of Life Rheumatology Module 3.0; SMILEY = Simple Measure of Impact of Lupus Erythematosus in Youngsters; C‐HAQ = Childhood Health Assessment Questionnaire; CHQ‐PF50 = Child Health Questionnaire with 50 questions.
^b Scoring: A = 12, B = 8, C = 1, D = 0, E = 0.
^c On a 10‐point Likert scale, where 0 = inactive disease.
^d Range 0–47, where 0 = absence of damage.
^e P < 0.001 and r > 0.30.

Responsiveness

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

Effect size: -0.04 to -0.03

Children with Asthma

(Howell et al 2016)

PROMIS	Association between asthma control status and HRQoL by individual time points
T1 poor	49.7
T1 good	47.4
T1 Cohen’s D ES	0.23
T2 poor	48.4
T2 good	46.7
T2 Cohen’s D ES	0.13
T3 poor	48.4
T3 good	47.6
T3 Cohen’s D ES	0.09
T4 poor	47.7
T4 good	44.6
T4 Cohen’s D ES	0.32

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

Howell, C.R., Thompson, L.A., Gross, H.E., Reeve, B.B., DeWalt, D.A, Huang I-C. (2016). Responsiveness to Change in PROMIS® Measures among Children with Asthma: A Report from the PROMIS Pediatric Asthma Study. Value Health, 19(2), 192–201 doi:10.1016/j.jval.2015.12.004

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 LifeOutcomes, 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

Last Updated

Expertise, Instruction and Mentorship

Upcoming Stroke Course

Purpose

Link to Instrument

Area of Assessment

Assessment Type

Cost

Actual Cost

Cost Description

CDE Status

Number of Items

Required Training

Instrument Reviewers

Considerations

Minimally Clinically Important Difference (MCID)

Normative Data

Test/Retest Reliability

Internal Consistency

Construct Validity

Responsiveness

Bibliography

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