TY - JOUR
T1 - Gaining the Patient Reported Outcomes Measurement Information System (PROMIS) perspective in chronic kidney disease
T2 - a Midwest Pediatric Nephrology Consortium study
AU - Selewski, David T.
AU - Massengill, Susan F.
AU - Troost, Jonathan P.
AU - Wickman, Larysa
AU - Messer, Kassandra L.
AU - Herreshoff, Emily
AU - Bowers, Corinna
AU - Ferris, Maria E.
AU - Mahan, John D.
AU - Greenbaum, Larry A.
AU - MacHardy, Jackie
AU - Kapur, Gaurav
AU - Chand, Deepa H.
AU - Goebel, Jens
AU - Barletta, Gina Marie
AU - Geary, Denis
AU - Kershaw, David B.
AU - Pan, Cynthia G.
AU - Gbadegesin, Rasheed
AU - Hidalgo, Guillermo
AU - Lane, Jerome C.
AU - Leiser, Jeffrey D.
AU - Song, Peter X.
AU - Thissen, David
AU - Liu, Yang
AU - Gross, Heather E.
AU - DeWalt, Darren A.
AU - Gipson, Debbie S.
N1 - Publisher Copyright:
© 2014, IPNA.
PY - 2014/12
Y1 - 2014/12
N2 - Background and objectives: Chronic kidney disease is a persistent chronic health condition commonly seen in pediatric nephrology programs. Our study aims to evaluate the sensitivity of the Patient Reported Outcomes Measurement Information System (PROMIS) pediatric instrument to indicators of disease severity and activity in pediatric chronic kidney disease.Methods: This cross sectional study included 233 children 8–17 years old, with chronic kidney disease from 16 participating institutions in North America. Disease activity indicators, including hospitalization in the previous 6 months, edema, and number of medications consumed daily, as well as disease severity indicators of kidney function and coexisting medical conditions were captured. PROMIS domains, including depression, anxiety, social-peer relationships, pain interference, fatigue, mobility, and upper extremity function, were administered via web-based questionnaires. Absolute effect sizes (AES) were generated to demonstrate the impact of disease on domain scores. Four children were excluded because of missing glomerular filtration rate (GFR) estimations.Results: Of the 229 children included in the final analysis, 221 completed the entire PROMIS questionnaire. Unadjusted PROMIS domains were responsive to chronic kidney disease activity indicators and number of coexisting conditions. PROMIS domain scores were worse in the presence of recent hospitalizations (depression AES 0.33, anxiety AES 0.42, pain interference AES 0.46, fatigue AES 0.50, mobility AES 0.49), edema (depression AES 0.50, anxiety AES 0.60, pain interference AES 0.77, mobility AES 0.54) and coexisting medical conditions (social peer-relationships AES 0.66, fatigue AES 0.83, mobility AES 0.60, upper extremity function AES 0.48).Conclusions: The PROMIS pediatric domains of depression, anxiety, social-peer relationships, pain interference, and mobility were sensitive to the clinical status of children with chronic kidney disease in this multi-center cross sectional study. We demonstrated that a number of important clinical characteristics including recent history of hospitalization and edema, affected patient perceptions of depression, anxiety, pain interference, fatigue and mobility. The PROMIS instruments provide a potentially valuable tool to study the impact of chronic kidney disease. Additional studies will be required to assess responsiveness in PROMIS score with changes in disease status over time.
AB - Background and objectives: Chronic kidney disease is a persistent chronic health condition commonly seen in pediatric nephrology programs. Our study aims to evaluate the sensitivity of the Patient Reported Outcomes Measurement Information System (PROMIS) pediatric instrument to indicators of disease severity and activity in pediatric chronic kidney disease.Methods: This cross sectional study included 233 children 8–17 years old, with chronic kidney disease from 16 participating institutions in North America. Disease activity indicators, including hospitalization in the previous 6 months, edema, and number of medications consumed daily, as well as disease severity indicators of kidney function and coexisting medical conditions were captured. PROMIS domains, including depression, anxiety, social-peer relationships, pain interference, fatigue, mobility, and upper extremity function, were administered via web-based questionnaires. Absolute effect sizes (AES) were generated to demonstrate the impact of disease on domain scores. Four children were excluded because of missing glomerular filtration rate (GFR) estimations.Results: Of the 229 children included in the final analysis, 221 completed the entire PROMIS questionnaire. Unadjusted PROMIS domains were responsive to chronic kidney disease activity indicators and number of coexisting conditions. PROMIS domain scores were worse in the presence of recent hospitalizations (depression AES 0.33, anxiety AES 0.42, pain interference AES 0.46, fatigue AES 0.50, mobility AES 0.49), edema (depression AES 0.50, anxiety AES 0.60, pain interference AES 0.77, mobility AES 0.54) and coexisting medical conditions (social peer-relationships AES 0.66, fatigue AES 0.83, mobility AES 0.60, upper extremity function AES 0.48).Conclusions: The PROMIS pediatric domains of depression, anxiety, social-peer relationships, pain interference, and mobility were sensitive to the clinical status of children with chronic kidney disease in this multi-center cross sectional study. We demonstrated that a number of important clinical characteristics including recent history of hospitalization and edema, affected patient perceptions of depression, anxiety, pain interference, fatigue and mobility. The PROMIS instruments provide a potentially valuable tool to study the impact of chronic kidney disease. Additional studies will be required to assess responsiveness in PROMIS score with changes in disease status over time.
KW - Children
KW - Chronic kidney disease
KW - End stage kidney disease
KW - Patient reported outcomes
KW - Pediatrics
KW - Quality of life
KW - Transplant
UR - http://www.scopus.com/inward/record.url?scp=84939874528&partnerID=8YFLogxK
U2 - 10.1007/s00467-014-2858-8
DO - 10.1007/s00467-014-2858-8
M3 - Article
C2 - 24908324
AN - SCOPUS:84939874528
SN - 0931-041X
VL - 29
SP - 2347
EP - 2356
JO - Pediatric Nephrology
JF - Pediatric Nephrology
IS - 12
ER -