Validation and domain development in mental health and sleep-wake function

描述（由申请人提供）：患者报告结局测量信息系统（PROMIS）的目标是开发一种用于测量慢性疾病结局的自适应系统。匹兹堡大学自2004年以来一直担任PROMIS研究网站，专注于情绪困扰和睡眠-觉醒功能领域。我们开发了5个PROMIS项目银行（抑郁，焦虑，愤怒，睡眠障碍，觉醒障碍）的11个目前可用。这种更新应用程序将继续和扩展我们以前的工作（a）通过进一步验证我们使用新样本开发的项目库，代表性不足的群体（非洲裔美国人和老年人）和纵向分析（B）通过开发新的项目库在心理健康积极的心理功能的补充领域。我们的具体目标是：（1）通过证明CAT管理的可行性和价值，通过以更明确的方式检查种族和年龄的差异项目功能（DIF），并通过在高危人群-老年抑郁症患者中建立与传统工具相比，PROMIS测量对变化的更大敏感性，进一步验证PROMIS情绪困扰项目库;（2）进一步验证PROMIS睡眠障碍和觉醒障碍试题库的结构效度（比较已知的临床诊断为睡眠障碍的组与无睡眠障碍的组）;使用其他常见的回顾性、定性睡眠-觉醒测量和前瞻性、定量评估的收敛和判别效度（睡眠日记，腕动记录）;和治疗反应性和最小的重要差异，通过跟踪睡眠障碍患者从初始评估到6-8周的治疗;（3）在12个月的时间里，对来自兰德美国生活小组的参与者进行4个波的前瞻性管理，以检查情绪困扰和睡眠-觉醒功能之间的纵向和相互关系;以及（4）开发新的项目库来评估积极心理功能，这是PROMIS领域框架中的一个心理健康领域，与我们在情绪困扰方面的工作相辅相成。在所有研究中，我们建议调查综合PROMIS健康状况概况的价值（即，在所有11个当前PROMIS项目库中进行评估），用于识别慢性疾病患者的领域和新特征之间的新关联。我们的工作将涉及与匹兹堡大学和全国各地（兰德，杜克大学和路易斯安那州立大学健康科学中心什里夫波特）的各种研究小组的合作。公共卫生相关性：我们提出的新研究将通过纳入老年人和少数民族人群的新样本来增强PROMIS的价值和公共卫生影响;检查PROMIS措施在应用治疗环境中的效用;评估心理健康和睡眠-觉醒功能领域之间的纵向关系;利用CAT在现实世界中最大限度地提高效率;并证明可以从所有可用的PROMIS项目库导出的总体健康状况概况的价值。

DESCRIPTION (provided by applicant): The goal of the Patient-Reported Outcomes Measurement Information System (PROMIS) is to develop an adaptive system for measuring outcomes in chronic diseases. The University of Pittsburgh has served as a PROMIS research site since 2004, focusing on the domains of emotional distress and sleep-wake function. We developed 5 PROMIS item banks (depression, anxiety, anger, sleep disturbance, and wake disturbance) of the 11 currently available. This renewal application will continue and extend our earlier work (a) by validating further the item banks we have developed using new samples, underrepresented groups (African Americans and older adults), and longitudinal analyses and (b) by developing new item banks in a complementary area of mental health-positive psychological functioning. Our specific aims are (1) to validate further the PROMIS item banks for emotional distress by demonstrating the feasibility and value of CAT administration; by examining in a more definitive way differential item functioning (DIF) for race and age; and by establishing the greater sensitivity to change of the PROMIS measures compared to conventional legacy instruments in a high-risk population-geriatric patients with depression; (2) to validate further the PROMIS sleep disturbance and wake disturbance item banks with work on construct validity (comparing known groups with clinically diagnosed sleep disorders versus no sleep disorder); convergent and discriminant validity using other common retrospective, qualitative sleep-wake measures and prospective, quantitative assessments (sleep diaries, wrist actigraphy); and treatment responsiveness and minimal important differences by following patients with sleep disorders from initial evaluation through 6-8 weeks of treatment; (3) to examine longitudinal and reciprocal relationships between emotional distress and sleep-wake function by administering these banks prospectively in 4 waves over the course of 12 months to a sample of participants from the RAND American Life Panel; and (4) to develop new item banks to evaluate positive psychological functioning, an area of mental health in the PROMIS domain framework complementary to our work on emotional distress. In all studies, we propose to investigate the value of the comprehensive PROMIS health status profile (i.e., assessments across all 11 current PROMIS item banks) for identifying novel associations between domains and novel profiles of patients with chronic diseases. Our work will involve collaboration with various research groups within the University of Pittsburgh and across the country (RAND, Duke University, and LSU Health Sciences Center-Shreveport). PUBLIC HEALTH RELEVANCE: Our proposed new studies will enhance the value and public health impact of PROMIS by including new samples of older adults and minority populations; examining the utility of PROMIS measures in applied treatment contexts; evaluating longitudinal relationships between the domains of mental health and sleep- wake function; utilizing CAT to maximize efficiency in real-world settings; and demonstrating the value of the overall health status profile that can be derived from all available PROMIS item banks.