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

描述(由申请人提供)：患者报告结果测量信息系统(PROIS)的目标是开发一种用于测量慢性病结果的适应性系统。匹兹堡大学自2004年以来一直作为PROMIS研究网站，专注于情绪困扰和睡眠唤醒功能领域。我们开发了11个PROMIS题库中的5个(抑郁、焦虑、愤怒、睡眠障碍和觉醒障碍)。这一续期申请将继续并扩展我们早先的工作：(A)通过使用新样本、代表性不足的群体(非裔美国人和老年人)和纵向分析进一步验证我们开发的题库，以及(B)通过在心理健康积极心理功能的补充领域开发新的题库。我们的具体目标是(1)通过展示CAT管理的可行性和价值，进一步验证PROMIS题库对于情绪困扰的有效性；通过更明确的方式检验种族和年龄的差异项目功能(DIF)；通过在高危人群-老年抑郁症患者中建立对PROMIS测量变化的更高的敏感性；(2)进一步验证PROMIS睡眠障碍和觉醒障碍题库的结构效度(比较已知的有临床诊断的睡眠障碍组和无睡眠障碍组)；通过使用其他常见的回顾、定性的睡眠觉醒测量和前瞻性、定量的评估(睡眠日记、手腕动作描记)，以及治疗反应性和最小的重要差异，通过对睡眠障碍患者从最初的评估到6-8周的治疗，来检验收敛和判别效度；(3)通过在12个月中对来自兰德美国生活小组的参与者的4波前瞻性地实施这些库来检验情绪苦恼和睡眠觉醒功能之间的纵向和相互作用关系；以及(4)建立新的题库来评估积极的心理功能，这是Promis领域中心理健康领域与我们关于情绪苦恼的工作相辅相成的一个领域。在所有研究中，我们建议调查全面的PROMIS健康状况概况(即，对所有11个当前PROMIS题库的评估)在确定慢性病患者的领域和新概况之间的新关联方面的价值。我们的工作将涉及与匹兹堡大学和全国各地的各种研究小组(兰德大学、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)合作。公共卫生相关性：我们拟议的新研究将通过纳入老年人和少数群体的新样本，检查PROMIS措施在应用治疗环境中的效用，评估心理健康领域和睡眠-觉醒功能之间的纵向关系，利用CAT在现实世界环境中最大限度地提高效率，以及展示可从所有可用PROMIS题库中得出的整体健康状况概况的价值，从而提高PROMIS的价值和公共健康影响。

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.