Validation of PROMIS Physical Function Instruments in Patients With an Orthopaedic Trauma to a Lower Extremity
Validation of PROMIS Physical Function Instruments in Patients With an Orthopaedic Trauma to a Lower Extremity
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DOI：
10.1097/bot.0000000000001493
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发表时间：
2019-08-01
影响因子：
2.3
通讯作者：
Gershon, Richard C.
中科院分区：
文献类型：
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作者：
Rothrock, Nan E.;Kaat, Aaron J.;Gershon, Richard C.
目的：评估患者报告结果测量信息系统（PROMIS）移动计算机适应性测试（CAT）和PROMIS身体功能8a简表的可靠性、收敛效度、已知组效度和反应性。设计：前瞻性队列研究。设置：两个I级创伤中心。患者：连续接触接受治疗的孤立性下肢创伤损伤的合格成人（n = 402，在时间1时同意，中位数=治疗后80天）。6个月后，122（30.3%）完成了另一项评估。干预：对患者进行横断面和纵向监测。主要结果测量：地板和天花板效应，可靠性（边际信度和Cronbach’s alpha），收敛效度，已知组区分效度（负重状态和骨折严重程度）和反应性（Cohen's d效应量）进行PROMIS活动性CAT、PROMIS身体功能8a简表和其他5项身体功能指标的评估。PROMIS PFSF 8a和足踝能力测量日常生活活动指数具有天花板效应。两个PROMIS措施表现出良好的内部一致性可靠性（平均边际可靠性0.94和0.96;克朗巴赫的α = 0.96）。收敛有效性的支持与其他措施的身体功能（r = 0.70-0.87）的高相关性。已知组的有效性的负重状态和骨折的严重程度是支持的反应性（活动CAT效应大小= 0.81;身体功能简表8a = 0.88）。结论：PROMIS活动CAT和身体功能8a简表表现出可靠性，收敛和已知组的判别效度，并在一个样本的患者下肢骨科创伤损伤的反应。
Objectives: To evaluate the reliability, convergent validity, known-groups validity, and responsiveness of the Patient-Reported Outcomes Measurement Information System (PROMIS) Mobility Computer Adaptive Test (CAT) and PROMIS Physical Function 8a Short Form.Design: Prospective cohort study.Setting: Two Level-I trauma centers.Patients: Eligible adults with an isolated lower extremity trauma injury receiving treatment were approached consecutively (n = 402 consented at time 1, median = 80 days after treatment). After 6 months, 122 (30.3%) completed another assessment.Intervention: Cross-sectional and longitudinal monitoring of patients.Main Outcome Measurements: Floor and ceiling effects, reliability (marginal reliability and Cronbach's alpha), convergent validity, known-groups discriminant validity (weight-bearing status and fracture severity), and responsiveness (Cohen's d effect size) were evaluated for the PROMIS Mobility CAT, PROMIS Physical Function 8a Short Form, and 5 other measures of physical function.Results: PROMIS PFSF8a and Foot and Ankle Ability Measure Activities of Daily Living Index had ceiling effects. Both PROMIS measures demonstrated excellent internal consistency reliability (mean marginal reliability 0.94 and 0.96; Cronbach's alpha = 0.96). Convergent validity was supported by high correlations with other measures of physical function (r = 0.70-0.87). Known-groups validity by weight-bearing status and fracture severity was supported as was responsiveness (Mobility CAT effect size = 0.81; Physical Function Short Form 8a = 0.88).Conclusions: The PROMIS Mobility CAT and Physical Function 8a Short Form demonstrated reliability, convergent and known-groups discriminant validity, and responsiveness in a sample of patients with a lower extremity orthopaedic trauma injury.