549 Measurement properties of four different patient-reported outcomes to assess sleep disturbance in adults with atopic dermatitis

Abstract

Sleep is commonly impacted in atopic dermatitis (AD). However, the ideal patient-reported outcome measures to assess sleep in AD patients has not been determined. We sought to determine the measurement properties of the Patient-Reported Outcomes Measurement Information System (PROMIS) Itch Questionnaire (PIQ)-Mood and Sleep, Sleep Disturbance (SD), Sleep-Related Impairment (SRI), and Epworth Sleepiness Scale (ESS) in adults with AD. We performed a prospective dermatology practice-based study using questionnaires and evaluation by a dermatologist (n=491). PIQ Mood and Sleep, PROMIS SD, SRI, and ESS had good convergent validity with intensity and frequency of sleep disturbance, Patient-Oriented Eczema Measure, Eczema Area and Severity Index, total and objective-Scoring AD, Numerical Rating Scale of worst-itch and average-itch, and Dermatology Life Quality Index. PIQ Mood and Sleep had significantly better correlations with other severity measures than the other sleep measures (Fisher z-scores, P≤0.04 for all). PIQ Mood and Sleep had fair ability to distinguish between levels of severity of sleep disturbance, AD or itch, i.e. criterion validity. PROMIS SD, PROMIS SRI and ESS had poor to fair ability to distinguish between different levels of sleep, AD and/or itch severity. All four sleep assessments showed fair responsiveness to change of severity of sleep-disturbance, AD and itch, had good internal consistency, with no floor or ceiling effects, and were feasible for use in clinical practice. In conclusion, PIQ Mood and Sleep, PROMIS SD, PROMIS SRI and ESS showed good construct validity, internal consistency and responsiveness in adult AD. PIQ Mood and Sleep, followed by PROMIS SD, had the best measurement properties in adult AD.