Preliminary construct validity of patient-reported outcomes to assess chronic pain in adults with sickle cell disease.
Preliminary construct validity of patient-reported outcomes to assess chronic pain in adults with sickle cell disease.
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DOI：
10.1182/bloodadvances.2023009707
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发表时间：
2023-07-25
期刊：
影响因子：
7.5
通讯作者：
Brandow, Amanda M.
中科院分区：
文献类型：
--
作者：
Mucalo, Lana;Field, Joshua J.;Highland, Janelle;Khan, Hamda;Hankins, Jane S.;Singh, Ashima;Brandow, Amanda M.
疼痛相关PRO在区分患有和不患有慢性SCD疼痛的个体方面显示出初步的结构效度。在PROMIS PRO上，患有慢性疼痛的个体有中度损伤，而没有慢性疼痛的个体没有或轻度损伤。慢性疼痛影响30%至40%的镰状细胞病（SCD）患者，并损害患者的功能。临床上有意义的，实用的，有效的评估工具的调查，评估和管理慢性疼痛是有限的，代表了一个障碍，推进SCD护理。我们试图确定患者报告的结果（PRO）是否显示初步的结构效度，以识别根据先前发表的标准被先验定义为暗示患有慢性疼痛的SCD个体。所有受试者均完成了患者报告结局测量信息系统（PROMIS）领域：疼痛干扰、疼痛行为、疼痛质量（伤害性、神经性）、疲劳、睡眠障碍、抑郁和焦虑;成人镰状细胞生活质量测量信息系统（ASCQ-Me）领域：疼痛影响和情绪影响;以及painDETECT问卷。33名患有SCD的成年人入选，42.4%患有慢性疼痛。疼痛相关的PRO评分明显区分患有慢性疼痛的个体和没有慢性疼痛的个体。慢性疼痛患者的疼痛相关PRO评分显著更差：PROMIS疼痛干扰（64.2 vs 54.3），PROMIS疼痛行为（63.2 vs 50）和ASCQ-Me疼痛影响（42.9 vs 53.2）。根据已发表的疼痛相关领域的PROMIS临床评分，慢性疼痛患者被归类为中度损伤，而那些没有慢性疼痛的患者则有轻度或无损伤。慢性疼痛患者的PRO疼痛特征与神经性疼痛一致，疲劳、抑郁、睡眠障碍和情绪影响评分更差。疼痛相关PRO在区分慢性SCD疼痛和非慢性SCD疼痛的个体方面显示出初步的结构效度，并且可以用作慢性疼痛的研究和临床监测的有价值的工具。
Pain-related PROs show preliminary construct validity in differentiating individuals with and without chronic SCD pain. On PROMIS PROs, individuals with chronic pain had moderate impairment, whereas those without chronic pain had no or mild impairment. Chronic pain affects 30% to 40% of individuals with sickle cell disease (SCD) and impairs patient functioning. Clinically meaningful, practical, and valid assessment tools for investigation, evaluation, and management of chronic pain are limited, representing a barrier for advancing SCD care. We sought to determine whether patient-reported outcomes (PROs) show preliminary construct validity in identifying individuals with SCD who were a priori defined as suggestive of having chronic pain based on previously published criteria. All individuals completed the Patient-Reported Outcomes Measurement Information System (PROMIS) domains: pain interference, pain behavior, pain quality (nociceptive, neuropathic), fatigue, sleep disturbance, depression, and anxiety; the Adult Sickle Cell Quality of Life Measurement Information System (ASCQ-Me) domains: pain impact and emotional impact; and the painDETECT questionnaire. Thirty-three adults living with SCD were enrolled, and 42.4% had chronic pain. Pain-related PROs scores distinctly differentiated individuals with chronic pain from those without. Individuals with chronic pain had significantly worse pain-related PROs scores: PROMIS pain interference (64.2 vs 54.3), PROMIS pain behavior (63.2 vs 50), and ASCQ-Me pain impact (42.9 vs 53.2). According to published PROMIS clinical cut scores for the pain-related domains, individuals with chronic pain were categorized as having moderate impairment, whereas those without chronic pain had mild or no impairment. Individuals with chronic pain had PRO pain features consistent with neuropathic pain and worse scores in fatigue, depression, sleep disturbance, and emotional impact. Pain-related PROs show preliminary construct validity in differentiating individuals with and without chronic SCD pain and could be used as valuable tools for research and clinical monitoring of chronic pain.
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