Abstract
In this cross-sectional study, we aimed to assess the reliability, validity, and efficiency of the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Global Health scale (PGH-7) to reduce patient burden when assessing overall health in clinical practice. In total, 1082 children (8–18), representative of the Dutch population, completed the PGH-7 and the Pediatric Quality of Life Inventory (PedsQL™ 4.0), a common legacy instrument used in clinical practice to assess overall health. The assumptions for fitting an item response theory model were assessed: unidimensionality, local independence, and monotonicity. Subsequently, a model was fitted to the data to assess item fit and cultural differential item functioning (DIF) between Dutch and US children. A strong correlation (> .70) was expected between the PGH-7 and PedsQL, as both instruments measure physical, mental, and social domains of health. Percentages of participants reliably measured (> 0.90) were assessed using the standard error of measurement (SE(θ) < 0.32). Efficiency was calculated ((1 − SE(θ)2)/nitems) to compare how well both measures performed relative to number of items administered. The PGH-7 met all assumptions and displayed good structural and convergent (r = .69) validity. One item displayed cultural DIF. Both questionnaires measured reliably (%nPGH-7 = 73.8%, %nPedsQL = 76.6%) at the mean and 2SD in clinically relevant direction. PGH-7 items were 2.6 times more efficient in measuring overall health than the PedsQL. Conclusion: The PGH-7 displays sufficient validity and reliability in the general Dutch pediatric population and measures more efficiently than the PedsQL, the most commonly used legacy instrument. The PGH-7 can be used in research and clinical practice to reduce patient burden when assessing overall health.What is Known:• Generic instruments which validly and reliably assess overall pediatric health are scarce.• Brief instruments are required for implementation of self-report patient-reported outcomes in clinical practice.What is New:• The PROMIS Pediatric Global Health (PGH-7) can be used in research and clinical practice to briefly assess overall pediatric health, while providing valid and reliable measurements.• The PGH-7 provides more efficient assessment of pediatric overall health than the Pediatric Quality of Life Inventory.
Highlights
The increasing interest in value-based health care and shared decision-making in pediatrics has stimulated the use of patient-reported outcome measures (PROMs) in clinical practice and research in order to monitor and screen individual patients or patient populations and to improve the quality of health care [1,2,3]
The Pediatric Global Health 7 scale v1.0 (PGH-7) can be used in research and clinical practice to reduce patient burden when assessing overall health
Brief instruments are required for implementation of self-report patient-reported outcomes in clinical practice
Summary
The increasing interest in value-based health care and shared decision-making in pediatrics has stimulated the use of patient-reported outcome measures (PROMs) in clinical practice and research in order to monitor and screen individual patients or patient populations and to improve the quality of health care [1,2,3]. Generic PROMs that assess overall health are intended to provide a quick overview of the overall health (status) of a patient, while taking into account multiple domains [4,5,6]. These generic measures of overall health can be used in addition to or as a replacement of domain-specific measures to standardize the measurement of overall health across populations. Using generic instruments to measure overall health and expressing it as a single uniform score instead of assessing health with multiple domain-specific instruments allow for easier interpretation and comparisons across disease groups
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