Ability of PROMIS Pediatric Measures to Detect Change in Children With Cerebral Palsy Undergoing Musculoskeletal Surgery.
Ability of PROMIS Pediatric Measures to Detect Change in Children With Cerebral Palsy Undergoing Musculoskeletal Surgery.
复制标题
DOI：
10.1097/bpo.0000000000000533
复制
发表时间：
2016-10
期刊：
影响因子：
--
通讯作者：
Jette AM
中科院分区：
文献类型：
--
作者：
Mulcahey MJ;Haley SM;Slavin MD;Kisala PA;Ni P;Tulsky DS;Jette AM
患者报告的结果测量信息系统（PROMIS®）的开发是为了提供患者报告的结果（PROs）的测量被设计为普遍相关的健康状况，低负担和精确。脑瘫（CP）研究和临床实践的一个主要问题是缺乏能够评估该临床人群固有的广泛能力和广泛年龄谱的结果工具。鉴于PROMIS®的巨大潜力，本研究的研究问题是“PROMIS®儿科计算机适应性测试（CAT）和简短表格（SF）如何检测选择性肌肉骨骼手术后CP儿童的变化？”和“PROMIS®仪器如何与儿科生活质量量表™脑瘫模块3.0版（PedsQL CP）、儿科结局数据收集仪器（PODCI）、大肌肉运动功能测试（GMFM）。术前和术后分别给予PROMIS®儿科cat和sf以及PedsQL、PODCI、TUG和GMFM。计算效应量（Effect Size， ES）和标准化反应均值（standard Response Mean， SRM）。评估了最低和最高效应，并检查了PROMIS®题库的暴露率。所有PROMIS®儿童测量指标的ES和SRM均不显著。在6个月（ES =0.26； SRM= 0.31）和12个月（ES =0.36； SRM=0.36）时，PedsQL CP检测到显著的阳性活动变化；12个月疼痛（ES=0.29； SRM=0.34）；6个月（ES=0.24； SRM=0.22）和12个月（ES=0.36； SRM=0.41）时的疲劳程度。PODCI （ES= - 0.20， SRM= - 0.26）、GMFM （ES= - 0.13， SRM= -0.24）和TUG （ES= - 0.29， SRM= - 0.25）检测到显著的负变化。天花板效应很高。暴露于适当范围的PROMIS®移动项目银行是有限的。与其他方法相比，PROMIS®方法检测变化的能力较差。PROMIS®措施可以通过调整开始/停止规则或添加项目以包括适合行动障碍儿童的内容来改进。诊断研究III级
The Patient Reported Outcomes Measurement Information System (PROMIS®) was developed to provide patient-reported outcome (PROs) measures that are designed as being universally relevant across health conditions, low burden and precise. A major problem for research and clinical practice in cerebral palsy (CP) is the void of outcomes instruments that are capable of evaluating the wide range of abilities and broad age spectrum inherent in this clinical population. Given the tremendous potential of PROMIS® , the research questions for this study were “How do PROMIS® pediatric computer adaptive tests (CAT) and short forms (SF) detect change in children with CP following elective musculoskeletal surgery?” and “How do PROMIS® instruments compare to the Pediatric Quality of Life Inventory™ Cerebral Palsy Module Version 3.0 (PedsQL CP), Pediatric Outcomes Data Collection Instrument (PODCI), the Timed Up and Go (TUG) and the Gross Motor Functional Measure (GMFM). PROMIS® Pediatric CATs and SFs and the PedsQL, PODCI, TUG and GMFM were administered before and after surgery. Effect Size (ES) and Standardized Response Mean (SRM) were calculated. Floor and ceiling effects were evaluated and, exposure rates for the PROMIS® item banks were examined. ES and SRM for all PROMIS® Pediatric Measures were non-significant. PedsQL CP detected significant, positive change in mobility at 6 (ES =0.26; SRM = 0.31) and 12 (ES = 0.36; SRM=0.36) months; pain at 12 months (ES=0.29; SRM=0.34); and fatigue at 6 (ES=0.24; SRM=0.22) and 12 (ES=0.36; SRM=0.41) months. Significant negative changes were detected by the PODCI (ES= - 0.20; SRM= - 0.26), GMFM (ES= - 0.13; SRM = -0.24) and TUG (ES= - 0.29; SRM= - 0.25). Ceiling effects were high. Exposure to an appropriate range of the PROMIS® Mobility item bank was limited. PROMIS® measures were less able to detect change than other measures. PROMIS® measures may be improved by tailoring start\stop rules or by adding items to include content appropriate for children with mobility impairments. Diagnostic Study, Level III