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PROMIS Pediatric - Mobility

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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

Functional Mobility

Assessment Type

Patient Reported Outcomes

Cost

Free

Actual Cost

$0.00

Cost Description

Free for short forms, $499.99 annual subscription fee 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)

Key Descriptions

  • 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 bases on the domain being measured.
  • Higher scores means more of the concept being measured. Example = more mobility

Number of Items

Item Bank
Pediatric
• Item bank: 24
• Short form: 8
Parent proxy report for pediatric patients
• Item bank: 23
• Short form: 8
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.

Time to Administer

5 minutes

Required Training

No Training

Age Ranges

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

Body Part

Upper Extremity
Lower Extremity

ICF Domain

Body Function

Measurement Domain

Motor

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

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 points

 

Pediatric PROMIS Domain

Adjacent Categories

Mean MID (SD) for pwJIA

 

Mobility

 

 

Mild Problems

5.03 (3.79)

 

Moderate Problems

0.1 (1.20)

 

Severe Problems

3.73 (2.41)

 

Cut-Off Scores

Juvenile Idiopathic Arthritis

Morgan et al 2017; n=4; Age Range=15-20; Severity = no problems/mild problems, mild/moderate problems, moderate/severe problems

 

Pediatric PROMIS Domain

Adjacent Categories

Pediatric patients with JIA Classifications

Mobility

No Problems

>40

Mild Problems

40-30

Moderate Problems

29-25

Severe Problems

<25

Normative Data

Diverse Patient Sample

Dewitt et al, 2011; n=3048; age=8-17; Diverse Sample of Pediatric Patients

     - Mean (SD) Pediatric PROMIS; 50 (10)

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

  • Baseline
    • Mean score (n=127): 46.3(9.2)
  • Event visit [occurred after remission or 3-months post baseline]
    • Mean score (n=112): 50.8 (9.5)
  • Final visit [12-months post-baseline]
    • Mean score (n=90): 52.4 (9.2)

Cerebral Palsy: (Kratz et al, 2013; n=97; Age = 12.67 (2.96); Children with Cerebral Palsy who were going to have eligible surgery)

Short form

  • Mean score: 41.43
  • Median score: 40.00

CAT

  • Mean score: 43.38
  • Median score: 42.80

Test/Retest Reliability

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

  • Excellent test-retest Reliability for short form (ICC = .73)
  • Excellent test-retest Reliability for CAT (ICC = .72)

Internal Consistency

Cerebral Palsy: (Kratz et al, 2013; n=97; Age = 12.67 (2.96); Children with Cerebral Palsy who were going to have eligible surgery), short form

     - Adequate internal consistency for PROMIS Mobility SF (14-59)  (Cronbach Alpha = .75).

    

 

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

  • Adequate internal consistency (α=.73-.74)

 

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 = 0.93)

Construct Validity

Cerebral Palsy: Kratz et al, (2013)

Pearson bivariate correlation coefficients for PROMIS® and legacy measures of mobility

 

PROMIS® CAT *

PedsQL Move*

PODCI Mobility **

PODCI Sports **

Gillette **

SHC CP-CAT**

TUG***

GMFM Stand***

GMFM Walk***

PROMIS® Short Form

0.88**

0.58**

0.52**

0.60**

0.48**

0.54**

−0.30**

0.39**

0.39**

PROMIS® Mobility CAT

0.60**

0.39**

0.49**

0.41**

0.38**

−0.16

0.21

0.19

*Child Self-report
**Parent report
***Performance Based

 

 

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

    • Adequate correlation with Peds QL Physical Functioning (ρ=.60)
    • Poor correlation with Peds QL Emotional Functioning (ρ=.39)
    • Poor correlation with Peds QL Social Functioning (ρ=.45)
    • Poor correlation with Peds QL School Functioning (ρ=.37)
    • Adequate correlation with overall health-related QOL (ρ=.60)

 

 Childhood-Onset Systemic Lupus Erythematosus (SLE)

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

 

 

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

Legacy measures

 

Mobility

SLEDAI2K

 

−0.23

BILAGb

 

−0.26

MDglobalc

 

−0.16

SDId

 

−0.11

Functional Disability Inventory

 

−0.70e

PedsQLGC

 

 

-Summary score

 

0.69e

-Physical function

 

0.72e

-Emotional function

 

0.51e

-Social function

 

0.49e

-School function

 

0.52e

PedsQLRM

 

 

-Summary score

 

0.62e

-Pain and hurt

 

0.68e

-Daily activity

 

0.56e

-Treatment

 

0.43e

-Worry

 

0.36e

-Communication

 

0.32e

SMILEY

 

 

-Summary score

 

−0.22

-Effect on self

 

−0.30

-Limitations

 

−0.05

-Social

 

0.49e

-Burden of childhood‐onset SLE

 

−0.31e

CHAQ

 

 

-Summary score

 

−0.62e

-Dressing/grooming

 

−0.58e

-Arising

 

−0.68e

-Eating

 

−0.55e

-Walking

 

−0.61e

-Hygiene

 

−0.61e

-Reach

 

−0.58e

-Play

 

−0.68e

-Grip

 

−0.54e

CHQPF50

 

 

-Psychosocial summary score

 

0.40e

-Physical summary score

 

0.52e

-Physical functioning

 

0.57e

-Bodily pain

 

0.52e

-General health perception

 

0.28

-Role/social‐physical

 

0.34e

-Role/social‐emotional/behavioral

 

0.49e

-Self‐esteem

 

0.48e

-Mental health

 

0.37e

-Behavior

 

0.14

-Mental health

 

0.37e

  • a Values are the pooled correlation coefficients (rpool) 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.

Floor/Ceiling Effects

Cerebral Palsy: (Kratz et al, 2013)

  • No Floor effects for either the PROMIS Mobility SF (14-59) or the PROMIS Mobility CAT (20-80).
  • Adequate ceiling effect (N=6, 7.2%) for PROMIS Mobility SF (14-59)
  • Adequate ceiling effect (N=2, 2.5%) for PROMIS Mobility CAT (20-80).

Responsiveness

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

  • Effect size: .37 to .38

Bibliography

Dewitt, E.M., Stucky, B.D., Thissen, D., Irwin, D.E., Langer, M., Varni, J.W., Lai, J.S., Yeatts, K.B., Dewalt, D.A. (2011). Construction of the eight-item patient-reported outcomes measurement information system pediatric physical function scales: Built using item response theory. Journal of Clinical Epidemiology, 64(7), 794-804. doi:10.1016/j.jclinepi.2010.10.012

 

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

Kratz, A., Slavin, M., Mulcahey, M., Jette, A.M., Tulsky, D.S., Haley, S.M. (2013). An Examination of the PROMIS Pediatric Instruments to Assess Mobility in Children with Cerebral Palsy. Quality of Life Research, 22: 2865. doi: 10.1007/s11136-013-0397-6.

Morgan, E.M., Mara, C.A., Huang, B., Barnett, K., Carle, A.C., Farrell, J.E., Cook, K.F. (2017).  Establishing clinical meaning and defining important differences for Patient-Reported Outcomes Measurement Information System (PROMIS®) measures in juvenile idiopathic arthritis using standard setting with patients, parents, and providers. Quality of Life Research, 26(3), 565–586. doi:10.1007/s11136-016-1468-2

 

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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