Gaining the Patient Reported Outcomes Measurement Information System (PROMIS) perspective in chronic kidney disease: a Midwest Pediatric Nephrology Consortium study
Gaining the Patient Reported Outcomes Measurement Information System (PROMIS) perspective in chronic kidney disease: a Midwest Pediatric Nephrology Consortium study
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DOI：
10.1007/s00467-014-2858-8
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发表时间：
2014-12-01
影响因子：
3
通讯作者：
Gipson, Debbie S.
中科院分区：
文献类型：
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作者：
Selewski, David T.;Massengill, Susan F.;Gipson, Debbie S.
慢性肾脏疾病是一种在儿科肾脏病项目中常见的持续性慢性健康状况。本研究旨在评估患者报告结果测量信息系统(PROIS)儿科仪器对疾病严重程度和活动性指标的敏感性。这项横断面研究包括来自北美16个参与机构的233名8-17岁慢性肾脏疾病儿童。收集疾病活动性指标，包括过去6个月的住院时间、水肿和每天服用的药物数量，以及肾功能和共存的医疗条件的疾病严重程度指标。PROMIS领域，包括抑郁、焦虑、社交同伴关系、疼痛干扰、疲劳、灵活性和上肢功能，通过基于网络的问卷进行测试。产生绝对效应大小(AES)以显示疾病对领域分数的影响。4名儿童因缺少肾小球滤过率(GFR)评估而被排除在外。在最终纳入分析的229名儿童中，221名完成了完整的PROMIS问卷调查。未调整的Promis区域对慢性肾脏疾病活动指标和共存条件的数量有反应。在最近住院(抑郁AES 0.33，焦虑AES 0.42，疼痛干扰AES 0.46，疲劳AES 0.50，活动AES 0.49)、浮肿(抑郁AES 0.50，焦虑AES 0.60，疼痛干扰AES 0.77，活动AES 0.54)和共存的医疗状况(社交同伴关系AES 0.66，疲劳AES 0.83，活动AES 0.60，上肢功能AES 0.48)的情况下，Promis领域的得分更差。在这项多中心横断面研究中，活动度和活动度对慢性肾脏疾病儿童的临床状况敏感。我们证明了一些重要的临床特征，包括最近的住院史和水肿史，影响了患者的抑郁、焦虑、疼痛干扰、疲劳和活动能力。PROMIS仪器为研究慢性肾脏疾病的影响提供了一个潜在的有价值的工具。将需要更多的研究来评估PROMIS评分中的反应性，以及随着时间的推移疾病状态的变化。
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.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.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).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.